Modular training for percutaneous nephrolithotripsy: The safe way to go

Area of Science:

• Urology
• Surgical Education
• Medical Training

Background:

• Percutaneous nephrolithotripsy (PCNL) requires specialized skills.
• Standardized training is crucial for patient safety in PCNL.

Purpose of the Study:

• To describe a modular training scheme (MTS) for percutaneous nephrolithotripsy (PCNL).
• To ensure patient safety during PCNL training.

Main Methods:

• A five-module MTS was implemented, starting with animal laboratory training and progressing to clinical cases.
• Two novice trainees underwent the MTS under expert mentorship and objective evaluation.
• Trainees performed 60 independent PCNL procedures post-training, with peri-operative variables compared to a mentor's 25 procedures.

Main Results:

• Surgical and fluoroscopy times plateaued to mentor levels after approximately 30 procedures.
• Key outcomes including hemoglobin decrease, stone-free rates, and complication rates were similar between trainees and the mentor.
• The complication rate for both trainees and the mentor remained below 13.3%.

Conclusions:

• The MTS successfully integrated animal laboratory and clinical training.
• A standardized technique and objective evaluation within the MTS led to safe and effective PCNL training.