A Multimodal Animal-Tissue Simulation Model for Training Single-Stage Hypospadias Repair Techniques: A Descriptive Proof-of-Concept Study.

Abstract

Introduction: Although hypospadias is a common condition and pediatric urology fellowship training programs exist, they have recently been described as insufficient to mediate the necessary skills to master hypospadias surgery. Simulation-based education is increasingly promoted, but training is limited by simulators that typically focus on a single surgical technique. We aimed to develop and demonstrate a single adaptable simulator capable of simulating the six commonly used single-stage hypospadias repair methods.

Methods: A model made from lamb tenderloin and chicken skin was used to simulate the six most common single-stage repair techniques: The Meatal-based Flap (Mathieu), the Tubularized Preputial Island Flap, the Island Onlay, the Meatal Advancement and Glanduloplasty (MAGPI) technique, the Koyanagi-Nonomura technique, and the Yoke repair technique. Simple adaptations were employed to modify the model, including sulcus and meatal repositioning, as well as suture- and resection-based skin adaptations.

Results: The model could be adapted to simulate six major hypospadias correction techniques on one single platform. The model required minimal resources and preparation, making it accessible and cost-effective.

Conclusion: With the animal tissue model presented, the simulation of six commonly used single-stage reconstruction techniques on one adaptable, easily accessible platform becomes possible. Formal validation studies are warranted prior to their incorporation into standardized training curricula.