A Novel Ureteroscopy Training Platform That Utilizes CT Urograms to Replicate Complex Renal Collecting System...

Area of Science:

• Urology
• Medical Simulation
• 3D Printing Technology

Background:

• Flexible ureteroscopy (fURS) is a critical surgical skill, but intraoperative training is limited for surgical trainees.
• Existing fURS simulators often fail to accurately represent complex renal collecting system anatomies.
• There is a need for realistic simulation tools to enhance fURS training.

Purpose of the Study:

• To develop and evaluate an anatomically accurate flexible ureteroscopy simulator.
• To assess the simulator's fidelity in replicating complex renal collecting system anatomy.
• To compare the novel simulator's performance and user feedback against existing fURS benchtop models.

Main Methods:

• Utilized patient-specific CT urograms for 3D reconstruction of renal collecting systems.
• Employed 3D printing with elastomer materials to create hollow, anatomically precise kidney models.
• Conducted a volunteer study with novices, residents, and urologists to evaluate anatomical deduction, navigation, and task completion times.

Main Results:

• The 3D-printed simulator accurately replicated complex renal collecting system anatomies.
• Trainees (novices and residents) demonstrated difficulty identifying lower pole calices, highlighting the simulator's challenge.
• The novel simulator received significantly higher ratings for visualization, tactile feedback, and overall fidelity compared to existing models (p < 0.05).

Conclusions:

• Anatomically accurate fURS simulators can be successfully created using 3D reconstruction and printing.
• This simulator offers a more realistic scoping experience, particularly beneficial for learning challenging renal collecting system navigation.
• The developed simulator shows significant potential to improve surgical trainee proficiency in flexible ureteroscopy.