Development of a Simulation Model for Minimally Invasive Vaginal Cuff Closure

INTRODUCTION: Minimally invasive vaginal cuff closure requires fundamental surgical skills such as appropriate tissue handling, needle manipulation, and suture management. However, gynecologic surgical volumes are declining, and there is concern that current OB/GYN residents’ surgical training may not provide adequate exposure for surgical proficiency. Teaching fundamental surgical skills to trainees in a climate of decreasing surgical volume highlights the importance of surgical simulation education. To enhance robotic hysterectomy simulation education, Gheza et al. proposed a realistic, high-fidelity vaginal cuff model using porcine hearts. OBJECTIVE: The purpose of this video is to demonstrate how to prepare and utilize a porcine heart vaginal cuff model in simulation education with a robotic trainer. METHODS: Using readily available supplies, we demonstrate how to prepare and set up a porcine vaginal cuff model. We also review surgical fundamentals for an efficient and secure vaginal cuff closure. RESULTS: This video provides the step-by-step method for creating a vaginal cuff simulation model that can be utilized for laparoscopic or robotic simulation education. This model can be reused multiple times and allows trainees an opportunity to practice intracorporeal knot tying, suture management, and tissue handling during robotic vaginal cuff closure. CONCLUSIONS: A secure closure of the vaginal cuff during minimally invasive hysterectomy is vital. This video promotes the incorporation of a low-cost, high-fidelity model in surgical education that will allow trainees to practice minimally invasive vaginal cuff closure in an immersive environment.