Standardized porcine robotic transversus abdominis release training: the SPORT model

TL;DR

The SPORT model is a realistic training framework for robotic transversus abdominis release using live pigs, helping surgeons practice complex abdominal wall reconstruction techniques.

Contribution

The SPORT model introduces a standardized, high-fidelity porcine training platform for robotic TAR, validated for anatomical accuracy and surgical reproducibility.

Findings

The SPORT model replicates key human abdominal wall anatomy, including the arcuate line and watershed zone.

A step-by-step rTAR protocol was developed and tested on multiple robotic platforms.

The model provides a structured training framework to bridge synthetic/cadaveric training and live surgery.

Abstract

Robotic platforms are increasingly adopted for complex abdominal wall reconstruction, yet transversus abdominis release (TAR) remains technically demanding with a steep learning curve. Structured training models are therefore essential to ensure safe implementation. Building on the experience of a previous model for inguinal hernia repair, the SPORT (Standardized POrcine Robotic Transversus abdominis release Training) model was developed as a stepwise, high-fidelity platform for robotic TAR.

Ethical approval was obtained (EC2021/067) under the Belgian Animal Use Act. Crossbred pigs (Landrace × Large White, 14–16 weeks, ~ 50 kg) underwent open and laparoscopic dissections to assess abdominal wall anatomy. Based on these findings, a structured stepwise rTAR protocol was developed and tested on standard robotic platforms (da Vinci Xi, da Vinci X, Hugo RAS, Versius). This study does not include quantitative or qualitative performance data; rather, it provides a methodological description and validation of a standardized, reproducible training framework for robotic transversus abdominis release using a live porcine model.

The SPORT model reproduces key anatomical features of the human abdominal wall, including the arcuate line, the watershed zone at the costal margin, and the cranial extension of the transversus abdominis. A structured step-by-step description is provided, emphasizing critical landmarks, technical pitfalls, and system-specific docking maneuvers.

The SPORT model offers a realistic and reproducible training framework for robotic TAR, allowing surgeons to practice both classical and modified techniques before performing them in human patients. By bridging the gap between synthetic or cadaveric training and live surgery, SPORT represents an essential component of structured curricula for robotic abdominal wall reconstruction.

The online version contains supplementary material available at 10.1007/s00464-025-12484-9.

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