Can the simultaneous laparoscopic approach improve the learning of vaginal surgery with meshes in the anatomical model?

• Published in: Neurourology and urodynamics Vol. 38; no. 7; pp. 1812 - 1817
• Main Authors: Sanchez‐Ferrer, Maria Luisa, Fernández‐Andres, Íñigo, Martínez‐Escoriza, Juan Carlos, Romero‐Maroto, Jesús, Sánchez del Campo, Francisco, Gómez‐Pérez, Luis
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-09-2019
• Subjects: anatomical knowledge; Cadaver; Cadavers; Dissection; Female; Gynecologic Surgical Procedures - education; Humans; laparoscopic approach; Laparoscopy; Laparoscopy - methods; Learning; Models, Anatomic; Pelvis; Prostheses and Implants; Surgery; Surgical Mesh; surgical skills; Surgical techniques; Thiel anatomical model; Urologic Surgical Procedures - education; Vagina; Vagina - surgery; vaginal mesh; anatomical knowledge; Thiel anatomical model; surgical skills; vaginal mesh; laparoscopic approach
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.24082

Aims
To evaluate the usefulness of simultaneous laparoscopic assistance to improve understanding of the nonvisible surgical steps in Thiel‐embalmed cadaver models for training in vaginal surgery using vaginal mesh kits and to evaluate opinions of this surgical learning procedure in comparison with other learning models.
Methods
Recording of anterior compartment prolapse repair with vaginal mesh kits using an external camera simultaneously with laparoscopic vision during the execution of the procedure at the dissection room. To measure the usefulness of this procedure, we designed an anonymous online survey that was made available to program participants via a computer application (a link to video 1 and the survey is available at [e-mail]).
Results
After watching the video, 97.2% of participants agreed that laparoscopic vision combined with the vaginal approach was useful in learning this surgical technique, and 95.8% agreed they had learned details of the surgical anatomy of the pelvis. All participants agreed that it should be mandatory to train in these techniques with cadavers before practice with live patients. In addition, 84.7% responded that the cadaveric model was superior to animal and other types of models.
Conclusion
Laparoscopic inspection of the procedure performed with the vaginal approach allowed a better understanding of the surgical technique by making “visible” the anatomical structures that were commonly only palpated. Use of the cadaverous model was considered most efficient for training in this surgical technique.