A fast and easy-to-learn technique for liver resection in a porcine model.

OBJECTIVE: Despite the recent advances in surgical techniques and perioperative care, liver resection (especially extended hepatectomy) is still a high-risk procedure with considerable morbidity and mortality. Experimental large animal models are the best option for studies in this regard. The present study was performed to present an easy-to-learn, fast, and multipurpose model of liver resection in a porcine model. METHOD: Stepwise liver resections (resection of segments II/III, IVa/IVb, and VIII/IV) were performed in eight pigs with intraoperative monitoring of hemodynamic parameters. The technical aspects, tips, and tricks of this method are explained in detail. RESULTS: Based on the specific anatomical characteristics of the porcine liver, all resection types including segmental resection, hemihepatectomy, and extended hepatectomy could be performed in one animal in an easy-to-learn and fast technique. All animals were hemodynamically stable following stepwise liver resection. CONCLUSION: Stepwise liver resection using stapler in a porcine model is a fast and easy-to-learn method with which junior staff and research fellows can perform liver resection up to extended hepatectomy under stable conditions.

Promoting medical competencies through a didactic tutor qualification programme - a qualitative study based on the CanMEDS Physician Competency Framework.

BACKGROUND: In peer-led tutorial courses, qualified medical students ("tutors") provide their peers with opportunities to deepen their theoretical knowledge effectively and to practice clinical skills already in preclinical semesters. At the Medical Faculty of Heidelberg University, a structured medical didactic qualification programme prepares and trains future tutors for their responsibilities. This programme consists of four modules: 1. medical didactics and group leadership, 2. subject-specific training, 3. performance of tutorial courses as well as 4. collegial advice and reflection on the tutors' activities. The aim of this study is to systematically analyse and present the development of role competencies for medical tutors based on the CanMEDS Physician Competency Framework through the didactic qualification programme. METHODS: We applied a qualitative research approach to detect CanMEDS role competencies acquisition within the tutor qualification programme. The CanMEDS framework describes key competencies, grouped thematically under seven professional roles. Two tutors and three training coordinators independently assigned the individual modules of the tutor qualification programme to the key competencies of the CanMEDS framework. Tutors and training coordinators compared and discussed the allocations within the groups in a consensus finding process. All authors analysed the findings in order to find out the so-called "hidden curriculum". The views of both groups are presented separately. RESULTS: The training programme promotes the acquisition of competencies in all seven CanMEDS roles. The roles of the scholar and the leader are promoted in all modules. In addition, the first and fourth module focus predominately on the role of the collaborator, the second on the role of the medical expert and communicator, and the fourth on the role of the professional. CONCLUSIONS: The systematic analysis through assignment of the CanMEDS roles to the individual modules of the tutor qualification programme documents the comprehensive acquisition of competencies, not only with regard to the tutor activity, but generally with regard to the later role of the physician. The reflection on one's own competency acquisition can support the promotion of corresponding competencies in the qualification programme and their transfer into the professional practice later.

Note: New design of a cryogenic linear radio frequency multipole trap.

A new design of a cryogenic linear 22-pole ion trap has been constructed and tested. It is essentially a copper housing to which opposite inner walls two electrode sets are attached via sapphire insulators. These stainless steel electrodes are electroformed in one piece to guarantee good heat conduction. Connected to an external coil, they form an LC-circuit of about 19 MHz resonance frequency. This circuit is excited with a rf power supply made of a commercial digital synthesizer followed by a 10 W amplifier. Buffer gas-cooled H(2)D(+) ions have been stored in this trap at a nominal trap temperature of 14 K. Spectroscopy of the ions confirmed that the kinetic (Doppler) temperature is in reasonable agreement with this value.