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Interactive video module and simulated model for uterine manipulation during laparoscopic hysterectomy

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Abstract

Background

Hysterectomy is one of the most common gynecologic surgeries, with an increasing proportion of hysterectomies performed by a laparoscopic approach. Uterine manipulation is critical for patient safety and surgical efficiency; however, the most junior member of the surgical team assumes the responsibility of uterine manipulation, commonly without preparation. The objective of our study was to determine whether kinesthetic learning using a low-cost simulated pelvic model while learning the uterine manipulation maneuvers of a laparoscopic hysterectomy improves learning efficacy and application efficiency compared to an interactive video module alone.

Methods

Our randomized control trial at an academic medical center included forty first-year and second-year medical students. Participants were randomized to the intervention group that used a low-cost simulated pelvic model for kinesthetic learning during the video module or the control group who only had the interactive video module to learn the uterine manipulation maneuvers of a laparoscopic hysterectomy.

Results

Participants in the intervention group were less likely to make unnecessary movements with demonstration of both pelvic side walls (right wall: control 78.9%, intervention 42.9%, p < 0.027; left wall: control 94.7%, intervention 66.7%, p < 0.046), and this was more pronounced in novice first-year participants (p < 0.009). Additionally, participants in the intervention group reported higher perceived preparedness (100% versus 71.4% in control group, p < 0.037). However, there was no difference in verbal or physical cues required, time per task, or force used between the groups.

Conclusion

Kinesthetic practice may not be required for learning the uterine manipulation maneuvers of a laparoscopic hysterectomy, but it may be beneficial for more novice learners and to increase learners’ perceived preparedness. Our novel interactive video module alone may be sufficient to prepare learners to perform uterine manipulation maneuvers prior to the operating room.

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Acknowledgements

We wish to acknowledge the support of the Council on Resident Education in Obstetrics and Gynecology (CREOG) for the 2019 Empower Award, the Mayo Clinic Alix School of Medicine medical student participants, the anatomy laboratory staff, and those who donated their bodies for research and were used in this study.

Funding

Council on Resident Education in Obstetrics and Gynecology (CREOG) 2019 Empower Award, Mayo Clinic OB/GYN Department Research Funding.

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Authors and Affiliations

  1. Division of Gynecologic Surgery, Department of Obstetrics and Gynecology, Mayo Clinic, 200 2nd Street SW, Rochester, MN, 55905, USA

    Anousheh Shafa, Adela G. Cope, Tatnai L. Burnett, Michelle A. Wyatt & Isabel C. Green

  2. Mayo Clinic Learning Solutions Center, Jacksonville, FL, USA

    Kristopher P. Kolish

  3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Kristin C. Mara

Authors
  1. Anousheh Shafa
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  2. Adela G. Cope
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  3. Tatnai L. Burnett
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  4. Kristopher P. Kolish
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  5. Kristin C. Mara
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  6. Michelle A. Wyatt
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  7. Isabel C. Green
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Corresponding author

Correspondence to Anousheh Shafa.

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Disclosures

Anousheh Shafa, Adela G. Cope, Tatnai L. Burnett, Kristopher P. Kolish, Kristin C. Mara, Michelle A. Wyatt, and Isabel C. Green have no conflicts of interest or financial ties to disclose.

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Shafa, A., Cope, A.G., Burnett, T.L. et al. Interactive video module and simulated model for uterine manipulation during laparoscopic hysterectomy. Surg Endosc 37, 443–449 (2023). https://doi.org/10.1007/s00464-022-09499-x

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