Vaginal Hysterectomy Simulation

Abstract

BACKGROUND: There has been a decrease in the number of vaginal hysterectomy cases. Surgical simulation provides the opportunity for obstetrics and gynecology residents to familiarize themselves with the surgical technique needed to safely and efficiently perform a vaginal hysterectomy. OBJECTIVE: Our objective was to train residents using a cost effectively built vaginal hysterectomy simulator. METHODS: A low cost vaginal hysterectomy simulator, made of inexpensive hardware and household items (including wood, cardboard, a plastic tube, cloth, springs, screws, and tape) was constructed. Before the 2 hour simulation lab, each resident reviewed pelvic anatomy and surgical steps of the procedure. Residents performed simulated vaginal hysterectomies under the supervision of gynecologist attending. RESULTS: In the debriefing session after the 2 hours simulation lab, 100% of the residents attested that the simulator effectively mimicked the surgical performance on a patient. Innovations such as incising the stretched cloth to simulate peritoneal cavity entry, rope attached from the uterus to the side wall to simulate utero-sacral ligaments, and laterally placed springs to simulate the stretch of the broad ligament with traction were especially valuable. CONCLUSION: The vaginal hysterectomy simulator will provide a number of benefits to our residents and program including: 1) cost-effective training—low cost and easily constructed simulator and 2) a low stress learning environment for residents to ask questions and address any concerns about the procedure.