ArticleJournal of minimally invasive gynecology2021
Validation of Transvaginal Hysterectomy Surgical Model - Modification of the Flowerpot Model to Improve Vesicovaginal Plane Simulation.
Article in Journal of minimally invasive gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 4 citations in OpenAlex.
- Teaching Vaginal Surgery Through Simulation.O&G open · 2026Review
- Developing a Realistic and Cost-Effective Training Model (MaiSurge) for Laparoscopic Hysterectomies to Train and Assess Surgical Skill: Prospective Nonrandomized Controlled Trial.JMIR medical education · 2026Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
objectiveTo establish face and construct validity for a novel variation of American College of Obstetrics and Gynecology "Flowerpot Model" for transvaginal hysterectomy (TVH) surgical simulation with improved vesicovaginal dissection during surgical education simulation.
designCross-sectional face and construct validation study using the "Flowerpot Model." The vesicovaginal dissection plane was modified to include additional felt and balloon materials to simulate the bladder.
settingSingle academic center.
participantsFourteen residents and fellows, postgraduate year (PGY) 2 to 6, subdivided into junior (n = 8) with ≤10 prior TVH surgeries and senior groups (n = 6) with >10 prior TVH surgeries performed.
interventionsAll subjects watched a brief introductory video and then were filmed simulating a TVH. MEASUREMENTS AND MAIN
resultsFor face validity, subjects completed an anatomic checklist and pre/post simulation satisfaction survey. For construct validation, 2 independent, blinded expert surgeons (M.A. and J.M.) graded films using the Global Rating Scale of Operative Performance (GRS). Primary outcome was mean GRS between groups. The junior group consisted of PGY 2 to 3 with ≤ 10 prior TVH, median 7.5 (interquartile range [IQR] 6.75) and senior group PGY 3 to 6 with >10 TVH, median 19 (IQR 10) (p <.01). Subjects were "satisfied" or "very satisfied" with bladder and anterior peritoneal fold simulation (92%) and found vesicovaginal dissection "realistic" (100%). GRS score was significantly different between groups (juniors, 19.5 [IQR 5] vs seniors, 28.5 [IQR 8.5]; p = .048). Intergrader correlation was high (ρ = 0.87, p <.01). Surgeon volume of prior TVH was not significantly correlated to average GRS score, ρ = 0.49 (p = .10). The model improved comfort and confidence scores in the junior group more than senior group (p = .04), but senior group still had higher post simulation confidence scores than the junior group (p = .02).
conclusionFace and construct validity with the modified Flowerpot Model was demonstrated. This low fidelity model is capable of simulation of a TVH with a novel vesicovaginal dissection. Prior surgical experience was not correlated to GRS score or time to procedure completion.
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