Development and validation of a laparoscopic sacrocolpopexy simulation model for surgical training

J Minim Invasive Gynecol. 2014 Jul-Aug;21(4):612-8. doi: 10.1016/j.jmig.2013.12.124. Epub 2014 Jan 21.

Abstract

Study objective: To develop a valid laparoscopic sacrocolpopexy simulation model for use as an assessment and learning tool for performing this procedure.

Design: Simulation study (Canadian Task Force classification II-2).

Setting: Two tertiary academic centers.

Intervention: A training model was developed to simulate performance of a laparoscopic sacrocolpopexy. Construct validity was measured by comparing observed masked performances on the model between experienced Female Pelvic Medicine and Reconstructive Surgeons (experts) and upper level trainees. All videotaped performances were scored by 2 surgeons who were masked to subject identity and using the valid and reliable Global Operative Assessment of Laparoscopic Skills scale.

Measurements and main results: The expert group included Female Pelvic Medicine and Reconstructive Surgeons (n = 5) experienced in laparoscopic sacrocolpopexy, and the trainee group (n = 15) included fourth-year gynecology residents (n = 5) and fellows in Female Pelvic Medicine and Reconstructive Surgery and in Minimally Invasive Gynecologic Surgery (n = 10). The experts performed significantly better than the trainees in total score and in every domain of the Global Operative Assessment of Laparoscopic Skills scale (median [range] score: expert group, 33 [30.5-39] vs. trainee group, 20.5 [13.5-30.5]; p = .002). Previous surgical experience had a strong association with performance on the model (rho > 0.75). Most subjects "agreed" or "strongly agreed" that the model was authentic to the live procedure and a useful training tool. There was strong agreement between masked raters (interclass correlation coefficient 0.84).

Conclusion: This simulation model is valid and reliable for assessing performance of laparoscopic sacrocolpopexy and may be used for practicing key steps of the procedure.

Keywords: Laparoscopic sacrocolpopexy; Sacral colpopexy; Sacrocolpopexy; Surgical simulation.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Fellowships and Scholarships
  • Female
  • Gynecology / education*
  • Humans
  • Internship and Residency
  • Laparoscopy / education
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Models, Anatomic
  • Sacrum / surgery*
  • Uterine Prolapse / surgery*
  • Vagina / surgery*