Development of a simulation-based laparoscopic ventral rectopexy module: skills training for minimally invasive pelvic surgery
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Date
2025
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Abstract
Background Laparoscopic pelvic surgery presents significant technical challenges due to anatomical constraints such aslimited working space and proximity to neurovascular structures. Laparoscopic ventral mesh rectopexy (LVMR) was selectedas the procedural framework for model design and validation, given its complexity and relevance as a representative pelvicprocedure. This study aimed to develop and validate a synthetic and reproducible simulation model with structural andfunctional fidelity to support the acquisition of laparoscopic skills in anatomically restricted pelvic environments.Methods A synthetic pelvic model was developed through iterative prototyping, integrating 3D-printed bone structures andplatinum-cured silicone. Face validity and user reaction were initially assessed by eleven surgeons with varying expertise.Construct validity was then evaluated through performance in a simulated LVMR, using modified Objective StructuredAssessment of Technical Skills (OSATS) and a Procedure-Specific Rating Scale (SRS). Surgical time was recorded byprocedural steps. Data were analyzed using non-parametric methods.Results Experts achieved significantly higher OSATS scores (median 20.5 [20.38–21]) than non-experts (16 [14.75–17.25];p=0.01), and higher SRS scores (16.25 [16–16.88] vs. 13.5 [13.25–15]; p=0.009). Step-specific advantages were observed insurgical flow (p=0.025) and knot tying (p=0.018). Although global operative time was shorter in experts (29.3 vs. 52.8 min),it was not statistically significant (p=0.073). Most participants described the model as realistic, useful, and representativeof actual surgical conditions.Conclusion This validated, reusable model provides strong educational value for advanced laparoscopic pelvic training andstructured skill acquisition.
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Simulation training, Colorectal surgery, Colorectal cancer, Minimally invasive surgery