Ex-vivo training model for laparoendoscopic single-site surgery

Area of Science:

• Minimally Invasive Surgery
• Surgical Education
• Urology

Background:

• Laparoendoscopic single-site surgery (LESS) is technically demanding, requiring specialized skills and mentorship for surgical trainees.
• Acquiring proficiency in LESS necessitates dedicated training platforms to develop necessary skills before live patient procedures.

Purpose of the Study:

• To outline the construction of a cost-effective training model for practicing steeplechase exercises in LESS.
• To enable urological surgeons and trainees to acquire basic and advanced skills using various instruments.
• To conduct preliminary construct validity testing of the developed training platform.

Main Methods:

• A box model was equipped with an R-Port(™) and camera for simulation.
• Basic (e.g., suturing) and advanced (e.g., pyeloplasty) exercises were performed with conventional and articulated instruments.
• Validation involved medical students, fellows, and experienced consultants performing eight skill tasks.

Main Results:

• The ex-vivo model successfully facilitated trainee exercises at a low cost (under £150).
• Skill differentiation was observed, particularly in non-camera handling tasks (S2-S8), distinguishing novices from experienced surgeons.
• Tasks S4-S8 demonstrated high construct validity in differentiating skill levels among participant groups.

Conclusions:

• The described ex-vivo model offers a cost-effective solution for preliminary skill acquisition in LESS for urological trainees.
• The model possesses construct validity for several tasks, aiding in skill assessment.
• Further validation is recommended to optimize rapid skill acquisition before clinical application.