Development and use of a Porcine Liver Model (PLM) for robotic liver surgery training

ObjectivesEx-vivo models may be useful in shortening the learning curve and increasing proficiency in robotic surgery. Our team developed an ex-vivo Porcine Liver Model (PLM) for Hepato-Pancreato-Biliary (HPB) robotic surgery training we aimed to validate it.DesignThe model was used in a robotic HPB surgery course. A Likert scale survey was administered to participants, investigating reliability, face validity, content validity and operator confidence.Results25 surgeons responded to the survey: 11 residents (median training 4 years), 14 consultants (median practice 5 years). The PLM was used on a step-by-step chain of exercises including cholecystectomy, hepatic hilum dissection, liver mobilization, transection and hepato-jejunal anastomosis. The model was costless and easy to prepare. The average results on the survey were above 4 for reliability, face validity and content validity (4.3, 4.2, 4.5 respectively) and 3.9 for operator confidence; The model scored better among residents, in particular in terms of reliability (4.5 vs 4.1, p=0.05) and face validity (4.4 vs 3.9, p=0.03).ConclusionsWe developed an ex-vivo liver model that may be a valuable tool for robotic surgery training in HPB. This is particularly useful for surgeons with no prior experience with the Da Vinci platform or with minimally invasive liver surgery.