Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S28: LAPAROSCOPY / ROBOTICS 2

Moderators: Mohan Gundeti (USA), Henning Olsen (Denmark)

ESPU Meeting on Saturday 17, October 2015, 16:07 - 16:49

16:07 - 16:10

S28-1

(PP)

★

PYELOPLASTY IN ROBOTIC SURGERY (PIRS): VALIDATION OF A NOVEL

SURGICAL TRAINING MODEL

Mesrur Selcuk SILAY

, Monty AGHAZADEH

, Minki BAEK

, Friedrich VON RUNDSTEDT

, Alvin C GOH

and Chester J KOH

1) TEXAS CHILDREN'S HOSPITAL AND BAYLOR COLLEGE OF MEDICINE, DIVISION OF PEDIATRIC UROLOGY,

DEPARTMENT OF UROLOGY, Houston, USA - 2) THE METHODIST HOSPITAL AND BAYLOR COLLEGE OF MEDICINE,

DEPARTMENT OF UROLOGY, Houston, USA

PURPOSE

Increased utility of robotic pyeloplasty in children requires realistic simulation for efficient training and objective skills

assessment. We describe a novel training model and its validation in surgeon volunteers and porcine kidneys.

MATERIAL AND METHODS

A total of 19 urological surgeons enrolled into the study. Subjects were categorized according to their robotic surgery

experience; novice (0 cases), intermediate (100 cases). Baseline demographics and prior minimally invasive surgery

experience were recorded. All participants were instructed with a video of the PIRS model prior to performing the

exercise. A dilated ureter and renal pelvis were achieved by installation of saline via the distal ureter with clamping. Five

mm robotic instruments were used for this model. Global Evaluative Assessment of Robotic Skills (GEARS) scores and

exercise specific performance scores were recorded. A post-training survey was used to assess for face (simulator

realism) and content (training usefulness) validity. Statistical analysis included comparison of all variables between the

three groups (construct validity).

RESULTS

There were 10 novices, 6 intermediates and 3 experts. Participants rated the PIRS model as very realistic (median visual

analog score 4/5) and rated the tasks difficulty at an appropriate level (3/5). Participants confirmed that the tasks were

useful for training (5/5), where an experienced robotic surgeon could perform all tasks (5/5). Experts outperformed

intermediates and novices in median GEARS scores (30.0 vs 21.7 vs 14.7, respectively, p<0.05).

CONCLUSIONS

The PIRS training model is a reproducible and realistic model for pediatric robotic pyeloplasty (face, content and

construct validity).