Simulation based training, which is hypothesized to increase skill proficiency among trainees, is currently gaining popularity in pediatric surgical training. High-fidelity simulators are expensive and not easily replicable in low to middle income countries; thus, the use of low-fidelity simulators are being suggested. This type of educational technique may have a role in complex procedures such as pull-through procedure among patients with Hirschsprung's disease. This study aimed to ascertain the development and associated validity of low-fidelity simulators for transanal pull-through among pediatric patients.

This is a validation study of a low-fidelity simulator for transanal pullthrough in pediatric surgery. The model was assembled by carefully harvesting the anus, colon and rectum from a pig cadaver, ensuring the tissues remained intact including the perianal skin. These tissues were then mounted onto a specially designed basket that simulates the human pelvic cavity. The prototype model underwent initial testing to ensure anatomical accuracy and durability. A panel of five pediatric surgeons were tapped for content validation.

The overall validity index of the simulator was 1.00 which was high. All panel experts agreed on the anatomical realism, educational value, and alignment with training objectives. Some positive feedback on its use included its ability to accurately simulate the surgical procedure and its potential to reduce the learning curve for trainees. Another feedback is that it can help clinicians feel more prepared and comfortable when performing the procedure on actual patients after practicing on the simulator. No negative feedback were reported.

The study showed that the use of an animal simulator for practicing transanal pullthrough in pediatric surgery is feasible and valid. This model has the potential to be adapted for educational purposes and hands-on training before doing actual case surgeries. The realistic anatomy and tactile feedback provided by the simulator can help trainees improve their skills and confidence in performing transanal pullthrough.