Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair

Ивахов, Г. Б.; Kolygin, A V; Titkova, S.; Anurov, M.; Сажин, А В

doi:10.1007/s10029-019-02032-5

Cited by 17 publications

(20 citation statements)

References 22 publications

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“…Construct validity was not assessed in this study. Ivakhov et al describe a box trainer for the simulation of TAPP repair [17]. This composed of a synthetic box structure with a flap or porcine stomach prepared to simulate the abdominal wall.…”

Section: Totally Extra-peritoneal (Tep) Inguinal Hernia Repairmentioning

confidence: 99%

Characteristics of laparoscopic and open hernia repair simulation models: a systematic review

Pelly

Vance-Daniel

Linder

2021

Hernia

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Purpose Barriers to education in open and laparoscopic hernia repair technique include a steep learning curve and reduced theatre time for junior surgical trainees. This is particularly evident during the current COVID-19 pandemic. Simulation models may provide further opportunities for training in hernia repair outside of the traditional surgical apprenticeship model. Methods A systematic review was carried out following PRISMA guidelines to identify and evaluate simulation models in hernia repair. Of the 866 records screened, 27 were included in the analysis. These were assessed for face, content and construct validity, as well as their attempt to measure educational impact. Results Simulation models were identified comprising of animal tissues, synthetic materials and virtual reality (VR) technology. Models were designed for instruction in repair of inguinal, umbilical, incisional and diaphragmatic hernias. Twenty-one laparoscopic hernia repair models were described. Many models demonstrated validity across several domains, and three showed transferability of skills from simulation to the operating room. Of the six open hernia repair simulation models, none were found to have demonstrated an educational impact in addition to assessing validity. Conclusion Few models individually were able to demonstrate validity and educational impact. Several novel assessment tools have been developed for assessment of progress when performing simulated and real laparoscopic inguinal hernia repair. More study is required, particularly for open hernia repair, including randomized controlled trials with large sample sizes to assess the transferability of skills.

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Section: Totally Extra-peritoneal (Tep) Inguinal Hernia Repairmentioning

confidence: 99%

Characteristics of laparoscopic and open hernia repair simulation models: a systematic review

Pelly

Vance-Daniel

Linder

2021

Hernia

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“…7 Animalbased tissue blocks and synthetic/artificial models are evolving rapidly and may represent less expensive and efficient simulation modalities. 8,9 Few simulators are currently available for training in foregut and/or bariatric surgery. The aim of this study was to review the current status and future directions of simulation in foregut and bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Simulation for Foregut and Bariatric Surgery: Current Status and Future Directions

Schlottmann

Herbella

Patti

2021

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Simulation offers the opportunity to practice in a safe, controlled, and standardized environment. Surgical simulation, in particular, is very attractive because it avoids learning and practicing surgical skills in the operating room. Many simulators are currently available such as box-lap trainers, virtual-reality platforms, cadavers, live animals, animal-based tissue blocks, and synthetic/artificial models. Endoscopic interventions can be practiced with high-fidelity virtual simulators. Box-lap trainers help practicing basic laparoscopic skills. Cadavers and live animals offer realism to train entire foregut and bariatric procedures. However, limited availability and high expenses often restrict their use. Ex vivo simulators with animal tissue blocks have been recently developed and appear to be a realistic and cost-effective alternative. Three-dimensional printing and real-time navigation systems have also emerged as promising training tools. Overall, further efforts are needed to develop a formal simulation curriculum with validated simulators for foregut and bariatric surgery.

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“…Despite the proven advantages of minimally invasive approaches, the widespread acceptance of LIHR has not yet been noted. 10 Recent studies have shown that the range of utilisation ranges from 10% to 48%, with nearly half of surgeons having never performed LIHR. 10 This is likely a result of the well-recognised steep learning curve associated with TEP and TAPP approaches, as well as the potential for rare but serious complications such as major vascular or visceral injury.…”

Section: Introductionmentioning

confidence: 99%

“…10 Recent studies have shown that the range of utilisation ranges from 10% to 48%, with nearly half of surgeons having never performed LIHR. 10 This is likely a result of the well-recognised steep learning curve associated with TEP and TAPP approaches, as well as the potential for rare but serious complications such as major vascular or visceral injury. 8,11 It is unsurprising that experienced surgeons will frequently default to an open approach, and those performing LIHR will be hesitant to offer opportunities to residents to learn these techniques.…”

Section: Introductionmentioning

confidence: 99%

“…8,11 It is unsurprising that experienced surgeons will frequently default to an open approach, and those performing LIHR will be hesitant to offer opportunities to residents to learn these techniques. 10 Currently, the Intercollegiate Surgical Curriculum Programme stipulates that 60 logged IH cases are required to be awarded the Certificate of Completion of Training in general surgery, but do not have any specific targets relating to LIHR. 12 For this reason, it can be highly challenging for surgical trainees to obtain the experience required to learn LIHR in an era where it will be increasingly be expected of them in consultant practice.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic totally extraperitoneal hernia repair performed by surgical trainees: overcoming the learning curve

Hannan

Duggan

Harding

et al. 2021

ANZ Journal of Surgery

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Background: Surgical trainees struggle to obtain experience in laparoscopic inguinal hernia repair (LIHR) due to a perceived steep learning curve. The purpose of this study was to compare outcomes in totally extraperitoneal (TEP) repair performed by surgical consultants and trainees under supervision as part of a standardised training regimen to assess the safety of residency training in this technique. Methods: A retrospective review of patients managed by TEP repair by either a consultant or a supervised trainee was performed. Demographic, perioperative and postoperative data were collected and compared. All trainees underwent a standardised approach to teaching TEP repair. Results: Trainees performed 133 procedures and consultants performed 121 procedures. Estimated blood loss was minimal in both cohorts. A significant difference was noted in mean operating time between consultants and trainees (33 vs. 50 min). However, it was also observed that the trainee mean operating time reduced significantly with experience (from 61 to 42 min). No statistically significant difference was demonstrated in postoperative complications, recurrence rate or length of stay. All trainees achieved the ability to complete a laparoscopic TEP repair under unscrubbed consultant supervision during a 1-year placement. Conclusion:With senior supervision and in the presence of a structured training regimen, trainees can safely and effectively perform LIHR, progressing to performing the procedure under unscrubbed consultant supervision. This is valuable information that can serve to inform the structure and direction of surgical training programmes as the ability to offer LIHR is increasingly becoming an expectation of consultant surgeons.

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Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair

Cited by 17 publications

References 22 publications

Characteristics of laparoscopic and open hernia repair simulation models: a systematic review

Characteristics of laparoscopic and open hernia repair simulation models: a systematic review

Simulation for Foregut and Bariatric Surgery: Current Status and Future Directions

Laparoscopic totally extraperitoneal hernia repair performed by surgical trainees: overcoming the learning curve

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