Validation of a Pulsatile Model for Laparoscopic Partial Nephrectomy: NEFPAR Model

Area of Science:

• Urology
• Surgical Simulation
• Medical Education

Background:

• Laparoscopic and robotic-assisted partial nephrectomy are standard treatments for small renal tumors.
• Ethical and regulatory considerations necessitate alternatives to animal models for surgical training.
• The NEFPAR pulsatile model was developed as a nonliving simulation for partial nephrectomy.

Purpose of the Study:

• To validate the NEFPAR pulsatile model as a realistic and effective training tool for laparoscopic partial nephrectomy.
• To assess participant perception of the model's realism, educational impact, and comparison to existing simulation methods.
• To evaluate the model's potential for integration into urology training curricula.

Main Methods:

• The NEFPAR model was constructed using porcine tissue, a pulsatile pump, and standard laparoscopic instruments.
• Eleven participants (4 urologists, 7 residents) performed simulated laparoscopic partial nephrectomies.
• Performance and perceptions were evaluated via survey, with data analyzed using Fisher's exact test (P < .05).

Main Results:

• 72.7% of participants found the NEFPAR model realistic for key steps like tumor resection and hilum dissection.
• 100% of participants highlighted the essential educational value of the simulated bleeding component.
• The NEFPAR model surpassed nonpulsatile animal models in simulating bleeding and was comparable to cadaveric models in appearance and texture.

Conclusions:

• The NEFPAR model effectively simulates critical aspects of laparoscopic partial nephrectomy, providing an ethical and cost-effective training solution.
• The model is highly valued for its educational benefits, especially in replicating surgical bleeding.
• Further refinements could enhance tissue consistency and tumor placement, supporting its integration into urology training to improve skills and reduce animal use.