Experimental Animal Model for Training Transobturator and Retropubic Sling Techniques

Introduction: Suburethral slings have become the treatment of choice for stress urinary incontinence. However, the lack of experimental models for surgical training is a problem for beginners. We present a model for sling training and evaluate its acceptance by surgeons who have had prior experience. Materials and Methods: There were 32 surgeons who performed the training program and filled out a questionnaire to evaluate the animal model. Eleven-month-old Santa Inês sheep were selected. The techniques used for minimally invasive transobturator and retropubic sling implantation were reproduced followed by cystoscopy. The anatomical similarities of sheep and humans were evaluated, in addition to the reproducibility of surgical techniques. Results: As far as anatomical similarities of vaginal structures are concerned, 13 surgeons (40.6%) reported similarities and 18 (56.2%) reported a strong correlation. Concerning cystoscopy, 18 (56.2%) found similarities and 13 (40.6%) a strong similarity. As for the transvaginal sling, 10 (3.1%) reported similarities and 19 (59.3%) a strong similarity. Among those who had previous experience with transobturator slings, 91.6% considered that the model presented a similarity or strong similarity. Regarding the degree of recommendation, 9 surgeons (28.1%) would recommend it and 22 (68.7%) would strongly recommend it. Conclusion: Ninety-seven percent of the surgeons would recommend this experimental model for training purposes. To our knowledge this is the first description of a successful animal model for transobturator sling training.