EUPSA Best of the Best Winner

The transanal endorectal pull-through (TERT) is a common surgical procedure in the treatment of Hirschsprung disease.

The TERT procedure consists of several component steps that require a structured approach and sufficient training is needed to acquire the skills to perform it.

Given the relatively rare nature of Hirschsprung disease, training for the TERT procedure can be challenging.

The low-cost TERT training model consists of a reusable wooden frame base, a sponge body, a silicone top layer mimicking skin, and a multi-layer balloon design simulating the different layers of the rectum and mesorectum.

Participants were recruited during the pediatric colorectal surgery course in 2020 and 2021, totaling 18 participants: 2 experts and 16 residents and fellows.

The model scored well on haptics, visual aspects and realism with a median score of 4 on a five-point Likert scale.

The model scored a median of 4.5 as a good tool to train the component steps of the TERT procedure.

Participants regarded training on the model as a valuable use of time and considered it useful during the workshop (median score of 5) and suitable for repetitive practice at home.

The take-home nature of the model makes it accessible not only to training pediatric surgeons but also to other countries around the world that may not have access to simulatory tools.

The researchers have not yet transferred the model to the clinical setting with a formal critical assessment form to extrapolate advances made on the model to evaluating functioning in the operating theater.

The study has been elaborated to include five experts total (expanded from the initial two), whose main feedback is that the model's true strength is its suitability for training the component steps of the procedure.

For the true dissection, the haptic feedback requires operative experience as well, which the model cannot fully replicate.

The additive value of the model is training the component steps so trainees have those internalized and don't have to go through that part of learning a procedure in the patient themselves.

Performance evaluation on the model uses a critical assessment form that looks at effectiveness of each step, sequence, and efficiency of movement, and can be used for self-assessment and peer assessment.