SP 1.10 Simulated Open Inguinal Hernia Repair: A Low-Cost Pilot Study Enhancing the Future of Surgical Training
Bhagat Manku, Sanskrithi Sravanam, David LukeAbstract
Aims
Achieving competency for open inguinal hernias can be challenging due to varied exposure to training lists and learning curves. The aim of this course was to evaluate simulation in enhancing surgical proficiency and confidence in conducting open inguinal hernia repairs amongst core surgical trainees and resident doctors.
Methods
Videos demonstrating operative steps on a patient and model were shown to 8 candidates. Hand-sewn models were constructed from neoprene, costing £30 each. Feedback was attained from questionnaires. Pre and post-course confidence levels were measured using a 5-point Likert scale across operative steps and compared using Wilcoxon signed-rank tests. p < 0.05 was statistically significant.
Results
Pre-course, 25% had no prior experience, 12.5% observed, 25% assisted and 37.5% performed steps supervised. Statistically significant improvements in self-reported confidence were observed in seven of the eight operative steps. Identifying surface anatomy (p = 0.206), skin incision and exposure of the inguinal canal (p = 0.023), identification of direct versus indirect inguinal hernia (p = 0.008), dissection and handling of hernia sac (p = 0.008), protection of cord structures (p = 0.017), mesh placement (p = 0.016) and fixation (p = 0.027) and wound closure (p = 0.023). All candidates found the model beneficial and would find a video-aided model course valuable.
Conclusion
This course allowed a safe environment to enhance confidence and approach to open inguinal hernias without patient safety risks. It has laid strong foundations to be incorporated into surgical training programmes, thereby enhancing access and facilitate tailored feedback to aid operative progression.