Development of a laparoscopic partial nephrectomy training model

DOI: 10.22591/magyurol.2018.1.sarlosd.8

Authors:
Sarlós Donát Péter dr., Czétány Péter med.
PTE KK, Urológiai Klinika, Pécs (igazgató: Szántó Árpád dr.

Summary

Objective: Urologists seek opportunities for the development of surgical skills. Our objective was the development of a laparoscopic partial nephrectomy (PN) training model.
Methods: The base of the PN model is polyurethane foam, in which a silicone artificial tumour is implanted. Latex Foley catheter and examination glove fingers are used to simulate vessels and collecting system. Sixteen medical students, who were novice in laparoscopy tested the model, performing a total of 160 PNs. CAE LapVR laparoscopic virtual-reality surgical simulator was used to test laparoscopic dexterity before and after the training.
Results: The model’s mechanic properties show good similarity with the normal human kidney. The steps of the PN operation can be trained, bleeding and urine leakage can be simulated. The price of the materials for one model is under 1 Euro and can be self-produced in less than 10 minutes. During the testing candidates showed a significant progression in resection time (746±338 s vs. 244±123 s, p<0.01), number of stitches placed (1 [0–2] vs. 4.5 [2–5.5], p<0.05) and post-operative bleeding (19.1±2.6 ml vs. 15.7±4.9 ml, p<0.05). Laparoscopic peg transfer, cutting and stitching dexterity has improved, along with significant reduction of unnecessary movements.
Conclusions: We created a widely available and low cost model for PN training that has been proven to better laparoscopic surgical skills. We hope it will help advance skill training in urology and flatten PN learning curves.

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