Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation. Issue 1 (July 2021)

• Record Type: Journal Article
• Authors: Senapati, Sangeeta; Alsaden, Iman M.; Schroer, Margaret; Tu, Frank
• Is Part Of: Obstetrics and gynecology. Volume 138:Issue 1(2021)
• Publication Date: 2021-07
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/AOG.0000000000004420
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : BACKGROUND: Obliteration of the posterior cul-de-sac is a challenging, often unexpected surgical finding. Developing the dissection skills required to manage this finding during laparoscopy is essential for optimizing treatment of many pain disorders during hysterectomy or ovarian surgery; however, exposure of trainees to cul-de-sac dissection is variable. Currently, there are no widely available simulation models for teaching and practicing this technique. METHOD: Our aim is to design a low-cost and high-fidelity laparoscopic simulation model that represents key anatomical structures and emphasizes skills for laparoscopic dissection of an obliterated posterior cul-de-sac. EXPERIENCE: A three-dimensional model was created and is described. Nine experts (gynecologic surgery fellows and attendings) and 17 residents completed a single 30-minute simulation session and completed several assessments to begin establishing the face validity of this model. CONCLUSION: Experts and residents rated the obliterated cul-de-sac simulation as highly realistic and useful. Residents showed a statistically significant increase in comfort with the dissection, from a median Likert score of 1 out of 5 (interquartile range 1–1) to 3 out of 5 (interquartile range 2–3) ( P <.001). Experts scored better than residents on blinded video grading of model performance ( P <.001). This low-cost and easily reproducible model fills a critical gap in gynecologic surgery education. Abstract : We designed and performed a usability assessment of a low-cost, obliterated posterior cul-de-sac simulation model to aid in surgical education for complex laparoscopic surgery.