Currently, the rapid development of minimally invasive surgical techniques poses significant challenges to the traditional surgical education and training system. The teaching model relying on laboratory animals is facing the need for transformation due to ethical controversies, high costs, and limitations of the model. Through a combined approach of systematic literature analysis and summarization of practical experience at the Da Vinci Surgical Robot Training Center at the First Affiliated Hospital of Naval Medical University, this study systematically evaluated the multidimensional efficacy of laboratory animals in training for the Da Vinci robot operating system and laparoscopic techniques. The results indicate that, under current technological conditions, laboratory animals—leveraging their advantages of authentic tissue tactile feedback, dynamic physiological responses, and the ability to be trained under complex surgical field exposure—remain the core modality for cultivating advanced surgical skills (such as vascular dissection and mobilization, organ suturing, etc.). Their irreplaceability lies primarily in key training aspects such as simulating intraoperative dynamic physiological responses and handling intraoperative emergencies. Based on interdisciplinary technical assessment and practical observation, the authors propose and construct an "Ethics-Technology Synergy" development framework. They further explore the innovative value of the virtual-real interaction mechanism in extended reality technology, the construction of pathological simulation platforms using organoid models, and the resource coordination mechanism of digital sharing platforms. Using application cases from the training center, the study verifies the potential of these technologies to form a "stepwise replacement" pathway for laboratory animals. It also highlights their key breakthroughs in standardized scenario replication, improved tactile simulation accuracy, and reduced laboratory animal usage. This study emphasizes that the transformation of the minimally invasive surgical education and training system is not only a technological innovation but also an advancement of ethical concepts. The "Ethics-Technology Synergy" pathway requires focusing on three key implementation areas: constructing a multi-modal hybrid training system from the perspective of technological integration; establishing a collaborative biological specimen sharing network from the perspective of resource management; and refining standards for assessing the necessity of animal use from the perspective of ethical practice. This provides an actionable pathway for building a new training paradigm that balances technical efficacy with ethical compliance, thereby promoting the transformation of surgical education towards precision and minimal harm.

ObjectiveTo verify the technical feasibility and safety of partial nephrectomy in experimental pigs using a single-port endoscopic surgical robot in a transcontinental ultra-remote environment spanning 13 000 km with an average network delay of 204 ms, and to explore a dynamic combined anesthesia strategy that can effectively prevent intraoperative body movement in animals. MethodsThe research team used one experimental pig in Shanghai, China, and one in Orlando, the United States, and performed bidirectional remote surgery using the same model of single-port endoscopic surgical robot system. The anesthesia regimen included preoperative administration of 0.02 mg/kg dexmedetomidine hydrochloride and 0.05 mg/kg fentanyl citrate for combined sedation and analgesia. During remote surgery, according to the animal's reflex activity, pain response, and train-of-four stimulation (TOF) count results, vecuronium bromide was continuously infused at an initial rate of 0.04 mg·kg^-1·h^-1, and the dose was dynamically adjusted. Together with isoflurane inhalation anesthesia, the animal was maintained in a deep neuromuscular block state (TOF=0) to prevent intraoperative body movement. In addition, heart rate, blood pressure, muscle relaxation, and other indicators were monitored throughout the operation. ResultsSurgical operations were successfully performed at both sites, and the network delay remained stable at 202-208 ms. There was no data packet loss and no robot equipment failure. The vital signs of the experimental animal in Shanghai, China, remained stable, with zero body movement throughout the operation. Intraoperative blood loss was controllable, and no abnormal bleeding occurred. ConclusionIn transcontinental ultra-remote robotic surgery with inherent network delay, a dynamically adjusted anesthesia strategy can effectively avoid accidental bleeding caused by animal body movement and reduce the risks associated with network latency, thereby verifying the feasibility of this technical approach. In the future, it will be necessary to build a real-time cross-regional physiological data synchronization platform, standardize anesthesia protocols for animals undergoing remote surgery, and provide a technical basis for clinical translation to human trials.

Objective This study aims to explore the application effectiveness of comprehensive case workshops in clini-cal teaching for pediatric interns.Methods Convenience sampling was used to select 100 medical students who completed their pediatric internship in a tertiary comprehensive hospital in Guangdong Province from June 2023 to May 2024.They were randomly divided into a control group and an observation group,with 50 students in each group.The control group received traditional pre-ceptorship teaching,while the observation group received pediatric comprehensive case workshop teaching on top of the traditional preceptorship.The interns'job competence(including theoretical knowledge,physical examination,medical record writing,and case analysis),self-evaluation(including learning interest,teamwork ability,self-directed learning ability,language organization ability,and learning achievements),and the satisfaction of students and teachers with the teaching activities were compared be-tween the two groups.Results The observation group showed significantly better job competence,self-evaluation,and satisfac-tion with the teaching activities compared to the control group.Conclusion The teaching model of comprehensive case work-shops can enhance the clinical teaching effectiveness of pediatric intern preceptorship,improve the job competence and self-evalu-ation of interns,and increase the satisfaction of both teachers and students with the teaching activities.It is worthy of promotion.

