A Multimodal Animal-Tissue Simulation Model for Training Single-Stage Hypospadias Repair Techniques: A Descriptive Proof-of-Concept Study

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Abstract
Although hypospadias is a common condition and pediatric urology fellowship training programs exist, they have recently been described as insufficient to mediate the necessary skills to master hypospadias surgery. Simulation-based education is increasingly promoted, but training is limited by simulators that typically focus on a single surgical technique. We aimed to develop and demonstrate a single adaptable simulator capable of simulating the six commonly used single-stage hypospadias repair methods. A model made from lamb tenderloin and chicken skin was used to simulate the six most common single-stage repair techniques: The Meatal-based Flap (Mathieu), the Tubularized Preputial Island Flap, the Island Onlay, the Meatal Advancement and Glanduloplasty (MAGPI) technique, the Koyanagi–Nonomura technique, and the Yoke repair technique. Simple adaptations were employed to modify the model, including sulcus and meatal repositioning, as well as suture- and resection-based skin adaptations. The model could be adapted to simulate six major hypospadias correction techniques on one single platform. The model required minimal resources and preparation, making it accessible and cost-effective. With the animal tissue model presented, the simulation of six commonly used single-stage reconstruction techniques on one adaptable, easily accessible platform becomes possible. Formal validation studies are warranted prior to their incorporation into standardized training curricula.

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