A novel training model for laparoscopic partial nephrectomy using porcine kidney

The purpose of this study was to create a simple model for teaching laparoscopic partial nephrectomy (LPN) for duplicating the blood supply setting and main technical points of the procedure.

A fresh porcine kidney was placed on an unfolded metallic box to help trainees observe, practice, and develop LPN skills in both tumor incision and suturing. The metallic box was specially designed not only for fixing and positioning the kidney but also for storing the outflow of the kidney while its artery was kept artificially infused. A spherical renal parenchyma excision about 2 cm in diameter was initially made and the suture-repairing work followed. This model was used by trainees who had fair laparoscopic competency after completing dry laboratory training programs. During a 20-day training period the trainees were assessed with respect to the time needed to complete LPN. A mentor-trainee fellowship program was planned to guarantee the success of the operations and the quality of LPN.

There was a good reduction in the total operative time from the fourth to the last attempt. There was also increasing improvement in the quality of the incision suturing during the attempts. By the end of 10 attempts all trainees were more confident in completing a good quality LPN in a mean time of 28.4 minutes.

This model not only offers trainees the opportunities to acquire the skills necessary for LPN but also provides for more economical practice by using easily available porcine kidney.