V02-07 DEVELOPMENT AND VALIDATION OF A BENCHTOP SIMULATOR FOR ULTRASOUND GUIDED PERCUTANEOUS NEPHROLITHOTOMY TRAINING USING 3D PRINTING AND HYDROGEL MOLDING

Abstract

You have accessJournal of UrologyCME1 Apr 2023V02-07 DEVELOPMENT AND VALIDATION OF A BENCHTOP SIMULATOR FOR ULTRASOUND GUIDED PERCUTANEOUS NEPHROLITHOTOMY TRAINING USING 3D PRINTING AND HYDROGEL MOLDING Lauren Shepard, Nathan Schuler, Aaron Saxton, Patrick Saba, Andrew Cook, Tyler Holler, Karen Stern, David Tzou, Helena Chang, Justin Ahn, Thomas Tailly, Thomas Chi, and Ahmed Ghazi Lauren ShepardLauren Shepard More articles by this author , Nathan SchulerNathan Schuler More articles by this author , Aaron SaxtonAaron Saxton More articles by this author , Patrick SabaPatrick Saba More articles by this author , Andrew CookAndrew Cook More articles by this author , Tyler HollerTyler Holler More articles by this author , Karen SternKaren Stern More articles by this author , David TzouDavid Tzou More articles by this author , Helena ChangHelena Chang More articles by this author , Justin AhnJustin Ahn More articles by this author , Thomas TaillyThomas Tailly More articles by this author , Thomas ChiThomas Chi More articles by this author , and Ahmed GhaziAhmed Ghazi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003232.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ultrasound-guided percutaneous nephrolithotomy (US-PCNL) is an effective and safe approach for management of large renal stones, yet adoption has been limited. The vast majority of US-PCNL are performed in the prone position vs supine position (80% vs 20%); however, there is a need for a safe, realistic procedural training platform for both approaches. We have previously demonstrated the ability of similar hydrogel simulations to improve operative outcomes during fluoroscopic PCNL training. Our objective was the development of a benchtop, non-biohazardous US-PCNL simulator using 3D printing and hydrogel molding and its validation using educational theory. METHODS: Consensus among 12 experts was reached regarding the essential aspects of an ideal US-PCNL model and an associated evaluation checklist using a Delphi consensus methodology. Segmentation software was used to generate a 3D model from an approved patient computed tomography (CT) scan, including kidney, pelvicalyceal system, stone, spine and ribs, abdominal wall, and iliac crest. Post-processing generated 3D printed casts into which hydrogel formulations replicating various anatomical and tissue mechanical properties of the structures were created according to the consensus statement. A prototype was fabricated for expert approval, after which 20 experts and 28 novices performed US-PCNL with performance assessed using the developed checklist. RESULTS: The simulator fulfilled all criteria established in the consensus statement, including external and ultrasound appearance mimicking in vivo appearance, a watertight pelvicalyceal system containing a functional stone that is distensible with retrograde instillation, and realistic tactile feedback during puncture. Experts agreed the simulator provides a safe training alternative (100%), bridges gaps between classroom and clinic (95.7%), and allows trainee performance evaluation (100%) in a risk free environment that can be modified for variable anatomy (88.9%). Highly significant differences were found between expert and novices using the checklist developed (93.4% vs 42.3%, p<0.001). In addition, novice performance improved with repeated practice (p<.001). A similar process was utilized to develop a supine version for US-PCNL simulation. CONCLUSIONS: We have successfully developed and validated a high-fidelity benchtop simulator for both Prone and Supine US-PCNL that can be easily tailored to varying anatomy. Further studies evaluating the transfer of skill are still required. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e170 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lauren Shepard More articles by this author Nathan Schuler More articles by this author Aaron Saxton More articles by this author Patrick Saba More articles by this author Andrew Cook More articles by this author Tyler Holler More articles by this author Karen Stern More articles by this author David Tzou More articles by this author Helena Chang More articles by this author Justin Ahn More articles by this author Thomas Tailly More articles by this author Thomas Chi More articles by this author Ahmed Ghazi More articles by this author Expand All Advertisement PDF downloadLoading ...