Purpose: To
develop an inexpensive bladder model that can be used to teach Ob-Gyn Residents
open and laparoscopic cystotomy repair.
Background: Recognition of cystotomy and repair is a requirement of Ob-Gyn surgical
milestones. Simulation products currently exist for cystoscopy but not for
cystotomy repair.
Methods: Pilot study of a novel low fidelity bladder model that can be used for
simulation of both open and laparoscopic cystotomy repair. A cystotomy model
was created using the following materials: small whoopee cushion “bladder
mucosa”, shelf liner “bladder muscularis” and Press\\\'n Seal® for “serosa”. Markings were placed inside the cushion to
represent the trigone with ureteral orifices. Residents were asked to identify
the model’s anatomic landmarks and rate their confidence in identifying
cystotomy and performing both and open and laparoscopic cystotomy repair, pre-
and post-simulation.
Results: 16 bladder models were constructed for approximately $1.50 per model. The
model is reusable and manipulated well with surgical instruments and suture
both open and laparoscopically; the model was a bit large for the laparoscopic
trainer and lighting became a challenge for suturing. All participating
residents correctly identified the anatomic structures post-simulation compared
to 12/13 pre-simulation. Change in mean resident
confidence was statistically significant for identifying cystotomy (pre M=3.1/5
vs post M=4.2/5, p=0.009) and performing open cystotomy repair (pre M=2.4/5 vs
post M=4/5, p= 0.03) but not for laparoscopic repair (pre M=1.6/5 vs post M
3.1/5, p=0.09).
Discussions: Our
bladder model is easily constructed and inexpensive. It performs well for open
cystotomy repair but has been decreased in size to better perform
laparoscopically.
Topics: CREOG & APGO Annual Meeting, 2018, Resident, Faculty, Residency Director, Medical Knowledge, Practice-Based Learning & Improvement, GME, Simulation, Minimally Invasive Surgery, General Ob-Gyn,
Kelli Braun, MD
