Category: Education, Simulation & Virtual Reality

MP19-6 - Construct validation study of a simulation model using swine tissue for laparoscopic dissection and suturing training

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :  Based on recent developments of surgical practice including laparoscopic procedures, working-hour restrictions, and ethical considerations, there is a growing need for surgical training outside the operating theater.  We recently started a laparoscopic training program using swine tissue.  The aim of this study was to evaluate the construct validity of our training model.


Methods : Since June 2017, using swine aortas and kidneys, we have provided simulation training to promote laparoscopic surgical skills.  So far, 11 experts (performed >50 laparoscopic surgeries), 6 intermediates (performed 11-49), and 22 novices (performed 0-10) have voluntarily joined this training program.  Participants were required to perform lymphadenectomy around the aorta (task-1), dissection and division of the renal artery (task-2), and renal parenchymal closure (task-3). Training sessions were video-recorded, performances were blindly evaluated by two experts (TA and KH), according to a score sheet that we developed (Table 1), and mean scores were used for subsequent analysis.  The inter-class coefficient (ICC) was evaluated for inter-rater reliability, and mean scores for the initial training session were compared among the three groups for construct validation.


Results : Thirty-nine performed a total of 56 training sessions, and the 55 sessions were successfully video-recorded.  In task-2, 6 sessions could not be performed due to the conditions of kidneys.  Therefore, a total of 159 movies (task-1/ 2/ 3= 55/ 49/ 55 movies) were independently assessed by the two raters.  For inter-rater reliability, the score assigned by each rater had an ICC of 0.741.  For construct validity, in all 3 tasks, there were significant differences in the total scores among groups (Kruskal-Wallis test, p<0.0001).


Conclusions : The present study showed the construct validity of our swine tissue training model.  The good inter-rater reliability may allow us to use it as an assessment tool.

Madoka Higuchi

clinical fellow
1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Takashige Abe

Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Kiyohiko Hotta

1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Ken Morita

2. Department of Urology, Kushiro City General Hospital, Kushiro, Japan
Kushiro, Hokkaido, Japan

Haruka Miyata

Clinical fellow
1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Takahiro Osawa

Assistant Professor
1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Ryuji Matsumoto

1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Hiroshi Kikuchi

1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Yo Kurashima

2. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Sachiyo Murai

1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan

Abdullatif Aydin

The Urology Foundation Simulation Research Fellow
MRC Centre for Transplantation, Guy's Hospital, King's College London
London, England, United Kingdom

Nicholas Raison

MRC Centre for Transplantation, King's College London
London, England, United Kingdom

Kamran Ahmed

MRC Centre for Transplantation, King's College London
London, England, United Kingdom

Muhammad SHAMIM.. Khan

4. Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom
London, England, United Kingdom

Prokar Dasgupta

MRC Centre for Transplantation, King's College London
London, England, United Kingdom

Nobuo Shinohara

Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Sapporo, Hokkaido, Japan