A novel bovine model for training urological surgeons in laparoscopic radical nephrectomy

To design a training phantom to allow trainees to demonstrate and practice the key steps of a laparoscopic nephrectomy, while demonstrating the anatomical landmarks, together with correct instrumentation and safe ergonomic layout.

Calves, prepared according to the strict standards of the meat industry, were purchased from a local abattoir. The skinned torso of a 30-kg calf was prepared by opening the abdomen and removing most of the ribs and the pelvis to create a larger working space. The small intestine and the majority of the large intestine were removed, leaving 30 cm of ascending colon, the liver, and spleen as internal landmarks and placed inside a standard laparoscopic abdominal trainer. This model was then used as part of a structured training course.

From April 2005 to April 2010, 104 urologists have worked on this phantom. Evaluation forms were completed by these participants, and analysis of the feedback shows all attendees found the model to be very realistic in terms of anatomical conditions, tissue color and consistency, and organ tactility, compared with human nephrectomy (average score of 4.8 on a Likert scale of 1 (unrealistic/poor) to 5 (realistic/useful)). Participants found the model useful for developing dissection techniques, electrosurgery, coagulation, and suturing skills.

This model can be easily established and is valuable as part of a multimodal training program for laparoscopy.