The effect of cadaveric hands-on training model on surgical skills and confidence for transobturator tape surgery

Emre Huri,İlker Selçuk,İlkan Tatar

doi:10.4274/jtgga.galenos.2018.2018.0043

Abstract

Objective:To demonstrate the role of cadaveric hands-on training model on surgical skills and confidence levels of surgeons during transobturator tape (TOT) surgery.Material and Methods:A pre-test and post-test evaluation to measure skills during the practice of the steps of TOT surgery was performed on a total of 15 postgraduate urologists and gynecologists during a urogynecologic cadaveric dissection course. The course was shaped with regard to theoretical lessons, full pelvic cadaveric dissection and TOT surgery on cadavers.Results:Good handling of the TOT needle, identifying the right place for groin incision, adequate size of groin incision, identifying the right place for incision at the anterior vagina, dissection of bladder pillars from the vagina, identifying the right place at the vaginal foramina for TOT needle exit, and good placement of mesh were reviewed. The post-test scores were statistically significant for all parameters and also for self confidence level (p<0.001).Conclusion:Cadaveric workshops are important landmarks of surgical education to improve surgical skills, and gain experience and confidence.

Highlights

Many residents and young surgeons attend to cadaveric dissection courses, which are in association with surgical anatomy and procedures, because detailed anatomic knowledge is essential for accurate practice in surgical procedures [1,2]
Parameters that were identified to measure the ability for transobturator tape (TOT) procedure were: good handling of the TOT needle, identifying the right place for the groin incision, adequate size of groin incision, identifying the right place for incision at the anterior vagina, dissection of the bladder pillars from the vagina, identifying the right place at the vaginal foramina for TOT needle exit, and good placement of mesh
It showed that proper surgical education at the cadaveric workshops improved the surgical skills for all steps of a procedure, with increased confidence levels for the operation room

Summary

Introduction

Many residents and young surgeons attend to cadaveric dissection courses, which are in association with surgical anatomy and procedures, because detailed anatomic knowledge is essential for accurate practice in surgical procedures [1,2]. Despite learning how to perform surgical procedures, the management of complications and related close anatomic landmarks are lacking in residency. Postgraduate courses highly focus on improving anatomic knowledge in surgical procedures, and physicians need a good knowledge of anatomy to manage patients intra-operatively and post-operatively. Cadaveric workshops have a beneficial status on the learning points of surgical procedures without any stress of the operation room [5]. Stress urinary incontinence (SUI) is highly common among pre and postmenopausal women, the prevalence is between 4% and 35% [6], and there are many abdominal and vaginal procedures to treat this problem.

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Results

Conclusion