Assuntos
Neoplasias dos Genitais Femininos/economia , Procedimentos Cirúrgicos em Ginecologia/economia , Mecanismo de Reembolso , Neoplasias do Endométrio/economia , Neoplasias do Endométrio/cirurgia , Tabela de Remuneração de Serviços , Feminino , Neoplasias dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Medicaid , Medicare , Estados UnidosRESUMO
OBJECTIVE: The purpose of this study was to subjectively evaluate the adequacy of the porcine model for training gynecologic oncology fellows. STUDY DESIGN: Following a defined surgical curriculum, fellow-attending pairs operated on female hogs. A predetermined dataset was collected for each procedure. RESULTS: Twenty pigs were operated on. The porcine model was determined to be a good model for laparoscopic lymphadenectomy (11), ureteroneocystostomy (7), repair of vascular injury (11), bowel anastamoses (21), distal pancreatectomy (5), nephrectomy (6), partial hepatectomy (5), diaphram stripping (5), and diaphragmatic resection (4). Two attendings and 1 fellow judged the porcine model to be fair (remaining 11 good) for ileocolonic urinary diversion, mainly due to significant differences in anatomy. Liver mobilization (5) and splenectomy (11) were determined to be fair or poor models by all participants due to the limited attachments in the pig. CONCLUSION: The porcine model is adequate for teaching some ancillary gynecologic oncology surgical procedures and is inadequate for others.