[Three dimensional anatomy and virtual surgery for transobturator approach].

INTRODUCTION Stress Urinary Incontinence (SUI) may be managed by transobturator approach. We developed a three-dimensional model, for understanding the surgical anatomy and manual training as well, in order to reduce the learning curve for pelvic surgeries. OBJECTIVE To demonstrate in synthetic models, the anatomical basis for the management of SUI and cystocele. METHOD The anatomical model includes: pelvic bones, the main layers of the pelvic muscles, ligaments and fascias. The surgical devices were transobturator needles, synthetic slings and meshes for anterior vaginal wall repair. The workshop was carried out with an anatomical overview and hands-on training in this tridimentional models and finally surgery in animals. At the end, a questionnaire was applied to verify the impact of this tool in the learning process and trainee satisfaction. RESULTS As far as the anatomical concept, 90% (n=72) of the participants classified this model as very good and 10% (n=8) as good. As a tool for understanding the tridimentional pelvic floor anatomy applied to transobturator procedures there were 100% of approval. CONCLUSIONS This synthetic model allows for understanding the pelvic floor tridimentional anatomy and surgical procedures as well. Further skill is got in the animal model reducing the learning curve for transobturator procedures.