V6-01 NERVE-SPARING TRANSDOUGLAS ROBOTIC ASSISTED PROSTATECTOMY: COMPLETE POSTERIOR APPROACH.

Abstract

PD plaque. This injection differs markedly from the use of currently non-FDA approved intralesional injections. Rather than a multiple puncture technique, CCH injection requires an accurate transverse placement of the needle into the plaque with the deposition of 0.25ml of solution. Furthermore, the safety and effectiveness of CCH injection requires accuracy of injection. We have designed and developed a simulation model to provide clinicians with an opportunity to practice and become familiar with the injection technique. METHODS: A silicone penis model was developed in conjunction with Simatry LLC (Montvale, NJ) to simulate a flaccid penis housing 3 PD plaques (Figure). The plaques vary in size and location consistent with the types of plaques identified in patients with PD. Feedback was provided by a panel of clinical urologists on common plaque density, size, and feel to create appropriate clinical representation. The simulator was designed with electronic feedback via both visual and audio responses to identify the accuracy of the injection. RESULTS: The model has 1 lateral plaque and 2 dorsal plaques (1 wide and 1 narrow) at various locations on the model penile shaft. Users can palpate plaques and apply pressure to elongate and stretch the model as part of the injection technique. A “smart syringe” provides both electronic and tactical feedback as to the location of the tip of the needle relative to the plaque, the amount of pressure used to traverse the resistance of the plaque, and injection pressure perceived with drug administration. CONCLUSIONS: This injection simulator will provide training opportunities due to its unique design. It has been developed with consideration of aspects of the injection procedure for CCH, which differ from existing intralesional injection options. Use of such a model in physician training will increase urologists’ familiarity with the intralesional injection technique for CCH treatment of PD.