Validation of a low-cost model for training laparoscopic ovary-sparing surgery (LOSS) in ovarian mature teratomas

Abstract

Background: Mature ovarian teratoma is the most common ovarian neoplasm in pediatrics. Laparoscopic ovary sparing surgery (LOSS) is effective and safe. Due to the expansion of this technique in recent years, education-based surgical simulation is a useful tool for skills development. Aim: To validate a low-cost model for training LOSS in pediatric ovarian teratomas. Methods: We developed a low-cost model, incorporated into Hands-On courses since 2018. After academic lectures, and surgical strategies video demonstration, all participants performed the procedure in pairs, in our pediatric gruyer-like-training-box, under supervision. Time and critical maneuvers were assessed. A Likert-type scale was used to evaluate: previous experience, anatomical appearance of the model, surgical anatomy compared to a real patient and utility as a training method. Statistical analysis was performed with R-Studio®. Results: 75 % considered the model as good or high degree of similarity in relation to the anatomical characteristics; and 91.3 % in relation to surgical anatomy. 78.8 % believe the model improves the majority of skills. Correlation in time assessment for 81 participants with different levels of experience was statistically significative (p<0.01*). Emphasis was placed on preserving the capsule and ovarian tissue without causing any injury to adjacent tissues, resulting in a homogeneous performance. Conclusion: We saw a correlation between the previous experience of the surgeon and their performance in the model. Introducing this model in a simulation curricula would improve the learning curve. A decrease in surgical technique complications is to be expected, and should be demonstrated in future studies.

Keywords

• Laparoscopic ovary sparing surgery
• Simulation based-training
• Minimally invasive surgery
• Low-cost model
• Surgical education