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Robot-assisted TAPP inguinal hernia repair training: validation of a synthetic hydrogel model-an international expert
Alexis Sanchez1, Omaira Rodriguez2, Hany Takla3,4
1Orlando Health Advanced Robotic Surgery Center, Orlando, FL, US. alexis.sanchez@orlandohealth.com.
Background:
Simulation-based training is a critical component of robotic surgical education. While virtual reality platforms are well established for basic skills acquisition, they lack the ability to replicate tissue handling required for procedural simulation. Synthetic models have emerged as a promising alternative; however, formal validation is required prior to their integration into training curricula. This study aimed to establish the face and content validity of the International Medical Robotics Academy (IMRA) Surgical model for robotic transabdominal preperitoneal (TAPP) inguinal hernia repair.
Methods:
A prospective content validity study was conducted using an international expert panel. Surgeons with experience in robotic TAPP repair and prior exposure to the IMRA model were recruited. A 48-item survey instrument was developed and organized across domains including anatomical fidelity, procedural relevance, haptic properties, and educational utility. Items were rated on a 4-point Likert scale. Item-level content validity indices (I-CVI) were calculated, with a threshold of ≥ 0.78 for retention. The scale-level content validity index (S-CVI/Ave) was computed, with ≥ 0.90 considered acceptable. Face validity was assessed using five global rating items (1-10 scale).
Results:
Ten expert surgeons from three countries participated. The overall face validity score was 8.78/10, with all domains exceeding 8.0, including educational value (9.40) and procedural relevance (8.90). The S-CVI/Ave was 0.929. Of 48 items, 44 (91.7%) achieved I-CVI ≥ 0.78. Four items did not meet the threshold, primarily related to advanced dissection steps and model-specific anatomical features. 90% of experts endorsed the model without reservations.
Conclusion:
The IMRA synthetic simulation model for robotic TAPP inguinal hernia repair demonstrates strong face and content validity. These findings support its integration into structured robotic training programs and provide a foundation for future studies evaluating construct and criterion validity.
