OBJECTIVES: To develop and test a porcine model to help teach the techniques needed to perform laparoscopic partial nephrectomy (LPN), which is a technically challenging procedure with necessary reconstructive skills that are difficult to transfer. METHODS: A tumor model was created by unilateral subcapsular percutaneous injection of liquid plastic (Smooth-Cast 320) in five pig kidneys. Five Washington University urologists performed LPN and assessed the efficacy of the tumor model. Subsequently, the tumor model was evaluated as a tool for teaching LPN during the Washington University Advanced Laparoscopic and Robotic Urologic Oncology Course. Twenty-eight participants performed unilateral porcine LPN with the tumor model. Questionnaires were used to assess the utility of this tumor model. RESULTS: Unilateral tumors were successfully created in five pigs and remained intact during all LPN procedures. Visually, the tumors appeared as white exophytic masses. Ultrasonography revealed a well-circumscribed, hypoechoic lesion and a mean diameter of 2.02 cm. The mean operative time was 32.4 minutes. In subsequent testing, 24 (86%) of the 28 participants returned the questionnaire, and 96% responded that the tumor model had enhanced their LPN learning experience. Seven course participants (29%) reported problems with hemostasis, ultrasonography, or laparoscopic instrumentation. Two tumor model-related complications occurred. During the initial evaluation, one pig experienced a fatal pulmonary embolism of the plastic. During the course, a second animal experienced extravasation of the solution into the renal collecting system. CONCLUSIONS: For surgical education purposes, the Smooth-Cast model is an effective surgical tool for LPN. Most of the surgeons in this evaluation believed the model enhanced their learning experience.
OBJECTIVES: To develop and test a porcine model to help teach the techniques needed to perform laparoscopic partial nephrectomy (LPN), which is a technically challenging procedure with necessary reconstructive skills that are difficult to transfer. METHODS: A tumor model was created by unilateral subcapsular percutaneous injection of liquid plastic (Smooth-Cast 320) in five pig kidneys. Five Washington University urologists performed LPN and assessed the efficacy of the tumor model. Subsequently, the tumor model was evaluated as a tool for teaching LPN during the Washington University Advanced Laparoscopic and Robotic Urologic Oncology Course. Twenty-eight participants performed unilateral porcine LPN with the tumor model. Questionnaires were used to assess the utility of this tumor model. RESULTS: Unilateral tumors were successfully created in five pigs and remained intact during all LPN procedures. Visually, the tumors appeared as white exophytic masses. Ultrasonography revealed a well-circumscribed, hypoechoic lesion and a mean diameter of 2.02 cm. The mean operative time was 32.4 minutes. In subsequent testing, 24 (86%) of the 28 participants returned the questionnaire, and 96% responded that the tumor model had enhanced their LPN learning experience. Seven course participants (29%) reported problems with hemostasis, ultrasonography, or laparoscopic instrumentation. Two tumor model-related complications occurred. During the initial evaluation, one pig experienced a fatal pulmonary embolism of the plastic. During the course, a second animal experienced extravasation of the solution into the renal collecting system. CONCLUSIONS: For surgical education purposes, the Smooth-Cast model is an effective surgical tool for LPN. Most of the surgeons in this evaluation believed the model enhanced their learning experience.
Authors: Réka Székely; Ferenc Imre Suhai; Kinga Karlinger; Gábor Baksa; Bence Szabaczki; László Bárány; Gergely Pölöskei; Gergely Rácz; Ödön Wagner; Béla Merkely; Tamás Ruttkay Journal: Pathol Oncol Res Date: 2021-04-26 Impact factor: 3.201