title: [Contribution of a virtual hysteroscopic simulator in the learning of hysteroscopic myoma resection].
abstract: OBJECTIVE
  Uterine myomas are a frequent pathology affecting 20% of women of reproductive age. Myomas induce abnormal uterine bleeding, pelvic pain and increase the risk of infertility and obstetrical complications. Symptomatic sub-mucosal myomas are classically treated by hysteroscopic resection. Simulation is a method of education and training. It could improve quality and security of cares. The aim of this study is to assess the interest of a hysteroscopic simulator for the resection of myoma by novice surgeons.
  
  
  METHODS
  Twenty medical students were recruited, in a prospective study, in august 2014. The virtual-reality simulator VirtaMed HystSim™ (VirtaMed AG, Zurich, Switzerland) was used to perform the hysteroscopic training. All students received a short demonstration of myoma resection. The practice consists of a submucous myoma type 0 resection. The procedure and the evaluation were performed before and after a specific training in hysteroscopic resection of sixty minutes long. The main outcome criteria were time for the resection before and after training. The second criteria were fluid quantity used, number of contact between optic and uterine cavity and uterine perforation.
  
  
  RESULTS
  Twenty students aged from 22 to 24 years were included. The time for the procedure was significantly reduced after training (170s versus 335s, P<0.01). There is the same for fluid quantity used (335 mL versus 717mL, P<0.01) and the number of contact between optic and uterine cavity (0.2 contact versus 3, P=0.012). No perforation occurred in the simulation.
  
  
  CONCLUSIONS
  The results suggest that hysteroscopic simulator enhances and facilitates hysteroscopic resection for novice surgeons.
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Faurant
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: S
authors.initials: S
authors.lastname: François
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: P-E
authors.initials: PE
authors.lastname: Bouet
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: L
authors.initials: L
authors.lastname: Catala
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: C
authors.initials: C
authors.lastname: Lefebvre-Lacoeuille
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: P
authors.initials: P
authors.lastname: Gillard
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: P
authors.initials: P
authors.lastname: Descamps
authors.affiliation: Fédération de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France; CESP-Inserm, U1018, équipe 7, genre, santé sexuelle et reproductive, université Paris Sud, 94276 Le Kremlin-Bicêtre cedex, France. Electronic address: g_legendre@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Legendre
mesh_terms: D004501:Education, Medical / Q000379:methods; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000193:education*; D007889:Leiomyoma / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*; D013337:Students, Medical; D063186:Uterine Myomectomy / Q000193:education* / Q000379:methods; D014594:Uterine Neoplasms / Q000601:surgery*; D055815:Young Adult
keywords: Hystéroscopie; Resection; Résection; Simulateur virtuel; Simulation; Training; Virtual simulator