Development and validation of a laparoscopic hysterectomy cuff closure simulation model for surgical training

Tunitsky-Bitton, Elena; Propst, Katie; Muffly, Tyler M.

doi:10.1016/j.ajog.2015.11.023

Cited by 28 publications

(15 citation statements)

References 13 publications

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“…King et al described a reusable, affordable plastic box model for practicing laparoscopic vaginal cuff closure; this model utilized a real camera and tower, thus offering participants a more realistic experience [ 16 ]. Tunitsky-Bitton et al developed a vaginal cuff closure simulation model by adapting the FLS box model [ 17 ]. The advantage of this model is that the FLS model is readily available in many teaching institutions, thus allowing trainees to practice this technique independently.…”

Section: Reviewmentioning

confidence: 99%

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Smith¹,

Caceres²

2017

Cureus

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Hysterectomy is one of the most common surgeries performed each year and can be indicated for many gynecologic conditions. The development of minimally invasive surgery has transformed this procedure, resulting in improved outcomes, superior cosmesis, and quicker return to normal function. Vaginal cuff closure is a critical component of hysterectomy, with many variations in surgical technique and materials. This review provides an overview of intracorporeal suturing and knot-tying techniques at the level of a junior resident in obstetrics and gynecology and describes several validated models that have been developed to test resident skill level in vaginal cuff closure. We also provide a review of the literature regarding vaginal cuff closure techniques and suture materials, including knotless barbed sutures. Finally, a brief discussion of single-site surgery, the latest development in minimally invasive hysterectomy, will be provided. We hope to provide a better understanding of vaginal cuff closure for residents in the field of obstetrics and gynecology.

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Section: Reviewmentioning

confidence: 99%

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Smith¹,

Caceres²

2017

Cureus

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“…This is a low number of procedures and raises the problem of proficiency with both the procedure and the laparoscopic suturing of the vaginal vault. Although suturing by laparoscopy can be facilitated by simulation models, 19 it can still be demanding and increase the operation time in the initial hysterectomy. The vaginal procedure is easy to learn and enhances skills for VH, which should be the preferred choice whenever possible.…”

Section: Discussionmentioning

confidence: 99%

“…the route of vaginal closure per se contribute to VCD.In this study all dehiscences were resutured vaginally. Although suturing by laparoscopy can be facilitated by simulation models,19 it can still be demanding and increase the operation time in the initial hysterectomy. No recurrent dehiscences were recorded.…”

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confidence: 99%

Vaginal cuff dehiscence is observed in a higher rate after total laparoscopic hysterectomy compared with other types of hysterectomy

Ala-Nissilä

Laurikainen

Mäkinen

et al. 2018

Acta Obstet Gynecol Scand

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“…Surgical training methods are frequently studied, but these evaluations frequently focus on validating subjective evaluation systems, either directly observed or during simulated procedures [ 9 10 11 12 ]. Various models have been developed for gynecologic surgery, and while useful for demonstrating 3-dimensional anatomy they do not provide objective data on trainee skills [ 13 14 15 ]. Various robotic simulators are also available, but again objective evaluation is typically limited to completion time, preventing truly focused feedback or training or practice [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Mapping the robotic hysterectomy learning curve and re-establishing surgical training metrics

Turner

Kim

2021

J Gynecol Oncol

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Objective Common robotic training curricula in the US entail completion of an online module followed by lab training with standardized exercises, such as manipulating needles with robotic needle drivers. Assessments are generally limited to elapsed time and subjective proficiency. We sought to test the feasibility of a simulation-based robotic hysterectomy curriculum to collect objective measurements of trainee progress, map the trainee learning curve and provide a system for trainee-specific evaluation. Methods An observational cohort study of a single institutions' residency members participating in a procedural hysterectomy simulation performed every 4 months. Each simulation episode had one-on-one teaching. The robotic platform was used to measure all movements within cartesian coordinates, the number of clutches, instrument collisions, time to complete the simulated hysterectomy, and unintended injuries during the procedure. Results Voluntary participation was high. Objective metrics were successfully recorded at each session and improved nearly universally. More senior residents demonstrated superior capabilities compared to junior residents as expected. The majority of residents (29/31) were able to complete an entire simulated hysterectomy in the allotted 30-minute training session period by the end of the year. Conclusions This program establishes learning curves based on objective data points using a risk-free simulation platform. The curves can then be used to evaluate trainee skill level and tailor teaching to specific objective competencies. The pilot curriculum can be tailored to the unique needs of each surgical discipline's residency training.

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Development and validation of a laparoscopic hysterectomy cuff closure simulation model for surgical training

Cited by 28 publications

References 13 publications

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Vaginal cuff dehiscence is observed in a higher rate after total laparoscopic hysterectomy compared with other types of hysterectomy

Mapping the robotic hysterectomy learning curve and re-establishing surgical training metrics

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