Top

International Urogynecology Journal

Published in:

01-10-2017 | Original Article

Feasibility and benefits of the ewe as a model for vaginal surgery training

Authors: Yohan Kerbage, Géraldine Giraudet, Chrystèle Rubod, Charles Garabedian, Géraldine Rivaux, Michel Cosson

Published in: International Urogynecology Journal | Issue 10/2017

Abstract

Introduction and hypothesis

The objective was to evaluate the ewe as an animal model for teaching and training in vaginal surgery.

Methods

Twenty-nine postgraduate surgeons attended a training course on vaginal prolapse surgery. After a review of human and sheep anatomy, the participants performed transvaginal meshes, vaginal hysterectomy, SSLF (Richter), and OAS repair in ewes and human cadavers. Participants completed questionnaires on the whole course.

Results

Questionnaires showed the significant superiority of ewes over human cadavers for all items evaluated regarding surgical dissections. Only identification of the sacrospinous ligament and the spine were judged to be similar in ewes and human cadavers. Participants noticed that ewe model is appropriate for vaginal prolapse surgery training for resident and for postgraduate surgeons. Two vaginal hysterectomies were also performed. Operating time, surgery, and anatomy were nearly identical to that of humans. The same conclusions were made while performing sacrospinous ligament fixation (Richter) and obstetric anal sphincter injury repair.

Conclusion

This series indicates that the ewe is a useful animal model for teaching vaginal surgery.

Available only for authorised users

Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BWJ, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2015;8:CD003677.

Unger CA, Barber MD. Vaginal mesh in pelvic reconstructive surgery: controversies, current use, and complications. Clin Obstet Gynecol. 2015;58(4):740–53.CrossRefPubMed

Kane SM, Siddiqui NY, Bailit J, Blanchard MH. Duty hour restrictions, ambulatory experience, and surgical procedural volume in obstetrics and gynecology. J Grad Med Educ. 2010;2(4):530–5.CrossRefPubMedPubMedCentral

Couri BM, Lenis AT, Borazjani A, Paraiso MFR, Damaser MS. Animal models of female pelvic organ prolapse: lessons learned. Expert Rev Obstet Gynecol. 2012;7(3):249–60.CrossRefPubMedPubMedCentral

Riccetto CLZ, Palma PCR, Thiel M, Miyaoka R, Netto NR. Experimental animal model for training transobturator and retropubic sling techniques. Urol Int. 2007;78(2):130–4.CrossRefPubMed

Development of an animal model for training in vaginal surgery for pelvic organ prolapse. IUGA Academy. MANSOOR A. 2015;141851.

Krause H, Goh J. Sheep and rabbit genital tracts and abdominal wall as an implantation model for the study of surgical mesh. J Obstet Gynaecol Res. 2009;35(2):219–24.CrossRefPubMed

Barnhart KT, Izquierdo A, Pretorius ES, Shera DM, Shabbout M, Shaunik A. Baseline dimensions of the human vagina. Hum Reprod Oxf Engl. 2006;21(6):1618–22.CrossRef

DeLancey JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol. 1992;166(6 Pt 1):1717–24; discussion 1724–8.

10.

Abramowitch SD, Feola A, Jallah Z, Moalli PA. Tissue mechanics, animal models, and pelvic organ prolapse: a review. Eur J Obstet Gynecol Reprod Biol. 2009;144 Suppl 1:S146–58.CrossRefPubMed

11.

McLean JW. Vaginal prolapse in sheep. NZ Vet J. 1956;4(2):38–55.CrossRef

12.

Barlow AM. Replacement of ovine vaginal prolapse. Vet Rec. 1998;142(5):120.PubMed

13.

Scott PR, Gessert ME. Ultrasonographic examination of 12 ovine vaginal prolapses. Vet J Lond Engl 1997. 1998;155(3):323–4.

14.

Nygaard I, Kreder K, Mueller E, Brubaker L, Goode P, Visco A, et al. Does urethral competence affect urodynamic voiding parameters in women with prolapse? Neurourol Urodyn. 2007;26(7):1030–5.CrossRefPubMed

15.

Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160–6.CrossRefPubMed

16.

Ennen S, Kloss S, Scheiner-Bobis G, Failing K, Wehrend A. Histological, hormonal and biomolecular analysis of the pathogenesis of ovine Prolapsus vaginae ante partum. Theriogenology. 2011;75(2):212–9.CrossRefPubMed

17.

Bassett EG. The anatomy of the pelvic and perineal regions of the ewe. Aust J Zool. 1964;13:201–41.CrossRef

Title: Feasibility and benefits of the ewe as a model for vaginal surgery training
Authors: Yohan Kerbage
Géraldine Giraudet
Chrystèle Rubod
Charles Garabedian
Géraldine Rivaux
Michel Cosson
Publication date: 01-10-2017
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 10/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3313-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Feasibility and benefits of the ewe as a model for vaginal surgery training

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2017

Vaginal repair of a vesicocervical fistula after labored-cesarean delivery without concomitant hysterectomy

The importance of a full thickness vaginal wall dissection. Comment on “Transvaginal mesh: a historical review and update of the current state of affairs in the United States”

Two techniques for assessing postoperative voiding function, a randomized trial

Response to Comment by Ting et al.: The importance of a full-thickness vaginal wall dissection

Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial

Erratum to: Surgeons’ views on sling tensioning during surgery for female stress urinary incontinence