Endoflex - the first portable virtual simulator for flexible ureterorenoscopy (fURS): pilot study

Area of Science:

• Urology
• Medical Simulation
• Virtual Reality Technology

Background:

• The market for virtual reality (VR) simulators for retrograde intrarenal kidney stone (RIRS) surgery is limited.
• Flexible ureteroscopes are crucial for RIRS procedures.
• There is a need for accessible and effective training tools for endourological skills.

Purpose of the Study:

• To conduct a pilot study on Endoflex, a transportable VR simulator for flexible ureterorenoscopy.
• To evaluate the effectiveness of Endoflex in training novices for kidney stone treatment.
• To assess the face and content validity of the Endoflex simulator.

Main Methods:

• Seventeen novices underwent virtual ureterorenoscopy with lithotripsy and lithoextraction using the Endoflex simulator.
• Performance metrics including simulation time, lasing time, and fluoroscopic time were recorded.
• Novice feedback on simulator usefulness and impact on motivation was collected; experienced urologists assessed validity.

Main Results:

• A significant decrease in simulation time, activated laser time, and fluoroscopy time was observed after training.
• The stone-free rate improved, with more novices fully clearing the pelvicalyceal system.
• All participants found the Endoflex simulator useful for education, with high face and content validity scores.

Conclusions:

• Endoflex shows promise as a VR simulator for urological simulation-based training.
• The simulator can enhance endourological skill acquisition and improve training outcomes.
• Further enhancements are needed for comprehensive RIRS training using Endoflex.