Objective This study aims to explore the application effectiveness of comprehensive case workshops in clini-cal teaching for pediatric interns.Methods Convenience sampling was used to select 100 medical students who completed their pediatric internship in a tertiary comprehensive hospital in Guangdong Province from June 2023 to May 2024.They were randomly divided into a control group and an observation group,with 50 students in each group.The control group received traditional pre-ceptorship teaching,while the observation group received pediatric comprehensive case workshop teaching on top of the traditional preceptorship.The interns'job competence(including theoretical knowledge,physical examination,medical record writing,and case analysis),self-evaluation(including learning interest,teamwork ability,self-directed learning ability,language organization ability,and learning achievements),and the satisfaction of students and teachers with the teaching activities were compared be-tween the two groups.Results The observation group showed significantly better job competence,self-evaluation,and satisfac-tion with the teaching activities compared to the control group.Conclusion The teaching model of comprehensive case work-shops can enhance the clinical teaching effectiveness of pediatric intern preceptorship,improve the job competence and self-evalu-ation of interns,and increase the satisfaction of both teachers and students with the teaching activities.It is worthy of promotion.

ObjectiveTo compare the effectiveness and safety of one-lung ventilation and small tidal volume two-lung ventilation anesthesia methods in the training of minimally invasive thoracic surgery on experimental pigs.MethodsForty experimental pigs undergoing robotic thoracic surgery were randomly divided into two groups: two-lung ventilation group (n=20) and one-lung ventilation group (n=20). The two-lung ventilation group underwent single-lumen tracheal intubation, utilizing a small tidal volume with a fast respiratory rate combined with carbon dioxide pneumothorax for anesthesia ventilation during the operation. The one-lung ventilation group received one-lung ventilation using a double-lumen bronchial catheter placed under fiberoptic bronchoscopic guidance. The anesthesia implementation indexes from the two groups were compared, including the values of vital signs such as operative heart rate (HR), noninvasive mean blood pressure (MAP), end-tidal carbon dioxide (ETCO₂), and oxygen saturation (SpO₂), as well as the assessment of surgical training performance.Results The intubation success rate for animals in both groups was 100%, with no intraoperative deaths. The intubation completion time was significantly shorter in the two-lung ventilation group compared to the one-lung ventilation group (P < 0.001). Within each group, SpO₂ levels were significantly higher in the two-lung ventilation group at 30 minutes after the start of thoracic surgery (T₁) and at surgery completion (T₃) compared to 60 minutes after the start of surgery (T₂) (P<0.05). ETCO₂, HR, and MAP were significantly higher at T₂ and T₃ compared to T₁ (P<0.05). In the one-lung ventilation group, SpO₂ levels were significantly higher at T₁ and T₃ compared to T₂ (P<0.05), while ETCO₂ levels gradually increasing over time (P<0.05). In the between-group comparisons at the same time points, SpO₂ levels of the two-lung ventilation group were significantly higher than those of the one-lung ventilation group at all time points (T₁, T₂, T₃) (P<0.05).Conclusion Both one-lung ventilation and two-lung ventilation anesthesia methods are effective and safe for use in surgical training, with controllable effects on intraoperative animal vital signs and minimal impact on surgical operation training, meeting the needs of robotic thoracic surgery training. One-lung ventilation provides a better experience during pneumonectomy procedures, while small tidal volume two-lung ventilation is easier to implement and does not require additional equipment purchase, making it a feasible supplemental anesthesia option for thoracoscopic surgery on experimental pigs.

Experimental pigs occupy a crucial position in life sciences research and have been indispensable in advancing the practical application of new clinical technologies and methods. The Da Vinci Surgical Robot System, developed by Intuitive Surgical in the United States, has been widely used across various surgical fields since its approval by the U.S. Food and Drug Administration (FDA) in 2000, and is highly esteemed for its precision and accuracy. With the continuous advancement of surgical robot technology, the skill requirements for medical professionals have also increased. Consequently, surgical skills training has become an essential component of ensuring both surgical safety and effectiveness. This article briefly reviews the current status of Da Vinci surgical robot training, both domestically and internationally, with a focus on the practical application of experimental pigs in domestic Da Vinci surgical robot training. It emphasizes that experimental pigs not only effectively simulate the human surgical environment, enabling trainees to practice in a safe and controlled setting, but also help accelerate the trainees' familiarity with and mastery of the surgical robot. This, in turn, significantly shortens the learning curve, enhances the precision and stability of surgical procedures, and reduces surgical risks. However, the use of experimental animals in surgical robot training also encounters challenges, including limitations caused by the differences between experimental animals and humans, potential ethical concerns, and public opinion pressures. In response to these challenges, the paper proposes suggestions such as improving and enforcing ethical regulations, as well as advancing the development of virtual reality (VR) and augmented reality (AR) technologies. These efforts aim to reduce reliance on experimental animals in surgical training while enhancing training effectiveness, thereby contributing to the innovation and development of Da Vinci surgical robot training models.

0.05),but there was a significant difference in the lowest SaO2,average SaO2 and AHI between the 2 groups(P

0.05). CONCLUSION Obesity was an influential factor of snoring. The PS and OSAHS have the same effect on children growth and their clinical features.