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Simulated management of urinary tract injury during robotic pelvic surgery utilizing the porcine model

Abstract

Urologic injury is an infrequent but serious complication of pelvic surgery. Training in the assessment and management of this injury might be enhanced through animated simulation. Our objective was to assess the intraoperative management of urologic injury with robotic pelvic surgery using a simulated injury animal model. We used a female domestic pig to create three types of urologic injury, which we then managed with robotically assisted surgery. An edited video of the model was assessed by 14 senior learners and 10 attending faculty. The assessments included key competencies and domains of fidelity. A scale of poor, fair, or good was utilized. The defects and repairs simulated those seen in humans, both anatomically and surgically, although deficiencies were noted. Related to fidelity of the anatomy of the ureter and bladder, lower ratings were given for some of the key competencies (determining the relationship to the trigone, ureteral mobilization, repair of all 3 injuries). The porcine model for simulation of urologic injury during robotically assisted pelvic surgery may be useful for training purposes.

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Author information

Correspondence to Mitchel S. Hoffman.

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Conflict of interest

Dr. Mitchel Hoffman declares that he has no conflict of interest. Dr. Philippe Spiess declares that he has no conflicts of interest. All applicable international, national, and institutional guidelines for the care and use of animals were followed.

Ethical approval

All applicable international, national, and institutional guidelines for the care and use of animals were followed. All procedures were performed in accordance with the ethical standards of the University of South Florida Institutional Animal Care and Use Committee

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Supplementary material 1 (MOV 17872 KB)

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Supplementary material 2 (MOV 129605 KB)

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Supplementary material 3 (MOV 64017 KB)

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Hoffman, M.S., Spiess, P.E. Simulated management of urinary tract injury during robotic pelvic surgery utilizing the porcine model. J Robotic Surg 13, 289–292 (2019) doi:10.1007/s11701-018-0852-z

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Keywords

  • Porcine
  • Robotic
  • Urologic injury