Development and Validity of a Silicone Renal Tumor Model for Robotic Partial Nephrectomy Training

• Published in: Urology (Ridgewood, N.J.) N.J.), 2018-04, Vol.114, p.114-120
• Main Authors: Monda, Steven M., Weese, Jonathan R., Anderson, Barrett G., Vetter, Joel M., Venkatesh, Ramakrishna, Du, Kefu, Andriole, Gerald L., Figenshau, Robert S.
• Format: Article
• Language: English
• Subjects: Adult; Clinical Competence; Humans; Kidney Neoplasms - surgery; Laparoscopy - education; Middle Aged; Models, Anatomic; Nephrectomy - education; Printing, Three-Dimensional; Robotic Surgical Procedures - education; Silicones; Simulation Training; Task Performance and Analysis
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2018.01.030

To provide a training tool to address the technical challenges of robot-assisted laparoscopic partial nephrectomy, we created silicone renal tumor models using 3-dimensional printed molds of a patient's kidney with a mass. In this study, we assessed the face, content, and construct validity of these models. Surgeons of different training levels completed 4 simulations on silicone renal tumor models. Participants were surveyed on the usefulness and realism of the model as a training tool. Performance was measured using operation-specific metrics, self-reported operative demands (NASA Task Load Index [NASA TLX]), and blinded expert assessment (Global Evaluative Assessment of Robotic Surgeons [GEARS]). Twenty-four participants included attending urologists, endourology fellows, urology residents, and medical students. Post-training surveys of expert participants yielded mean results of 79.2 on the realism of the model's overall feel and 90.2 on the model's overall usefulness for training. Renal artery clamp times and GEARS scores were significantly better in surgeons further in training (P ≤.005 and P ≤.025). Renal artery clamp times, preserved renal parenchyma, positive margins, NASA TLX, and GEARS scores were all found to improve across trials (P