Development and validation of a laparoscopic sacrocolpopexy simulation model for surgical training.
OBJECTIVE
To develop a valid laparoscopic sacrocolpopexy simulation model for use as an assessment and learning tool for performing this procedure.


METHODS
Simulation study (Canadian Task Force classification II-2).


METHODS
Two tertiary academic centers.


METHODS
A training model was developed to simulate performance of a laparoscopic sacrocolpopexy. Construct validity was measured by comparing observed masked performances on the model between experienced Female Pelvic Medicine and Reconstructive Surgeons (experts) and upper level trainees. All videotaped performances were scored by 2 surgeons who were masked to subject identity and using the valid and reliable Global Operative Assessment of Laparoscopic Skills scale.


RESULTS
The expert group included Female Pelvic Medicine and Reconstructive Surgeons (n = 5) experienced in laparoscopic sacrocolpopexy, and the trainee group (n = 15) included fourth-year gynecology residents (n = 5) and fellows in Female Pelvic Medicine and Reconstructive Surgery and in Minimally Invasive Gynecologic Surgery (n = 10). The experts performed significantly better than the trainees in total score and in every domain of the Global Operative Assessment of Laparoscopic Skills scale (median [range] score: expert group, 33 [30.5-39] vs. trainee group, 20.5 [13.5-30.5]; p = .002). Previous surgical experience had a strong association with performance on the model (rho > 0.75). Most subjects "agreed" or "strongly agreed" that the model was authentic to the live procedure and a useful training tool. There was strong agreement between masked raters (interclass correlation coefficient 0.84).


CONCLUSIONS
This simulation model is valid and reliable for assessing performance of laparoscopic sacrocolpopexy and may be used for practicing key steps of the procedure.
Center for Female Pelvic Medicine and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: lena0605@gmail.com.
Elena
E
Tunitsky-Bitton
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Cara R
CR
King
Center for Female Pelvic Medicine and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
Beri
B
Ridgeway
Center for Female Pelvic Medicine and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
Matthew D
MD
Barber
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Ted
T
Lee
Center for Female Pelvic Medicine and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
Tyler
T
Muffly
Center for Female Pelvic Medicine and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
Marie F
MF
Paraiso
Center for Female Pelvic Medicine and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
J Eric
JE
Jelovsek
D000328:Adult; D005257:Fellowships and Scholarships; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008953:Models, Anatomic; D012447:Sacrum / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
Laparoscopic sacrocolpopexy; Sacral colpopexy; Sacrocolpopexy; Surgical simulation