Acquisition of Surgical Skills in Animal and Simulation Laboratories

Recent advances in the management of hepatic trauma have favored nonoperative approaches for most liver injuries. The patients who now come to operation have generally been selected out by profuse, uncontained hemorrhage associated with profound hepatic destruction and physiologic instability. The shift to nonoperative management of most injuries combined with a reduction in resident working hours has left many graduating surgeons with little or no experience in the operative management of major hepatic hemorrhage. Curriculum-based, systematic education in the anatomy, tactics, tools, and techniques of operations for a variety of patterns of major liver injury has recently become possible because of the advent of hyperrealistic, physical simulators. The present chapter highlights the current deficits in training and the potential promise of teaching a variety of evidence-based techniques for the management of severe liver injuries using novel high-fidelity simulated physical models.