Abstract

Abstract Introduction There are barriers to education in both open and laparoscopic hernia repair technique, due to the laparoscopic learning curve, as well as reduced theatre time for junior surgical trainees. This is particularly evident during the current COVID-19 pandemic. Simulation models may provide further opportunities for training in hernia repair outside of the traditional surgical apprenticeship model. Method A systematic review was carried out following PRISMA guidelines to identify and evaluate simulation models in hernia repair. Of the 865 records screened, 26 were found to be relevant. These were assessed for face, content, and construct validity, as well as attempts to assess educational impact. Results Simulation models were identified comprising of animal tissues, synthetic materials, as well as VR technology. Models were designed for instruction in repair of inguinal, umbilical, incisional and diaphragmatic hernias. 4 of the 21 laparoscopic hernia repair models described demonstrated validity across several domains, and 3 of these 4 models were part of simulation-based courses demonstrating transferability of skills learnt in simulation to the operating room. Of the 5 open hernia repair simulation models, none were found to have demonstrated an educational impact in addition to assessing validity. Conclusions Few models individually were able to demonstrate validity and educational impact. Several novel assessment tools have been developed for assessment of progress when performing simulated and real laparoscopic inguinal hernia repair. More study is required, particularly for open hernia repair, including randomized controlled trials with large sample sizes to assess the transferability of skills.

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