Simulator development in vascular and visceral interventions
Résumé
Throughout the practice of procedural medicine, there is an unrelenting shift to management by less invasive techniques such as interventional radiology (IR). This subspecialty within radiology uses imaging to guide needles, wires and catheters using tiny access incisions. Like other minimally invasive techniques, risk, pain and recovery times are reduced as compared with more invasive approaches such as open surgery. These benefits, alongside the emergence of increasingly novel therapeutic technologies, are driving worldwide expansion. The core skills of IR include the Seldinger technique and the use of imaging and touch to effectively guide needles, wires and catheters in a wide range of procedures. Safe practice requires the operator to respond correctly to both visual and tactile cues in vascular angioplasty, stenting and stent-grafting, as well as control of bleeding, biopsy, abscess drainage and catheterization of the urinary and biliary tracts for drainage and stenting. The operator's deliberations may then initiate and inform a range of motor actions, including very fine translational and rotational motions, particularly in challenging anatomy. As the spectrum of available techniques increases, so the limited number and availability of suitably trained practitioners becomes a factor in their restricted availability to patients. Awareness of the need to expand IR training facilities is thus highly topical.
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