Procedural simulators for teaching and learning vasectomy techniques: a scoping review

Abstract

Background: Procedural simulators can facilitate teaching and improve learning vasectomy surgical techniques. The objectives of this scoping review were to identify available vasectomy simulators (scrotal models), and to assess their characteristics and potential suitability for optimal transfer of surgical skills of most recommended techniques in clinical practice.

Methods: We performed searches up to December 2023 using PubMed and Google search engines to identify existing vasectomy simulators. Articles and Web pages reporting vasectomy simulators were also examined using a snowball strategy. In addition, we asked members of the Vasectomy Network, an international Google discussion group, if they knew any other simulators. Two members of the research team performed the initial evaluations of the physical and functional characteristics of retrieved simulators. All team members made consensus on final evaluations.

Results: We retrieved 10 relevant scrotal models through PubMed (n=2), Google (n=4), and the Vasectomy Network (n=4). Three were commercially available simulators produced by Gaumard^® in the USA and seven were homemade models. All had limited visual and haptic realism of internal and external structures. Most, however, were suitable for simulating some basic skills of the no-scalpel technique to deliver the vas deferens. Fascial interposition could not be simulated with any model. Commercially available models had no advantage over homemade models.

Conclusions: Most vasectomy simulators currently available allow learning some basic surgical skills of the procedure but have limitations for optimal learning of the recommended techniques and skill transfer in clinical practice. There appears to be a need to develop and evaluate new simulators with enhance visual and haptic characteristics for teaching and learning vasectomy techniques.

Keywords: Vasectomy; competency-based education; high-fidelity simulation training; scoping review; surgical models.

Figure 1

Flow diagram of the PubMed searches (December 2023). The first set (Search #1) was specifically focusing on scrotal models. The second set (Search #2) was broader, covering all aspects of vasectomy education and simulation.

Figure 2

Retrieved simulators (scrotal models) for teaching and learning vasectomy. (A) Gaumard^®, no-scalpel vasectomy skills trainer S-518 model (S230.11 and S230.200 not shown) (18,23,24); (B) Gauze and latex tubing model (19); (C) Coe and Curington’s model (20); (D) Department of Urology, University of Wisconsin School of Medicine and Public Health model adapted from Coe and Curington’s model (21); (E) Wilson’s model; (F) Weissman’s model (22); (G) Kaza’s model; (H) Ballon model. Photographs (A-F) by Michel Labrecque; (G) by Ramchandra Murti Kaza; (F) by Mandy Glitter.