Development and Validation of a Laparoscopic Sacrocolpopexy Training Model.

Abstract

Importance: Proper training is necessary to develop the highly specialized skills required to safely perform laparoscopic sacrocolpopexy. Currently, there is no validated training model for laparoscopic sacrocolpopexy that includes dissection of the presacral space, both vaginal and presacral mesh attachments, and peritoneal closure.

Objectives: This study aimed to create a procedure specific hierarchical task analysis for laparoscopic sacrocolpopexy and then develop and validate a corresponding laparoscopic sacrocolpopexy pelvic training model for the simulation environment.

Study design: This was an observational simulation study that was divided into 5 phases: (1) development of hierarchical task analysis, (2) model construction, (3) participant recruitment and simulation testing, (4) reliability and validity testing, and (5) creation of a standard passing performance measure.

Results: Construct, face, and content validity were established for this model. According to the participating experts, the model was able to replicate the steps of presacral dissection, anterior vaginal and sacral mesh attachment, and peritoneal closure. Thirteen trainees and 5 experts completed the simulation, and all "agreed" or "strongly agreed" that the model seemed useful for improving suturing technique and learning the procedure. Additionally, a passing performance measure was determined through contrasting groups methodology.

Conclusions: We developed a novel, reusable, and validated training model that can be utilized as a training resource for the many critical skills necessary to safely and efficiently perform laparoscopic sacrocolpopexy.