443Shergill et al. had 36 participants use the model for SPT insertion and scored their
ability using a 0–5 visual analog scale. The authors found that before training, the
participants had an average score of 3.14 for ability to do SPT placement, which
increased to 4.48 after the course. This suggests that this model may be a viable and
easy method to help junior residents learn this procedure.
A second model was published by Hossack et al. in 2013, which, again, is rela-
tively simple in nature [ 7 ]. The model is made by filling a standard party balloon
with tap water and affixing it with tape. The authors recommended “Mefix” tape
(Molnlycke Health Care, Sweden) because it kept adherence to the balloon even
when wet, prevented the balloon from popping, and provided realistic resistance to
trocar placement. The balloon was then placed within a plastic container with a hole
cut in the lid. On top of the balloon, a standard household sponge was placed (rep-
resenting perivesical fat), on top of which a three-layer square of Transpore (3 M)
tape was placed (rectus sheath), and finally covered with another sponge (abdomi-
nal wall fat). In their study with 30 surgical resident participants, the authors found
that 96% felt the model accurately represented a bladder and 84% felt much more
confident in performing SPT insertion [ 7 ].
Singal et al. described the most recently published model in 2015 [ 8 ]. The model
was created by first making a bony pelvis from urethane foam and stabilized with
resin glue. Plastic parts simulating the anterior superior iliac spine and pubic sym-
physis were embedded within the foam to provide palpable bony landmarks. The
bladder was constructed from silicone rubber with attached IV tubing and Luer
Lock syringe for instillation of fluid. This was then filled and placed within the bony
pelvis and covered with multiple skin and fat layers (made of silicone rubber and gel
wax). The model was studied with 25 rural general surgeons under the supervision
of urologists. The surgeons scored the model well in terms of value as a training or
testing model (4.1/5) and overall realism (3.9/5) [ 8 ].
Fig. 24.3 (continued)
bc24 Simulation in Surgery