2021 General Surgery Presentations

Ashley S Hafer, MD, MPA; William B Sweeney, MD, FACS; Brenton R Franklin, MD, MHPE, FACS; Walter Reed National Military Medical Center

Introduction and Objectives: Urologic procedures are amongst the most commonly reported procedures performed at sea by Navy general surgeons, yet there are currently no urologic procedure requirements during general surgery residency training. Urologic Care Afloat Navy Provider Education (UCANPE) was created to provide Navy general surgeons with needed training to diagnose and treat frequently encountered urologic emergencies in austere environments. Using urologist feedback, simulation models were developed and refined for hands-on training during UCANPE.

Materials and Methods: UCANPE includes didactic content followed by simulated practice for six procedures including: dorsal slit for both phimosis and paraphimosis, open suprapubic catheter placement, scrotal exploration, orchiectomy, and orchiopexy. Cost-effective, low fidelity simulators for each procedure, all made from commercially available components, were developed and tested by urologists. Models were rated using a 5-point Likert scale on similarity to actual tissue and to real-life procedure performance. This program was granted educational exemption by the Institutional Review Board.

Results: Five urologists participated in the model testing. A summary of the survey results is seen in Table 1.

Table 1. UCANPE Simulation Models Survey Results

Changes were made to the models based on the survey results and feedback from the urologists. The most changes were made to the to the scrotum model based on recommendations to improve consistency of the vas deferens and to increase tissue thickness and testicular size. Additionally, the foreskin of the dorsal slit models and the bladder of the open suprapubic catheterization model were thickened based on feedback. The final materials used for model construction are listed in Figure 1.

Figure 1. Materials Used for Model Construction

Conclusions: We created procedural simulation models for a novel urologic emergencies curriculum. The refined models will be tested again by the urologists and modified further, if needed, for use in our upcoming inaugural UCANPE course.