Journal of Surgical Simulation 2017; 4: 44 - 47
Published: 29 December 2017
The validity of a surgical model simulating loss of vessel control in an abdominal hysterectomy
Background: Resident surgical training in open gynecologic surgery is steadily decreasing with the advent of minimally invasive surgery. The role of this study was to evaluate the content and face validity of a low-fidelity surgical model simulating loss of uterine artery control in an abdominal hysterectomy.
Methods: A low-fidelity surgical model was created to simulate ligation of the uterine artery during an abdominal hysterectomy. The model was designed to “bleed” at the time of ligation, requiring the gynecology resident to secure the pedicle. Interns and chief residents from a single institution were timed from the start of the simulated bleeding to when they regained control of the pedicle. The times of each year group were then compared using a t test. All residents who completed the simulation participated in a post-simulation survey.
Results: In the post-simulation survey, 100% of the 15 residents who had previously performed an abdominal hysterectomy believed the model was a “somewhat” or “very close representation” of a real hysterectomy. The mean times for the first and fourth year residents were 43 and 27 seconds, respectively. This difference between years was statistically significant (P = 0.05).
Conclusion: The speed with which the simulated bleeding vessels were ligated improved significantly between first and fourth year residents as surgical experience increased. This study demonstrates the content and face validity of this surgical model. Therefore, this model could be used to objectively evaluate ability to secure a bleeding uterine artery pedicle and aid in resident training.
hysterectomy; gynecology; abdominal surgery; simulation