Hypospadias Reconstruction Training: Development of an Ex-Vivo Model for Objective Evaluation of Surgical Skills.

To objectively evaluate technical skill acquisition in hypospadias repair procedures during surgical training using non-invasive wearable sensor technology. We combined subjective video evaluations with objective electromyography (EMG) measurements in a hands-on hypospadias training course. Surgeons wore wireless EMG and accelerometer sensors on their dominant hand while performing tasks on ex-vivo cadaveric calf penises. The study focused on four skills: urethral mobilization, dorsal inlay graft harvest/implantation, meatal-based flap urethroplasty, and dorsal plication. Machine learning techniques analyzed muscle activation patterns and attributes for assessing surgical precision. The course included 18 participants (10 female, 8 males; average age 40.18 ± 8.46 years) categorized as novice (n=10, <3 years' experience), intermediate (n=5, 3-5 years), and expert (n=3, >5 years). Video evaluations did not reveal significant differences due to short-term training. However, EMG measurements showed significant reductions in average EMG power, total time, dominant frequency, and cumulative muscle workload after training. Additionally, the mean power spectral density of the EMG signal decreased notably post-training. This study presents a structured approach for hypospadias training and highlights the effectiveness of wearable sensor technology for objective skill assessment. While video evaluations did not detect significant changes, EMG data provided measurable differences in skill acquisition, suggesting that wearable sensors could enhance objective evaluations of surgical proficiency in residency programs.

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tariq Abbas reports was provided by Sidra Medicine. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.