eP601 - Cadaveric Model for Ileoanal Pouch Procedure: A Feasibility Study

Purpose/Background: Background: The need for surgery in the treatment of inflammatory bowel disease has been known for 20 years to be decreasing in incidence globally. Colectomy for ulcerative colitis specifically has seen a drastic drop in performance, likely as a result of treatment with biologic agents. Training programs in colorectal surgery have been particularly impacted, as total proctocolectomy with ileoanal pouch (IPAA) is one of the most extensive procedures performed in the specialty, and ulcerative colitis is the most common indication for the procedure. Educators in colorectal surgery are investigating other avenues in which this procedure can be taught to trainees in a safe and effective manner. SIU, long a leader in surgical education research, has a well-established Surgical Simulation Laboratory with the necessary materials and personnel to support this feasibility study.Methods/Interventions:

Methods: We have designed a feasibility study to teach the IPAA procedure to trainees in colorectal surgery in a high fidelity model utilizing cadaver torsos in a surgical simulation laboratory setting. The curriculum includes a didactic and a practical module. The didactic module includes patient selection and assessment, nuances of body habitus. The practical module includes operative approach to total proctocolectomy, ileal pouch construction, technique for assuring adequate length to perform a pouch-anal anastomosis, and performance of the anastomosis. The problem of the pouch that will not reach the required area for safe anastomosis will also be modeled. We anticipate sufficient cadaveric material for both minimally invasive and open approaches to be undertaken. Curriculum prerequisites include advanced operative skills with both laparoscopic and open approaches to colectomy.Cadaver torsos employed are fresh. Previous uses have shown remarkable fidelity regarding in vivo insufflation for minimally invasive procedures as well as fidelity of tissue handling. Standard operating laparoscopic towers and instruments are used as well as standard instrumentation for open approach.Results/Outcomes: Outcomes: The primary outcome of the feasibility study will be demonstration of success at teaching the IPAA procedure, both preoperative assessment and technical aspects, to colorectal surgery trainees and other senior surgical trainees.Conclusion/

Discussion:

Discussion: This will allow us to consider expanding the curriculum to invite trainees from other colorectal training programs to participate in the curriculum as well, with the secondary outcome of providing colorectal surgical training programs another tool for the training of a specialty procedure that has become far less common, yet remains a key knowledge point for the specialty of Colorectal Surgery.