Experimental animal model for training transobturator and retropubic sling techniques.
BACKGROUND
Suburethral slings have become the treatment of choice for stress urinary incontinence. However, the lack of experimental models for surgical training is a problem for beginners. We present a model for sling training and evaluate its acceptance by surgeons who have had prior experience.


METHODS
There were 32 surgeons who performed the training program and filled out a questionnaire to evaluate the animal model. Eleven-month-old Santa Inês sheep were selected. The techniques used for minimally invasive transobturator and retropubic sling implantation were reproduced followed by cystoscopy. The anatomical similarities of sheep and humans were evaluated, in addition to the reproducibility of surgical techniques.


RESULTS
As far as anatomical similarities of vaginal structures are concerned, 13 surgeons (40.6%) reported similarities and 18 (56.2%) reported a strong correlation. Concerning cystoscopy, 18 (56.2%) found similarities and 13 (40.6%) a strong similarity. As for the transvaginal sling, 10 (3.1%) reported similarities and 19 (59.3%) a strong similarity. Among those who had previous experience with transobturator slings, 91.6% considered that the model presented a similarity or strong similarity. Regarding the degree of recommendation, 9 surgeons (28.1%) would recommend it and 22 (68.7%) would strongly recommend it.


CONCLUSIONS
Ninety-seven percent of the surgeons would recommend this experimental model for training purposes. To our knowledge this is the first description of a successful animal model for transobturator sling training.
Riccetto
Cássio Luis Zanettini
CL
Division of Urology, Universidade Estadual de Campinas, São Paulo, Brazil. cássio.riccetto@uol.com.br
Palma
Paulo Cesar Rodrigues
PC
Thiel
Marcelo
M
Miyaoka
Ricardo
R
Netto
Nelson Rodrigues
NR
D000818:Animals; D002983:Clinical Competence; D005260:Female; D012756:Sheep; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000193:education*