TITLE:
Improving the Evaluation and Management of Cystotomy in Gynecologic Surgery with a Cadaver Surgical Curriculum
AUTHORS:
Cassandra Presti, Conway Xu, Chang Liu, Larry Walker, Lauren Scott, S. Abbas Shobeiri, Francine McLeod
KEYWORDS:
Bladder Injury, Cystotomy Repair, Cadaver Lab, Resident Curriculum
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.9,
September
24,
2021
ABSTRACT: Objectives: Urinary tract injuries are a known complication of gynecologic surgery, occurring
in 0.18% - 0.80% of procedures and most commonly involving the bladder. Appropriate
identification, evaluation, treatment, and follow-up by gynecologic surgeons are
important to reduce the associated long-term morbidities. The
purpose of this study was to implement a comprehensive cadaver curriculum in
cystotomy repair for OBGYN residents. Methods: This was a prospective observational
cohort study including 10 OBGYN residents (PGY1-3) at a single institution in
2020 (56% of the 18 eligible residents). The curriculum consisted of a one-hour
didactic lecture and one-hour hands-on surgical skills training with fresh
frozen cadavers. Residents were evaluated in three domains: 1) knowledge, 2)
surgical skills, and 3) confidence. Knowledge, confidence, and resident
satisfaction were evaluated with pre- and post-surveys. The bladder model,
derived from the ACOG Simulation Working Group, was used to evaluate surgical
skills at baseline and at completion of the curriculum. Results: Across
all three PGY levels, statistically significant improvements were observed in
knowledge, surgical skills, and confidence after didactic and cadaver education
(p = 0.001, p Conclusions: Educating and training OBGYN residents to manage
and repair cystotomies can be challenging given the low incidence of injury in
the operating room. The cadaver surgical skills curriculum was an effective
training module and remains an important component of skills training in
conjunction with simulation and traditional didactic sessions.