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Accepted for/Published in: JMIR Medical Education

Date Submitted: Sep 19, 2024
Date Accepted: Sep 22, 2025

The final, peer-reviewed published version of this preprint can be found here:

Developing a Realistic and Cost-Effective Training Model (MaiSurge) for Laparoscopic Hysterectomies to Train and Assess Surgical Skill: Prospective Nonrandomized Controlled Trial

Brechter AM, Schwab R, Dold C, Skala C, Schröder M, Schiestl L, Gillen K, Brenner W, Hasenburg A, Schmidt MW

Developing a Realistic and Cost-Effective Training Model (MaiSurge) for Laparoscopic Hysterectomies to Train and Assess Surgical Skill: Prospective Nonrandomized Controlled Trial

JMIR Med Educ 2026;12:e66369

DOI: 10.2196/66369

PMID: 41678655

PMCID: 12900277

MaiSurge – A realistic and cost-effective training model for laparoscopic hysterectomies to train and assess surgical skill: A prospective non-randomised, controlled trial

  • Anna Maria Brechter; 
  • Roxana Schwab; 
  • Christoph Dold; 
  • Christine Skala; 
  • Maria Schröder; 
  • Lina Schiestl; 
  • Katharina Gillen; 
  • Walburgis Brenner; 
  • Annette Hasenburg; 
  • Mona Wanda Schmidt

ABSTRACT

Background:

Laparoscopic surgery has a flatter learning curve compared to traditional open surgery. Therefore, structured programs and realistic training models are imperative to ensure patients’ safety. However, commercially available models are often too expensive or technically unrealistic for continuous surgical training.

Objective:

The aim of this trial was to develop a cost-efficient and highly realistic uterus model to perform a total laparoscopic hysterectomy (TLH) and to evaluate its applicability.

Methods:

A training model (MaiSurge) for a total laparoscopic hysterectomy with salpingectomy/adenectomy was developed using a 3D printer and different cast materials. Polyvinylalcohol was used to allow the use of electrosurgery. To gather first validity evidence, Novice and Expert gynecologists performed a TLH on the model. Operative time as well as surgical performance scores (H-OSATS) were compared between both groups.

Results:

Twelve participants in the Novice group and eighteen participants in the Expert group completed the simulation. The Experts performed significantly better than the Novices in the modified H-OSATS-Score (74±12.9 vs 60.3 ± 14.9, p=0.049) and faster than the Novices (69.5 minutes (49.5-74.3) vs 37.5 minutes (30.5-38.8), p<0.001). Around 92% of Novices felt that they had improved their surgical performance after training on the MaiSurge uterus model. Compared to that, only 12.5% of Experts reported an improvement in their performance. Overall, all participants agreed that the new MaiSurge uterus model should be integrated into training curricula to improve the performance of residents for TLHs.

Conclusions:

A new highly realistic and cost-effective training model (MaiSurge) to perform a TLH was developed. The model distinguishes between good and poor laparoscopic performances and can thus be used in training as well as assessment of surgical skills. The possibility of simulating even complex laparoscopic procedures in a realistic environment may be an opportunity to train a future generation of gynecologists without compromising patient safety or exhausting the limited availability of operating room time. Clinical Trial: Deutsche Register für Klinische Studien (DRKS00031825)


 Citation

Please cite as:

Brechter AM, Schwab R, Dold C, Skala C, Schröder M, Schiestl L, Gillen K, Brenner W, Hasenburg A, Schmidt MW

Developing a Realistic and Cost-Effective Training Model (MaiSurge) for Laparoscopic Hysterectomies to Train and Assess Surgical Skill: Prospective Nonrandomized Controlled Trial

JMIR Med Educ 2026;12:e66369

DOI: 10.2196/66369

PMID: 41678655

PMCID: 12900277

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