A training model for laparoscopic urethrovesical anastomosis

Area of Science:

• Urology
• Surgical Education
• Laparoscopic Surgery

Background:

• Laparoscopic urethrovesical anastomosis is a complex surgical procedure.
• Effective in vitro training models are crucial for developing surgical proficiency.
• Existing models may lack anatomical fidelity or be prohibitively expensive.

Purpose of the Study:

• To develop and assess an innovative in vitro training model for laparoscopic urethrovesical anastomosis.
• To compare the effectiveness of this new model against a conventional chicken skin model.

Main Methods:

• A novel model was constructed using chicken posterior trunks (simulating pelvis) and porcine colons (simulating bladder/neobladder).
• Urologic residents (n=40) were randomized into two groups for 8-hour training: new model (Group A) vs. chicken skin model (Group B).
• Surgical skill was evaluated via anastomosis time and quality in a porcine model before and after training.

Main Results:

• Both groups showed improvement post-training, but Group A (new model) demonstrated significantly greater improvements.
• Group A achieved a shorter anastomosis time (63.55 vs. 76.55 minutes, P < 0.05) compared to Group B.
• Group A also attained a higher quality score (8.80 vs. 7.65, P < 0.05) than Group B after training.

Conclusions:

• The developed training model offers superior anatomical resemblance to human pelvic structures.
• It is an effective, convenient, and cost-efficient tool for laparoscopic urethrovesical anastomosis training.
• This model significantly enhances surgical residents' skills in performing urethrovesical anastomosis.