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Validation of a synthetic simulation model of endoscopic rectus sheath plication

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Abstract

Purpose

Literature reviews outline minimally invasive approaches for abdominal diastasis in patients without skin excess. However, few surgeons are trained in endoscopic rectus sheath plication, and no simulated training programs exist for this method. This study aimed to develop and validate a synthetic simulation model for the training of skills in this approach under the Messick validity framework.

Methods

A cross-sectional study was carried out to assess the participants’ previous level of laparoscopic/endoscopic skills by a questionnaire. Participants performed an endoscopic plication on the model and their performance was evaluated by one blinded observer using the global rating scale OSATS and a procedure specific checklist (PSC) scale. A 5-level Likert survey was applied to 5 experts and 4 plastic surgeons to assess Face and Content validity.

Results

Fifteen non-experts and 5 experts in abdominal wall endoscopic surgery were recruited. A median OSATS score [25 (range 24–25) vs 14 (range 5–22); p < 0.05 of maximum 25 points] and a median PSC score [11 (range 10–11) vs 8 (range 3–10); p < 0.05 of maximum 11 points] was significantly higher for experts compared with nonexperts. All experts agreed or strongly agreed that the model simulates a real scenario of endoscopic plication of the rectus sheath.

Conclusion

Our simulation model met all validation criteria outlined in the Messick framework, demonstrating its ability to differentiate between experts and non-experts based on their baseline endoscopic surgical skills. This model stands as a valuable tool for evaluating skills in endoscopic rectus sheath plication.

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Funding

This study was financed by own funds and by funds of the Experimental Surgery and Simulation Center of the Pontificia Universidad Católica de Chile.

Author information

Authors and Affiliations

  1. General Surgeon at Clínica Bupa Santiago, Vaticano 4008, Las Condes, Región Metropolitana, Santiago, Chile

    María Fernanda Rojas

  2. Experimental Surgery and Simulation Center, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile

    Úrsula Figueroa, Julian Varas & Pablo Achurra

  3. Plastic and Reconstructive Surgeon at Hospital Dr. Victor Ríos Ruiz, Los Angeles, Chile

    Javier Torres

  4. Plastic and Reconstructive Surgeon at Pontificia, Universidad Católica de Chile, Santiago, Chile

    Alfonso Navia, Álvaro Cuadra & Susana Searle

Authors
  1. María Fernanda Rojas
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  4. Julian Varas
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  5. Pablo Achurra
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  8. Susana Searle
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were carried out by María Fernanda Rojas and Javier Torres. The first draft of the manuscript was written by María Fernanda Rojas and all authors provided feedback on subsequent versions. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to María Fernanda Rojas.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Pontificia Universidad Católica de Chile Ethics Committee.

Human and animal rights

The study included human participants and was performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.

Informed consent

All participants provided informed consent after receiving a general explanation of the surgical procedure, the simulator, and the study design.

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Rojas, M.F., Torres, J., Figueroa, Ú. et al. Validation of a synthetic simulation model of endoscopic rectus sheath plication. Hernia (2024). https://doi.org/10.1007/s10029-024-03059-z

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