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3D pelvic cadaver model: a novel approach to surgical training for penile implant surgery

Journal Contribution - Journal Article

A well-known problem in surgical training is the fact that many young surgeons have insufficient exposure to practical surgical training once they start their own career operating their own patients. The Halsted principle of "see one, do one, teach one" has run its course and is at best outdated given the recent financial, medico-legal, and ethical considerations of intraoperative training. Furthermore , the implementation of shorter residency training programs and resident work-hour restrictions has resulted in several training programs incorporating simulation into their training curriculum to supplement the hands-on experience gained in the operating room. Therefore, safe and effective training modalities that fill the created gap are required. To meet these needs, we developed a training platform that enables us to offer alternative possibilities for the training of young residents and to provide opportunities for practicing surgeons to pick up new techniques or to become more experienced in certain techniques and specific surgical procedures. This educational strategy consists of sequential levels of training. Primarily, a theoretical level using dedicated handbooks is to be followed by an interactive online library where surgical procedures can be learned using interactive videos displaying the surgery from different angles and including anatomical drawings. The videos can be mastered using a touch screen from a tablet, smart phone, laptop, desktop, etc. The third level in this training curriculum utilizes three-dimensional (3D) pelvic cadaver models. Once surgical techniques are adequately acquired using these 3D models, trainees are allowed to continue training in cadaver settings. This enables us to use these precious cadaver models much more efficient. Given the fact that cadaver models are much more expensive than 3D models, besides the ethical aspects of using human bodies, including those 3D models is an important step forward in surgical training. Last but not least, training and surgical education takes place in centres of excellence under direct supervision of high-volume dedicated surgeons. Once trainees have completed this training module they can become safety certified to offer their patients these types of interventions [1-6]. Cadaveric models remain the gold standard for realistic procedural instruction but their high cost, regulated availability, risks of transferable diseases, and potential ethical concerns limit their widespread use. Nevertheless, they restrict operative practice with specific pathology or anatomic variability that is required to achieve proficiency in advanced surgical skills. Researchers at the Simulation Innovation Lab (University of Rochester Medical Centre, Rochester, New York) have created a high fidelity , nonbiohazardous, and cost-effective penile model to simulate penile prosthetics surgery. The model is intended to help supplement resident, fellow, and low-volume penile prosthesis surgeon training to increase procedural knowledge and confidence with placement of a penile prosthesis. The penile model is composed of a synthetic hydrogel tissue that can mimic the biomechanical properties of human tissue. The model is made using polyvinyl alcohol (PVA) powder that is dissolved to create a viscous gel. To retain the geometry of various male pelvic structures PVA gel is molded in plastic casts created utilizing 3D printing. The casts are designed from a Computer-Aided Design model (Fig. 1) representing the geometry of the target anatomy. To replicate the texture of various tissue components, the PVA is solidified through successive freeze-thaw cycles that result in * Koenraad van Renterghem
Journal: International journal of impotence research
ISSN: 0955-9930
Issue: 3
Volume: 32
Pages: 261 - 263
Publication year:2020
BOF-keylabel:yes
IOF-keylabel:yes
BOF-publication weight:1
CSS-citation score:2
Authors:International
Authors from:Higher Education, Hospital
Accessibility:Open