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Multiparous Ewe as a Model for Teaching Vaginal Hysterectomy Techniques

Kerbage, Yohan; Cosson, Michel MD, PhD; Hubert, Thomas VD, PhD; Giraudet, Géraldine MD

doi: 10.1097/AOG.0000000000002363
Contents: Procedures and Instruments

BACKGROUND: Despite being linked to improving patient outcomes and limiting costs, the use of vaginal hysterectomy is on the wane. Although a combination of reasons might explain this trend, one cause is a lack of practical training. An appropriate teaching model must therefore be devised. Currently, only low-fidelity simulators exist. Ewes provide an appropriate model for pelvic anatomy and are well-suited for testing vaginal mesh properties. This article sets out a vaginal hysterectomy procedure for use as an education and training model.

METHOD: A multiparous ewe was the model. Surgery was performed under general anesthesia. The ewe was in a lithotomy position resembling that assumed by women on the operating table.

EXPERIENCE: Two vaginal hysterectomies were performed on two ewes, following every step precisely as if the model were human. Each surgical step of vaginal hysterectomy performed on the ewe and on a woman were compared side by side. We identified that all surgical steps were particularly similar. The main limitations of this model are costs ($500/procedure), logistic problems (housing large animals), and public opposition to animal training models.

CONCLUSION: The ewe appears to be an appropriate model for teaching and training of vaginal hysterectomy.

The multiparous ewe appears to be an excellent model for teaching vaginal hysterectomy techniques.

Université de Lille, Faculté de Médecine, and CHU Lille, Service de gynécologie–obstétrique, Lille, France.

Corresponding author: Yohan Kerbage, Department of Gynecologic Surgery, Jeanne de Flandre Hospital, Avenue Eugène Avinée, 59000 Lille, France; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.