Evidence map›Paper›PMID 31792801›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2020

Incisional hernia repair in a high-fidelity silicone model for open retro-muscular mesh implantation with preparation of the fatty triangle: validation and educational impact study.

C T Zipper, U Friedrich, J Backhaus, S König, S Mavroveli, A Wiegering, S Olbrecht, F Puppe, S A Günster, U A Dietz

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

C T ZipperDepartment of General, Visceral, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany.
U FriedrichDepartment of General, Visceral, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany.
J BackhausInstitute of Medical Teaching and Medical Education Research, University of Wuerzburg, Josef-Schneider Strasse 2, 97080, Wuerzburg, Germany.
S KönigInstitute of Medical Teaching and Medical Education Research, University of Wuerzburg, Josef-Schneider Strasse 2, 97080, Wuerzburg, Germany.
S MavroveliLondon General Surgical Skills Programme, Imperial College London, South Wharf Road, Paddington, London, W2 1BL, UK.
A WiegeringDepartment of General, Visceral, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany.
S OlbrechtInstitute for Artificial Intelligence and Applied Informatics (VI), University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany.
F PuppeInstitute for Artificial Intelligence and Applied Informatics (VI), University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany.
S A GünsterInstitut für Allgemeinmedizin, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Universitaetsstrasse 29, 91054, Erlangen, Germany.
U A DietzDepartment of General, Visceral, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany. ulrich.dietz@spital.so.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncisional hernia repair requires detailed anatomic knowledge. Regarding median subxiphoidal hernias, the proper preparation of the fatty triangle is challenging. To foster proficiency-based training, a cost-efficient model for open median retromuscular mesh repair resembling the human body was developed, including the main anatomical structures related to the procedure. The aim is to create and validate a high-fidelity model on open retromuscular mesh repair suitable for "training before doing". MATERIALS AND

methodsDifferent types of fabrics for imitation of connective tissue and 2-component silicones were used to construct the incisional hernia model. Sample size for validation of the model was determined by a triangular testing approach. Operations from six beginners and six experts were assessed by three blinded-raters. Reliability and construct-validity were evaluated on a behaviorally anchored rating scale (highest score: 4) for the criteria: "instrument use", "tissue handling", "near misses and errors", and "end-product quality".

resultsThe model authentically mimicked an open median retromuscular mesh repair. Participants considered the procedure realistic. Reliability was excellent, ranging from 0.811 to 0.974 for "end-product quality", and "tissue handling" respectively. Construct-validity was confirmed with experts significantly outperforming beginners in the "use of instruments" (M

conclusionsThe model covers all relevant aspects involved in median-open retromuscular incisional hernia mesh repair. Performance differences between beginners and experts confirm construct-validity and thereby realism of the model. It enables to efficiently improve and practice technical skills of the demanding surgery.

Indexed as

AdultFemaleHerniorrhaphyHumansIncisional HerniaMaleSiliconesSurgical MeshSiliconesFatty triangleIncisional hernia repairRetromuscular mesh repairSimulationSurgical modelValidation

Identifiers

PMID31792801

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.