Simulation based training versus mentorship in the initial learning curve of holmium laser enucleation of the prostate (HoLEP) surgery. The effects of simulation training on surgical success, complication rates, and surgeon workload: a prospective comparative study.

OBJECTIVE

To evaluate the impact of mentor-guided anatomical endoscopic enucleation of the prostate (AEEP) surgical training on a realistic hydrogel-based prostate model on the outcomes of HoLEP surgery performed on patients. MATERIALS AND

METHODS

Four urologists without prior AEEP experience were divided into two groups. Group 1 performed five cases on a phantom model under mentorship. Then, both groups performed 10 HoLEP procedures per surgeon. The NASA-Task Load Index (NASA-TLX) was used to assess cognitive and physical workload after each case. Perioperative and three-month follow-up data were compared.

RESULTS

The mean surgical duration was 102.65 min for Group 1 and 133.8 min for Group 2 (p < 0.05). Group 2 had a longer laser time (41.05 min vs. 63.15 min, p < 0.05) and higher energy usage (248.4 kJ vs. 339.9 kJ, p < 0.05, Table 2). Surgeons in Group 1 demonstrated lower mental demand, physical demand, temporal demand, effort, discomfort levels, and total workload scores (p < 0.05, Table 3).

CONCLUSION

Simulation-based training has been shown to be a crucial tool in improving success rates and reducing complication rates in long procedures such as HoLEP. Additionally, it significantly decreases mental and physical workload. Expanding the use of simulation training will enhance the quality of surgical education and play a key role in ensuring patient safety.