Mp25-01 an ethical robotic surgical training curriculum using simulation and 3d printed synthetic organs

You have accessJournal of UrologyCME1 Apr 2023MP25-01 AN ETHICAL ROBOTIC SURGICAL TRAINING CURRICULUM USING SIMULATION AND 3D PRINTED SYNTHETIC ORGANS Daniel Costello, Dean Driscoll, Ahmed Ghazi, and Anthony Costello Daniel CostelloDaniel Costello More articles by this author , Dean DriscollDean Driscoll More articles by this author , Ahmed GhaziAhmed Ghazi More articles by this author , and Anthony CostelloAnthony Costello More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003253.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is no longer necessary to rely on live animals or cadavers for surgical training. We used 3D printing technology and injection moulding to produce realistic hydrogel synthetic organs for robotic surgery training. These synthetic organ models were a key pillar in a novel multistep robotic surgery curriculum. Phase 1 included an online learning program the first robotic surgery course accredited by the Royal Australasian College of Surgeons. This course included access to a catalogue of live 3D video accessible through VR headsets. Participants then proceeded to VR simulation training, dry lab exercises and human factors training in preparation for procedural training on hydrogel organs. When proficiency was achieved finally live human surgery. Following are results from the synthetic organ robotic procedures. METHODS: Three different synthetic organ models were fabricated for this study; an anatomically correct insufflatable anterior abdominal wall for port placement, a robot assisted partial nephrectomy model and a robot assisted radical prostatectomy model. These models were fabricated using 3D digital models segmented from patient CT images using computer aided-design software. These models were uploaded to 3D printers to generate negative moulds, which were injected with polyvinyl alcohol, a low-cost hydrogel. These positive casts went through freeze thaw cycles achieving different tissue consistencies. These casts were layered in anatomically correct positions creating multi-step procedural models with clinically relevant objective surgical performance metrics. Metrics include blood loss, nerve injury measured by digital strain gauges, cancer margins using fluorescence, anastomosis leak tests, operative time and video based skill assessment. RESULTS: Twenty surgeons performed robotic surgery on 5 synthetic abdomens, 10 hydrogel partial nephrectomies and 30 radical prostatectomies. Participants ranged in experience from novice to experts. Clinically relevant performance metrics were recorded and GEARS video tool was used to assess proficiency. Preliminary validity assessments demonstrate face, content, construct, concurrent and predictive validity. CONCLUSIONS: We demonstrated feasibility and preliminary educational validity of realistic synthetic human organ models for urological robotic surgery. These models offer a viable alternative to live animal and cadaver surgery training, without associated cost, ethical and accessibility drawbacks. Source of Funding: An equipment grant was provided by Intuitive Surgical for simulation surgeries © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e342 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Costello More articles by this author Dean Driscoll More articles by this author Ahmed Ghazi More articles by this author Anthony Costello More articles by this author Expand All Advertisement PDF downloadLoading ...