The freshly killed pig: a model for surgical training in gynaecological oncology.

Abstract

Surgical training in gynaecological oncology is complex and alternatives to the 'apprenticeship' model are being explored. Animate and inanimate simulation may be useful, allowing trainees to gain experience without the risk of harm to patients. Live animal models and ex vivo isolated material is commonly used. We present the use of a freshly killed pig (FKP) for training in the urological and gastrointestinal surgery pertinent to gynaecological oncology. An Anatomy of Complications Workshop was held for 12 specialists and subspecialty Trainees in gynaecological oncology. Seven freshly killed pigs were used for surgical training in a range of urological and intestinal operations including repair of a transected ureter, ureteric reimplantation, Boari flap, ileal conduit, bowel resection and anastomosis and stoma formation. A pre-workshop instructional video was sent to all participants. A live demonstration of each procedure preceded the participant's own closely supervised performance. All participants completed the procedures in the allocated time. The tissues felt 'live' throughout the 4 h session and were kept moist with a fine water spray. The use of sutures, ligatures and stapling instruments felt realistic. Formal participant feedback evaluation was enthusiastic about the FKP model. We have demonstrated that the FKP can be successfully used for training in urological and gastrointestinal procedures. The range of operations described in the present paper could be expanded for other surgical disciplines. This simulation is recommended to Trainees as a valuable addition to their training and development.