Department of Obstetrics, Gynecology and Women's Health, School of Medicine, University of Missouri, 500 N Keene St, Suite 400, Columbia, MO 65201, USA.
Simul Healthc. 2012 Dec;7(6):374-9. doi: 10.1097/SIH.0b013e318266d0c6.
The number of vaginal hysterectomy procedures performed by resident physicians in the United States is highly variable, with half of residency graduates completing 18 procedures or fewer as primary surgeon. Complex anatomy and technical challenge contribute to a steep learning curve for novice surgeons. Surgical simulation may be a useful adjunct to this surgical training, but a vaginal hysterectomy simulator is not currently available.
We describe the construction of a vaginal hysterectomy simulator that prioritizes low cost, wide availability of materials, and ease of assembly. Initial construction and per-use simulation costs were calculated. Per-use preparation time was recorded. Surgical learners who used the simulator (n = 12) completed a survey to determine its contribution to their learning.
Total cost per simulation was US $1.83 after an initial US $103.79 investment in a resin bony pelvis and stand. All relevant major anatomic landmarks (ureter, bladder, uterus, cervix, vesicouterine fold, vagina, and posterior cul-de-sac) were represented. Of the 12 surveyed surgical learners, 9 (75%) responded. On a 10-point scale (10 = highest), respondents noted that the simulator positively contributed to knowledge of procedure steps (8.3), anatomic relationships (7.7), preprocedure confidence with the first vaginal hysterectomy as primary surgeon (8), and overall learning on how to perform a vaginal hysterectomy (8.3).
This technical report details the construction of a vaginal hysterectomy simulator, the individual parts, the cost of each part, and the results of a blinded survey of resident physicians who used the simulator during their vaginal hysterectomy instruction.
美国住院医师施行阴道子宫切除术的数量差异很大，半数住院医师毕业后作为主刀医师完成的手术不到 18 台。复杂的解剖结构和技术挑战使得新手外科医生的学习曲线陡峭。手术模拟可能是这种手术培训的有用辅助手段，但目前还没有阴道子宫切除术模拟器。
我们描述了一种阴道子宫切除术模拟器的构建，该模拟器优先考虑低成本、广泛可用的材料和易于组装。计算了初始构建和每次使用模拟的成本。记录了每次使用前的准备时间。使用该模拟器的外科学习者（n = 12）完成了一项调查，以确定其对学习的贡献。
在最初投资 103.79 美元购买树脂骨盆和支架后，每次模拟的总成本为 1.83 美元。所有相关的主要解剖标志（输尿管、膀胱、子宫、宫颈、膀胱子宫皱襞、阴道和后盆腔）均有代表。在接受调查的 12 名外科学习者中，有 9 名（75%）做出了回应。在 10 分制（10 分为最高分）中，受访者指出模拟器对了解手术步骤（8.3）、解剖关系（7.7）、作为主刀医师进行第一次阴道子宫切除术的术前信心（8）以及整体学习阴道子宫切除术的技能（8.3）有积极贡献。
本技术报告详细介绍了阴道子宫切除术模拟器的构建、各个部件、每个部件的成本以及使用该模拟器的住院医师在阴道子宫切除术教学过程中进行的盲法调查结果。
