Laparoendoscopic single-site urethrovesical anastomosis training in an economical porcine model

Abstract

Purpose: To develop an economical animal model for laparoendoscopic single-site surgery (LESS) urethrovesical anastomosis (UVA) training.

Materials and methods: A homemade single-port device was used and the uterus cervix and the ileum were chosen to simulate UVA to reduce costs. Ten trainees were randomly divided into two groups: the conventional LESS UVA (CLUVA) group and the transurethral assistant LESS UVA (TALUVA) group. In TALUVA, a laparoscopic forceps was inserted through the urethra to assist operation after the bladder neck was disconnected, whereas CLUVA followed the conventional steps. Anastomosis time and knotting time were recorded, and the learning curves of both groups were analyzed. After training, questionnaires were given to the trainees to assess the difficulties and the satisfaction of the training.

Results: The final mean operating time significantly declined in both groups. Except for the first lesson, the trainees in the TALUVA group operated faster than those in the other group. The results from the questionnaires show that all trainees were satisfied with the training, and LESS UVA was considered more difficult in the CLUVA group than in the TALUVA group.

Conclusions: The female porcine model for LESS UVA was feasible and cost-effective. TALVUA could effectively reduce the difficulties involved in LESS UVA.