Assessing the realism and face validity of Fix For Life
an embalmed human cadaver model for high-fidelity laparoscopic training
A. Masie Rahimi (Cancer Center Amsterdam, Amsterdam UMC, Amsterdam Skills Centre for Health Sciences)
Michael van Emden (Amsterdam UMC)
Sem F. Hardon (Amsterdam UMC, Cancer Center Amsterdam, Amsterdam Skills Centre for Health Sciences)
Maarten Simons (Onze Lieve Vrouwe Gasthuis)
H. Jaap Bonjer (Amsterdam UMC, Cancer Center Amsterdam, Amsterdam Skills Centre for Health Sciences)
Tim Horeman (TU Delft - Medical Instruments & Bio-Inspired Technology, Amsterdam Skills Centre for Health Sciences)
Freek Daams (Amsterdam UMC, Amsterdam Skills Centre for Health Sciences, Cancer Center Amsterdam)
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Abstract
Background: Human cadaver simulation is vital in medical training, offering realistic experience crucial for skill development, especially in laparoscopic surgery. Traditional cadaver types, like fresh frozen and embalmed, have limitations. Fix4Life (F4L), a novel embalming technique, aims to overcome these drawbacks by providing flexible, pliable tissue without discoloration. This study evaluates the realism and face validity of the F4L embalmed cadaver model for laparoscopic training, aiming to enhance surgical education and patient safety. Methods: Surgical residents and expert surgeons from Amsterdam UMC participated in a hands-on laparoscopy course, performing laparoscopic appendectomy, cholecystectomy, and totally extraperitoneal (TEP) hernia repair on Fix4Life cadavers. Prior to this, residents completed questionnaires immediately after training, while experts reviewed procedure videos and provided evaluations. Ethical approval was obtained, and written consent was acquired from participants. Procedures were supervised, recorded, and securely shared for assessment. Face validation forms were filled by both novices and experts, assessing realism and key aspects of laparoscopic surgery. Statistical analysis included non-parametric tests due to non-normal data distribution. Results: Both residents and experts rated the laparoscopic procedures positively, with the TEP receiving particularly high scores. Residents rated the laparoscopic appendectomy and cholecystectomy as “Good” for all assessment points, while the TEP was frequently rated as “Very Good”. The experts also rated the procedures in the majority of cases as “Good”. Furthermore, novices tended to rate the procedures more favorably than experts, particularly in terms of lifelike tissue manipulation (p < 0.001), tissue color (p = 0.014), and comparability to reality (p = 0.046). Conclusion: The Fix4Life embalming method provides a realistic training modality for laparoscopic appendectomy, laparoscopic cholecystectomy, and TEP.
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