Development and Use of a Restructured Animal Tissue Model for Training in Laparoscopic Salpingostomy and Salpingectomy

Abstract

Ectopic pregnancy is commonly managed via either laparoscopic salpingostomy or salpingectomy. However, there is a proficiency gain curve in mastering these 2 surgical procedures, and an effective simulated model is essential for training students of gynecology. The objective of this study was to develop and evaluate a restructured animal tissue model that can be used in the surgical training of gynecologists in laparoscopic salpingostomy and salpingectomy. Since 2005, a hands-on laparoscopic training course for gynecologic students has been developed and conducted at the Cushieri Skills Centre, University of Dundee. A restructured animal tissue model of ectopic pregnancy was developed and used for practicing laparoscopic salpingostomy and salpingectomy. At the end of each course, data were collected using a standardized anonymous questionnaire using a Likert scale (1= strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; and 5 = strongly agree). Feedback on the ectopic pregnancy model from course participants was obtained insofar as the realism of the anatomical condition of the model, quality of the tissue and organ color, quality of organ consistency, and operative tactile properties during dissection. Over the last 6 years, from June 2005 to September 2010, 96 gynecologic trainees have practiced using this phantom. The mean (SD) overall satisfaction rate for the training phantom for laparoscopic salpingostomy and salpingectomy was 4.9 (0.1) on a scale of 1(unrealistic/poor) to 5 (very realistic/useful). Compared with real operating conditions, quality assessment of the model for anatomical condition was 4.9 (0.2), for quality of tissue and organ color was 4.9 (0.4), for organ consistency was 4.8 (0.3), and for operative tactility was 4.8 (0.6). It was concluded that the restructured animal tissue model of laparoscopic salpingostomy and salpingectomy in ectopic pregnancy is realistic, cost-effective, and simple enough to be produced for use in laboratory-based surgical training courses.