Validation of a bench model for endoscopic surgery in the upper urinary tract.

Abstract

Open surgery is increasingly replaced by endoscopic techniques. In urology, endoscopic procedures of the upper urinary tract are still evolving. The surgical techniques imply high accuracy and are difficult to teach since they are "one man" procedures. Training on bench models has essentially given promising results in general surgery but has never been validated for advanced endourology. In this study, ureteroscopy on a bench model was compared to the same procedure on patients. Fourteen urologists, trainees and consultants, were scored using a task-specific check list and a global score when performing rigid ureteroscopy on patients and on a bench model from Mediskills. The participants had not seen the check lists before the performance and the scoring was carried out by the same person in all cases. The urologists performed equally on patients and the model and they all considered the procedure on the model similar to real surgery. There was no statistical difference in the score between consultants and trainees but those urologists (five consultants and three senior registrars) who were sub-specialised in endourology scored significantly higher than the others on both patients and the model. Bench models are comparable to real surgery for, at least basic, endoscopic procedures in the upper urinary tract. The models are also useful for making the trainees familiar with the operating instruments.