Clinical application values of a novel synthetic training simulator for bulbar urethral anastomosis

Author:

Xue Jing‐Dong1ORCID,Zhang Ping23,Xu Yue‐Min4,Sa Ying‐Long4ORCID,Shu Hui‐Quan23,Wang Lin5,Xie Hong4,Li Chao1,Zhang Wei6,Feng Chao23,Wu Deng‐Long1

Affiliation:

1. Department of Urology Tongji Hospital, School of Medicine, Tongji University Shanghai China

2. Department of Reproductive Medicine The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China

3. Shanghai Key Laboratory of Embryo Original Disease Shanghai China

4. Department of Urology Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China

5. Department of Urology, Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

6. Department of Urology, Tangdu Hospital Air Force Military Medical University Xi'an Shaanxi China

Abstract

AbstractPurposeThis study aimed to report a newly developed, high‐fidelity synthetic simulator to simulate excision and primary anastomotic (EPA) bulbar urethroplasty and its clinical use for new practitioners in shortening the learning curve.Material and MethodsThe bulbar urethral anastomosis simulator consists of several standardized components created according to the actual size of the male patient. Interns, novice residents, and fellows inexperienced with urethral reconstruction (n = 10, 5, 5) from different medical centres were invited to participate in the training programme. Two reconstructive urology experts monitored each practice. Following the training, three kinds of validity testing were used to assess the simulator: face, content, and construct. In the intern group, the task performance in the first five training sessions and the last five training ones were compared using a self‐control approach. In the resident and fellow group, the real surgical data, including estimated blood loss, operative duration, and 6‐month post‐operative success rate of trainees after training, are plotted, which are compared with that of reconstructive urology experts (n = 5) included retrospectively to study the effectiveness of the simulator in shortening the learning curve.ResultsThe overall mean satisfaction rate for the simulators was inspiring and evaluated by experts. In the intern group, significant improvement can be achieved through 10 training sessions (p < 0.05). In clinical practice, the intraoperative indicators and surgical success rate of both the training groups showed the tendency to close or even better than those in the expert group. In terms of the learning curve, training groups performed better compared with experts in the early stages of their careers.ConclusionsIn conclusion, this synthetic training simulator for bulbar urethral anastomosis is novel, effective, and convenient for beginners of different groups. The training course can bridge the gap between preclinical use and actual surgery via this simulator.

Funder

National Natural Science Foundation of China

Publisher

Wiley

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