Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Jan;37(1):443-449.
doi: 10.1007/s00464-022-09499-x. Epub 2022 Aug 19.

Interactive video module and simulated model for uterine manipulation during laparoscopic hysterectomy

Anousheh Shafa  1 , Adela G Cope  2 , Tatnai L Burnett  2 , Kristopher P Kolish  3 , Kristin C Mara  4 , Michelle A Wyatt  2 , Isabel C Green  2
Affiliations
Randomized Controlled Trial

Interactive video module and simulated model for uterine manipulation during laparoscopic hysterectomy

Anousheh Shafa et al. Surg Endosc. 2023 Jan.

Abstract

Background: Hysterectomy is one of the most common gynecologic surgeries, with an increasing proportion of hysterectomies performed by a laparoscopic approach. Uterine manipulation is critical for patient safety and surgical efficiency; however, the most junior member of the surgical team assumes the responsibility of uterine manipulation, commonly without preparation. The objective of our study was to determine whether kinesthetic learning using a low-cost simulated pelvic model while learning the uterine manipulation maneuvers of a laparoscopic hysterectomy improves learning efficacy and application efficiency compared to an interactive video module alone.

Methods: Our randomized control trial at an academic medical center included forty first-year and second-year medical students. Participants were randomized to the intervention group that used a low-cost simulated pelvic model for kinesthetic learning during the video module or the control group who only had the interactive video module to learn the uterine manipulation maneuvers of a laparoscopic hysterectomy.

Results: Participants in the intervention group were less likely to make unnecessary movements with demonstration of both pelvic side walls (right wall: control 78.9%, intervention 42.9%, p < 0.027; left wall: control 94.7%, intervention 66.7%, p < 0.046), and this was more pronounced in novice first-year participants (p < 0.009). Additionally, participants in the intervention group reported higher perceived preparedness (100% versus 71.4% in control group, p < 0.037). However, there was no difference in verbal or physical cues required, time per task, or force used between the groups.

Conclusion: Kinesthetic practice may not be required for learning the uterine manipulation maneuvers of a laparoscopic hysterectomy, but it may be beneficial for more novice learners and to increase learners' perceived preparedness. Our novel interactive video module alone may be sufficient to prepare learners to perform uterine manipulation maneuvers prior to the operating room.

Keywords: Interactive learning module; Minimally invasive; Simulation.

PubMed Disclaimer

References

    1. National Center for Health Statistics. Health, United States, 1995 (1996) Public Health Service, Hyattsville, Maryland
    1. Morgan DM, Kamdar NS, Swenson CW, Kobernik EK, Sammarco AG, Nallamothu B (2018) Nationwide trends in the utilization of and payments for hysterectomy in the United States among commercially insured women. Am J Obstet Gynecol 218(4):425.e1-425.e18 - DOI
    1. van den Haak L, Alleblas C, Nieboer TE, Rhemrev JP, Jansen FW (2015) Efficacy and safety of uterine manipulators in laparoscopic surgery: a review. Arch Gynecol Obstet 292(5):1003–1011 - DOI
    1. Hald K, Viktil E, Lieng M (2015) Effect of Uterine Manipulation on the Relation of the Ureter and the Uterine Vessels. J Minim Invasive Gynecol 22(6S):S81 - DOI
    1. Forbes H, Oprescu FI, Downer T, Phillips NM, McTier L, Lord B, Barr N, Alla K, Bright P, Dayton J, Simbag V, Visser I (2016) Use of videos to support teaching and learning of clinical skills in nursing education: a review. Nurse Educ Today 42:53–56 - DOI

Publication types

LinkOut - more resources