Objective

evaluate impact of a simulation based training lab on surgical outcomes of different hysterectomy approaches in a resident teaching tertiary care centre 

Population 

1397 patients – total abdominal hysterectomy (TAH), vaginal hysterectomy (VH), total laparoscopy assisted hysterectomy (TLH, robot assisted hysterectomy (RAH) for benign gynaecologic conditions 

Simulation system

The Mimic Technologies dV-Trainer platform as robotic trainer, the 3-Dmed Trainer platform as a laparoscopy trainer, the Surgical Female Pelvic Trainer (SPET) with Advanced Surgical Uterus as open surgery trainer (does not mention what outcome measures were used for these systems) 

Outcomes of interest

Outcomes of patient who underwent hysterectomy in 2009 (before simulation training) vs 2010-2014 (after simulation training) for each technique (TAH, VH, LAH) – outcomes compared in terms of EBL, IOAE, length of HS, rate of BT and ORT for each approach 
Outcomes of hysterectomy performed by PGY2/3 residents vs outcomes of hysterectomy performed by PGY4 residents 

Limitations

Shift in hysterectomies from open to MIS throughout study years can influence patient outcomes 

Key findings

Simulation based training notably shortened outcomes of all hysterectomies in terms of HS TAH and RAH showed significant differences in terms of reduced average EBL by simulation based training in all systems IOAE were not influenced by simulation based training – did not seem to make a difference in any technique ORT better in PGY4 residents than hysterectomies performed by PGY2/3 residents irrespective of simulation training 

Conclusion

Sim lab improves hysterectomy outcomes performed at a teaching institution Skills learned under sim settings at least partially transferable to actual surgical cases of all types of hysterectomies