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An experimental model for training in renal transplantation surgery with human cadavers preserved using W. Thiel's
Ramiro Cabello1, Carmen González1, Cristina Quicios1
1Urology Department, Fundación Jiménez Díaz-Idcsalud/Universidad Autónoma de Madrid, Madrid, Spain.
Objective:
To describe a novel cadaver-based model for practicing renal transplant (RT) surgery.
Design:
A simulating model using cadavers preserved by Thiel's method is developed to teach surgical anatomy and operative skills in RT surgery. Participants were asked to complete a voluntary, anonymous survey evaluating perceptions of the model and comparing cadaver sessions to other types of learning (rating questions from 0-10).
Setting:
Large university teaching hospital.
Participants:
A total of 28 residents, junior transplant surgeons, and faculty members were participants in the cadaver simulation.
Results:
Overall, 9 cadavers were used with 17 grafts transplanted. Kidney procurement in human cadavers preserved using Thiel's embalming technique was performed following the conventional protocol; en bloc nephrectomy with the trunk of aorta and inferior vena cava. Bench surgery was performed, perfusing artery with saline and checking vascular permeability. Once suitability is established, RT was performed as is done in clinical practice. This embalming method enables tissue dissection that is comparable to the living body and provides suitable conditions for realistic RT simulation; handling human tissues and vessels in the same surgical field as the clinical scenario. This experimental model approximates to in vivo RT, providing a realistic and interesting learning to inexperienced surgeons. Overall, participants held a positive view of the cadaver sessions, believed them to be useful in their daily practice, and felt that the proposed model was similar to the clinical setting. Trainees believed that these practices improved skills and confidence in performing an RT.
Conclusions:
The proposed method of kidney procurement and RT in human cadavers preserved by Thiel's embalming technique is a promising, realistic, and reproducible method of practicing RT surgery.
