Surgical training in gynecological oncology using soft-embalmed human cadavers: first pilot study

Archives of Gynecology and Obstetrics https://doi.org/10.1007/s00404-025-08034-2 RESEARCH Surgical training in gynecological oncology using soft‑embalmed human cadavers: first pilot study Dariya Jaeger1 · Eric Hinrichs1 · Michael Eichbaum3 · Michael Friedrich4 · Friedrich‑Carl von Rundstedt5 · Sebastian D. Schäfer6 · Ralf Schoppe7 · Sven Schumann8 · Gebhard Reiss1 · Georg Feigl1 · Markus C. Fleisch1,2 Received: 20 March 2025 / Accepted: 9 April 2025 © The Author(s) 2025 Abstract Context Gynecological oncology requires a high level of surgical expertise. Therefore, new options for realistic surgical training for complex surgical procedures are required. This study aimed to determine how the trainees and experts perceive the use of soft-embalmed cadavers and how realistic it is compared to training on living patients. Methods A 2-day hands-on workshop was conducted. Eight trainees were able to practice laparoscopic and open surgical skills on four soft-embalmed cadavers. The training was carried out under the supervision of four gynecological oncology experts, one uro-oncological expert in complication management, and one expert in clinical anatomy. The feedback from trainees and experts was assessed using a structured questionnaire on a 5-point Likert scale. All the procedures were performed in a fully equipped surgical environment and complied with the principles outlined in the Declaration of Helsinki. Results The trainees assessed the anatomical and manipulative characteristics of the soft-embalmed cadavers as similar to real conditions. Color and consistency hardly differed from those of the live patients. The trainees stated that soft-embalmed cadavers were beneficial for learning and increased their self-confidence. In terms of realism, all surgical steps were rated a median of 4 out of 5 or higher on a Likert scale by both trainees and experts. Conclusion The use of soft-embalmed cadavers for training was perceived positively by trainees and experts. The evaluation results showed a high degree of realism compared with training on living patients. Hands-on training on soft-embalmed cadavers offers great potential as a new training method for surgical skills in gynecological oncology. Keywords Gynaecology · Gynecology · Oncology · Cadaver · Education · Surgical training · Skills training · Anatomy · Soft embalming · Dodge embalming · Thiel embalming * Dariya Jaeger 1 Institute of Anatomy and Clinical Morphology, University of Witten/Herdecke, Gleiwitzer Strasse 5, 58454 Witten, Germany 2 Department of Obstetrics and Gynecology, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany 3 Department of Obstetrics and Gynecology, Helios Klinikum Wiesbaden, Wiesbaden, Germany 4 Department of Obstetrics and Gynecology, Helios Klinikum Krefeld, Krefeld, Germany 5 Department of Urology, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany 6 Department of Obstetrics and Gynecology, Ludgerus Kliniken Münster GmbH, Clemenshospital, Münster, Germany 7 MoViDo gGmbH, Essen, Germany 8 Institute of Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany Vol.:(0123456789) Archives of Gynecology and Obstetrics What does this study add to the clinical work The use of soft-embalmed cadavers, according to Thiel and Dodge's methods, represents a promising educational approach for realistic surgical training for complex procedures in gynecological oncology. Introduction Gynecological oncology (GO) requires a high level of surgical expertise. The demand and significance of structured education of young surgeons is further highlighted by the findings of numerous studies that indicate a correlation between the level of surgical training and postoperative outcomes [1, 2] The high degree of complexity involved in these surgical procedures requires the implementation of comprehensive training concepts that incorporate various educational methodologies. The European Society of Gynecological Oncology (ESGO) has developed a curriculum to standardize training and enhance the preparedness of surgeons to undertake complex procedures such as cytoreductive surgery for ovarian cancer [3]. This initiative demonstrates a broader recognition of the necessity for comprehensive training programs that encompass both surgical skills and multidisciplinary collaboration, which are essential for managing the complexities associated with gynecological malignancies [3, 4]. An innovative approach is the use of soft-embalmed human cadavers. Research findings indicate that cadaveric dissection workshops significantly improve the surgical anatomical knowledge of gynecological oncology fellows. Furthermore, the participants reported high levels of satisfaction and perceived value from such training experiences [5]. Laparoscopic techniques and surgical anatomy workshops are essential for trainees, providing hands-on experience between theoretical knowledge and practical application [2]. Soft-embalmed cadavers according to Thiel [6] offer advantages over traditional formalin-preserved specimens [7], including better preservation of tissue texture and color, which facilitates a more realistic learning environment [7, 8]. Soft-embalmed cadavers according to Dodge (Dodge Solutions, Dodge Co., Billerica, MA, USA) also exhibit a high degree of realism, flexibility, and a high degree of realism in the colors of fresh tissue [9, 10]. Surgical training on Thiel embalmed cadavers (TeCs) provides an effective and realistic training option for challenging surgical procedures, which has already been demonstrated in previous studies [11–13]. To the best of our knowledge, there is only one published study on the use of Dodge embalmed cadavers (DeCs) in surgical workshops [10]. To date, there have been no reports of the use of DeCs in GO. The objective of this study was to provide a detailed account of our experiences with the inaugural pilot study utilizing soft-embalmed cadavers in accordance with Dodge’s and Thiel’s methods for surgical hands-on training in GO, including laparoscopic and open surgical techniques. Additionally, we aimed to ascertain the training experiences of trainees and experts regarding realism and special aspects of training on soft-embalmed cadavers as educational concepts. Material and methods Soft‑embalmed human cadavers: Thiel’s and Dodge’s methods Four soft-embalmed cadavers were used during training. Two cadavers were preserved using the Thiel method, and two cadavers were preserved using the Dodge method (Dodge Solutions, Dodge Co., Billerica, MA, USA). TeCs were donated to the Department of Anatomy at Gutenberg University of Mainz and subsequently transferred to the University of Witten/Herdecke for use in postgraduate courses following the completion of the embalming process. DeCs were donated to a non-profit prosecture MoViDo gGmbH placed in Essen, Germany, and given to the University of Witten/Herdecke for scientific examination f (...truncated)