Description and validation of the Pelv-Sim: a training model designed to improve gynecologic minimally invasive suturing skills

Abstract

Study objective: To describe and validate the Pelv-Sim trainer, an innovative training model for gynecologic laparoscopic suturing with 4 laparoscopic exercises: closing an open vaginal cuff, transposing an ovary to the pelvic sidewall, ligating an infundibulopelvic ligament, and closing a port-site fascial incision.

Design: Randomized controlled trial (Canadian Task Force classification I).

Setting: Academic medical center.

Participants: Obstetrics and gynecology residents (n = 19) and third-year medical students (n = 10).

Interventions: To test the Pelv-Sim model for construct validity, all participants were timed as they completed the 4 tasks, and their performances were compared. The residents were then randomized to a study group asked to train with the Pelv-Sim for 1 hour/week for 10 weeks, or to a control group. To evaluate the effectiveness of training with the Pelv-Sim model, both groups of residents were retested at the end of the 10-week study period. Pretraining and posttraining performances were compared within each group.

Measurements and main results: Before the intervention, the residents completed all 4 tasks in significantly less time than the medical students (all p values <or=.012). When retested after the 10-week study period, the control group showed no significant performance improvements. The trained group showed significant improvement in performance for the vaginal cuff closure task (p = .004) and the ovary transposition task (p = .047), but not for the infundibulopelvic ligament ligation or the fascial closure tasks.

Conclusion: Construct validity was shown for all 4 Pelv-Sim simulation tasks. Resident training improves performance on the vaginal cuff closure and ovary transposition tasks. The Pelv-Sim has the potential to be a valuable tool in laparoscopic training for gynecology residents.