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A live porcine model for robotic sacrocolpopexy training

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Abstract

Introduction and hypothesis

Robotic sacrocolpopexy is an effective and durable technique for pelvic organ prolapse repair. However, the learning curve for this procedure has underscored the need for an effective surgical training module. Given the cost, infection risk, poor tissue compliance, and scarcity of human cadavers, the live porcine model represents a realistic, available, and cost-effective alternative. This article describes a live porcine model for teaching robotic sacrocolpopexy to determine whether it teaches key aspects of live human robotic sacrocolpopexy to the learner.

Methods

This robotic sacrocolpopexy model was created using the Da Vinci Xi or Si robotic system on domestic pigs under general anesthesia. The main steps of the model include: (1) creating the porcine “cervix” and (2) performing robotic sacrocolpopexy. The model was evaluated with a survey given to 18 board-certified surgeons who attended the training course between December 2016 and April 2018.

Results

All of the participants reported improvements in their economy of motion, tissue handling ability, suturing efficiency, and overall performance of robotic sacrocolpopexy. Furthermore, a majority of participants were likely to incorporate aspects of the model into their practice (88.8%) and recommend the model to colleagues (94.2%).

Conclusions

The porcine model provides a feasible tool for teaching robotic sacrocolpopexy to physicians.

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Fig. 1

References

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Author information

Correspondence to Patrick J. Culligan.

Ethics declarations

Consent

No patients were part of this work—there were only the pig used in the video and the surgeons who filled out anonymous ratings of the model.

Conflicts of interest

Patrick Culligan is a consultant and paid instructor for Intuitive Surgical and Coloplast and a stockholder in Origami Surgical. The remaining authors, Khushabu Kasabwala and Ramy Goeuli, have no disclosures.

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Appendix

Appendix

Robotic sacrocolpopexy training course (post-test)

Thank you for attending our robotic training course. The goal of this course was to improve your surgical technique for the robotic sacrocolpopexy using a live pig model. With regards to this model for the robotic sacrocolpopexy, please answer the following questions.

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Kasabwala, K., Goueli, R. & Culligan, P.J. A live porcine model for robotic sacrocolpopexy training. Int Urogynecol J 30, 1371–1375 (2019). https://doi.org/10.1007/s00192-019-03936-7

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Keywords

  • Pelvic organ prolapse
  • Porcine model
  • Robotic sacrocolpopexy
  • Robotic surgery
  • Surgical training