Original Articles
Hysteroscopic Training: The Butternut Pumpkin Model

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Abstract

Operative hysteroscopy involves significant hand-eye coordination, utilizing energy sources, video imaging, and the safe control of distending media. We describe a safe, effective, inexpensive, and reproducible method of developing the skills and hand-eye coordination for diagnostic and operative hysteroscopy. In this inanimate model, advanced surgical skills can be practiced, and realistic, simulated electrosurgery including resection of the endometrium and rollerball ablation can be performed.

Section snippets

Endoscopy Hardware

A video-endoscopy trolley that includes monitor, light source, and camera control unit is required. A fully functional (electrically isolated from ground) electrosurgical generator with footswitch and return plate electrodes is necessary for the facilitation of the monopolar circuit.

Instrumentation

A full range of hysteroscopic instruments is used. A variety of instruments provide maximum exposure for hysteroscopy training. Instrument manufacturers and distributors are often happy to sponsor instruments for

Assembly of the Components

The hysteroscopy trainee assembles the hysteroscopic instruments and components. Significant instruction can be given about instrument assembly, care, and handling at this time. We begin by using a diagnostic hysteroscope. A demonstration and explanation of the relevant merits of different diagnostic configurations (e.g., gas versus liquid for distension of the uterine cavity, single flow versus continuous flow sheaths, and 30-degree versus zero-degree optics) are provided.

Diagnostic Hysteroscopy

The cavity of the

Discussion

In the last decade, technological advances in surgical simulators to teach various operative skills have given rise to tools with enormous potential for the education of medical and allied health professionals.4 The issue is whether these simulators are capable of objective and accurate skill simulation compared with the assessment of skills during real-time surgery.5, 6

At this time, no standardized or validated set of tools is available for the assessment of any given individual surgical

Conclusion

In a time when technological advances are expensive and have uncertain clinical value, a surgical simulator that is inexpensive, is readily available, has flexibility in its possible use, and provides education in a number of key surgical areas such as hand-eye co-ordination and electrosurgery offers significant advantages. We recommend this system to any individual or training body as a potential model to teach some aspects of hysteroscopic surgery.

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  • Gynecologic Endoscopy Skills Training and Assessment: Review

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    When a comparison was made between the butternut pumpkin model and a synthetic latex model, all 22 participants preferred the organic model [35]. Authors of these models profess that such simulators enable trainees to learn hand-eye coordination in a setting in which the operative and visual axes have been dissociated and to become familiar with the instruments [35,37]. A papaya model for manual vacuum aspiration has been assessed by participants [36].

  • How useful is hysteroscopy in the postmenopausal period?

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Presented at the 31st meeting of the American Association of Gynecologic Laparoscopists, Miami, Florida, November 20–24, 2002; and at the 12th Annual Scientific Meeting of the Australian Gynaecological Endoscopic Society, Sydney, Australia, May 15–18, 2002.

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