New Advanced Bench Model for Flexible Ureteroscopic Training: The Smart Simulator

Smart Simulator is a new advanced bench training model for achieving proficiency in flexible ureteroscopy (fURS). Its important features are portability and the ability to simulate breathing-induced kidney movements, model pyelocalices similar to those in humans, create a situation closely resembling a fURS field, and create papillae of a size equivalent to that of the access sheath. Smart Simulator thus creates a situation more closely resembling that in a clinical setting than the other bench training models for fURS. Sixteen urologists experienced in fURS assessed the Smart Simulator for face validity and content validity. The model was acceptable in terms of realism, acceptability, and feasibility. Trainees can use it to practice laser manipulation for kidney stone fragmentation and retrieval in accord with breathing-induced movements and various other created fields sometimes confronted during fURS. Training in situations in nearly real fURS surgical fields may improve trainees' technical skills.