A systematic review of the use of human body donor models for postgraduate laparoscopic surgical training

Abstract

While laparoscopy has become the gold standard for many abdominal surgical procedures, it has a steeper learning curve compared to an open surgical approach. Body donor (cadaveric) models (BDM) present a high-fidelity model for laparoscopic surgical training. There are a variety of models available from fresh-frozen models to soft-embalmed models using multiple proprietary preparation solutions. There remains uncertainty surrounding the models' relative strengths and weaknesses. This study aims to evaluate the different body donor models used in postgraduate laparoscopic surgical training. A systematic search was conducted across Medline, Embase, ClinicalTrials.gov, and Cochrane to identify articles relevant to postgraduate laparoscopic training using HBD following the PRISMA guidelines. A narrative review themed on HBD feasibility, validity, and educational utility in laparoscopic surgical training. PROSPERO Registration: NIHR CRD42023437230. Fifty-five studies were included. BDM in general were perceived as authentic and of high educational value. Soft embalmed models (e.g., Thiel^®, Genelyn^®, modified Larssen^®), were reported to be feasible and possess high face validity despite embalming and had advantages over fresh frozen body donors (FFBDs), including reusability, cost-effectiveness, and better odor satisfaction. Comparative studies reported a preference of human body donor models over other simulation methods due to its high fidelity. Body donor models including soft embalmed models provide high-fidelity laparoscopic training environments well perceived by trainees regardless of preservation or tissue fixation. Significant research gaps remain; head-to-head comparative studies between the different models remain sparse as well as data on non-educational aspects such as formal cost-utility analysis and ecological impact.

Keywords: Cadaver; Education; Laparoscopy; Minimally invasive surgical procedures; Systematic review.