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First launch of 3D-printed high-fidelity hypospadias models, for hands-on training of standard hypospadias repairs
Abeer Aboalazayem, Pediatric surgery trainee1, Muhammad Ba'Ath, professor2, Mahmoud M. Marie, professor3.
1Kasralainy school of medicine, Cairo university, Cairo, Egypt, 2American Hospital Dubai, Dubai, United Arab Emirates, 3faculty of medicine, Cairo university, Cairo, Egypt.

BACKGROUND: Simulated training in Paediatric Surgery/Urology is gaining significance due to: (A) being a specialty of rare diseases affects individual surgeon's exposure to index cases; (B) subspecialty areas are not universally accessible; (C) Covid-19 affected elective surgery. Consequently, targeted training, via workshops and simulated models, is necessary. Hypospadias is the index case/operation in Paediatric Urology, requiring a spectrum of dissection and reconstruction skills. It is further challenging to revisit and redo, thus sound initial repair is crucial. To date, there has been no successfully-utilizable 3D-printed hypospadias model. We hereby present our experience with silicone 3D-printed high-fidelity hypospadias models.
METHODS: Twenty-seven trainees from different countries, under supervision of 15 instructors, completed the training exercise. They were all given a seminar to show the relevant anatomy, and 8 key steps of the exercise. Each trainee filled a structured assessment form for the quality of the exercise and resemblance to live surgery. Each exercise was evaluated by a trainer on-site, who supervised the activity and two independent assessors through photographs of the cardinal steps.
RESULTS: Eleven-(40.7%) trainees were years:1-3 of specialist training, 10-(37%) were years:4-6, and 6-(22.2%) beyond. Two-(7.4%) trainees had nil hypospadias experience, 16-(59.2%) assisted in procedures or performed steps, 5-(18.5%) performed whole procedures with guidance and 4-(14.8%) without guidance. The trainees rated each steps from unsatisfactory-(1/5) to excellent-(5/5) for each of the (1)-degloving; urethral (2)-marking and (3)-incision; (4)-tubularisation; (5)-glanuloplasty; (6)-dartos layer preparation; (7)-preputioplasty and (8)-skin closure. Twenty-(74%) of trainees and 15-(100%) instructors judged the model to resemble the anomaly. Seventeen-(63%) trainees and 13-(86.6%) instructors rated needle penetrability of the material compared to human tissue ≥3/5. Sixteen-(59%) trainees and 13-(86.6%) instructors rated suture holding ≥3/5. Eleven-(73.3%) and 13-(86.6%) instructors rated sutures' evenness and edge cooptation ≥3/5.
CONCLUSIONS: Majority of instructors found this 3D-model able to mediate transferring skills. Trainees reported adequate skill acquisition


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