EUPSA - Training of the steps of the transanal endorectal pull-trough on a take home simulation model - Maja Joosten

The transanal endorectal pull-through (TERP) procedure is a common surgical procedure in the treatment of Hirschsprung's disease.

The TERP procedure consists of several component steps that require a structured approach.

Training for the TERP procedure can be challenging given the relatively rare nature of Hirschsprung's disease.

The simulation model uses a reusable wooden frame as its base, a sponge for the perineal body, a silicone top layer to mimic skin, and a multi-layer balloon design to simulate the different layers of the rectum and mesorectum.

Participants were recruited during the pediatric colorectal surgery course in 2020 and 2021.

There were 18 participants total: 2 experts and 16 participants in the target group (residents and fellows).

The model scored a median of 4 out of 5 for haptics, visual aspects, and realism.

The model scored a median of 4.5 out of 5 as a good tool to train the component steps of the TERP procedure.

The model was considered useful for exercise during the workshop with a median score of 5 out of 5.

The model was regarded as suitable for repetitive practice at home after the workshop.

A formal critical assessment form has not yet been developed to evaluate transfer of skills from the model to the clinical operating theater setting.

The study has been expanded to include five experts total (from the original two).

Expert feedback identified the model's main strength as being a good tool to train the component steps of the procedure.

The haptic feedback for true dissection requires operative experience and cannot be fully replicated by the model.

The model's additive value is allowing trainees to internalize component steps so they don't have to learn that part of the procedure on actual patients.

Performance on the model can be evaluated using a critical assessment form that looks at activity of each step, sequence, and efficiency of movement.