Advertisement

International Urogynecology Journal

, Volume 30, Issue 8, pp 1371–1375 | Cite as

A live porcine model for robotic sacrocolpopexy training

  • Khushabu Kasabwala
  • Ramy Goueli
  • Patrick J. CulliganEmail author
IUJ Video
  • 151 Downloads

Abstract

Introduction and hypothesis

Robotic sacrocolpopexy is an effective and durable technique for pelvic organ prolapse repair. However, the learning curve for this procedure has underscored the need for an effective surgical training module. Given the cost, infection risk, poor tissue compliance, and scarcity of human cadavers, the live porcine model represents a realistic, available, and cost-effective alternative. This article describes a live porcine model for teaching robotic sacrocolpopexy to determine whether it teaches key aspects of live human robotic sacrocolpopexy to the learner.

Methods

This robotic sacrocolpopexy model was created using the Da Vinci Xi or Si robotic system on domestic pigs under general anesthesia. The main steps of the model include: (1) creating the porcine “cervix” and (2) performing robotic sacrocolpopexy. The model was evaluated with a survey given to 18 board-certified surgeons who attended the training course between December 2016 and April 2018.

Results

All of the participants reported improvements in their economy of motion, tissue handling ability, suturing efficiency, and overall performance of robotic sacrocolpopexy. Furthermore, a majority of participants were likely to incorporate aspects of the model into their practice (88.8%) and recommend the model to colleagues (94.2%).

Conclusions

The porcine model provides a feasible tool for teaching robotic sacrocolpopexy to physicians.

Keywords

Pelvic organ prolapse Porcine model Robotic sacrocolpopexy Robotic surgery Surgical training 

Notes

Funding

Intuitive Surgical covered porcine laboratory cost. No other funding was provided.

Compliance with ethical standards

Consent

No patients were part of this work—there were only the pig used in the video and the surgeons who filled out anonymous ratings of the model.

Conflicts of interest

Patrick Culligan is a consultant and paid instructor for Intuitive Surgical and Coloplast and a stockholder in Origami Surgical. The remaining authors, Khushabu Kasabwala and Ramy Goeuli, have no disclosures.

Supplementary material

ESM 1

(MP4 144074 kb)

References

  1. 1.
    Serati M, Bogani G, Sorice P, et al. Robot-assisted sacrocolpopexy for pelvic organ prolapse: a systematic review and meta-analysis of comparative studies. Eur Urol. 2014;66(2):303–18.CrossRefPubMedGoogle Scholar
  2. 2.
    Linder BJ, Anand M, Weaver AL, et al. Assessing the learning curve of robotic sacrocolpopexy. Int Urogynecol J. 2016;27(2):239–46.CrossRefPubMedGoogle Scholar
  3. 3.
    Hayashi S, Naito M, Kawata S, et al. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method. Anat Sci Int. 2016;91(1):1–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Hoffman MS, Ondrovic LE, Wenham RM, et al. Evaluation of the porcine model to teach various ancillary procedures to gynecologic oncology fellows. Am J Obstet Gynecol. 2009;201(1):116 e1-3.Google Scholar
  5. 5.
    Vaughan MH, Kim-Fine S, Hullfish KL, et al. Validation of the simulated vaginal hysterectomy trainer. J Minim Invasive Gynecol. 2018.Google Scholar
  6. 6.
    Chahine EB, Han CH, Auguste T. Construct validity of a simple laparoscopic ovarian cystectomy model using a validated objective structured assessment of technical skills. J Minim Invasive Gynecol. 2017;24(5):850–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Malacarne DR, Escobar CM, Lam CJ, et al. Teaching vaginal hysterectomy via simulation: creation and validation of the objective skills assessment tool for simulated vaginal hysterectomy on a task trainer and performance among different levels of trainees. Female Pelvic Med Reconstr Surg. 2018.  https://doi.org/10.1097/SPV.0000000000000558.

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Urology, Weill Cornell Medical CollegeNew York Presbyterian HospitalNew YorkUSA

Personalised recommendations