Simulation‐based training for prostate surgery

Abstract

A review of the literature between 1999 and 2014 was performed. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves. Furthermore, relevant abstracts from the American Urological Association, European Association of Urology, British Association of Urological Surgeons and World Congress of Endourology meetings, between 1999 and 2013, were included. Only studies related to prostate surgery simulators were included; studies regarding other urological simulators were excluded. ResultsA total of 22 studies that carried out a validation study were identified. Five validated models and/or simulators were identified for TURP, one for photoselective vaporisation of the prostate, two for holmium enucleation of the prostate, three for laparoscopic radical prostatectomy (LRP) and four for robotassisted surgery. Of the TURP simulators, all five have demonstrated content validity, three face validity and four construct validity. The GreenLight laser simulator has demonstrated face, content and construct validities. The Kansai HoLEP Simulator has demonstrated face and content validity whilst the UroSim HoLEP Simulator has demonstrated face, content and construct validity. All three animal models for LRP have been shown to have construct validity whilst the chicken skin model was also content valid. Only two robotic simulators were identified with relevance to robot-assisted laparoscopic prostatectomy, both of which demonstrated construct validity. ConclusionsA wide range of different simulators are available for prostate surgery, including synthetic bench models, virtual-reality platforms, animal models, human cadavers, distributed simulation and advanced training programmes and modules. The currently validated simulators can be used by healthcare organisations to provide supplementary training sessions for trainee surgeons. Further research should be conducted to validate simulated environments, to determine which simulators have greater efficacy than others and to assess the cost-effectiveness of the simulators and the transferability of skills learnt. With surgeons investigating new possibilities for easily reproducible and valid methods of training, simulation offers great scope for implementation alongside traditional methods of training.

A Novel Cadaveric Simulation Program in Urology

“…[1][2][3] Increasing number of virtual reality (VR) simulators, bench-top models, and animal models have been described and evaluated for simulation-based training [4][5][6] in all aspects of urology. [7][8][9][10] However, despite their cost and lack of availability, human cadavers have been rated to be highly effective for procedural surgical training. [11][12][13] Although few studies have described their use in procedural training 11,14 and in trials of novel approaches, [15][16][17] a comprehensive and validated training program using human cadavers is lacking in urology.…”

Validation of the Advanced Scope Trainer for Flexible Ureterorenoscopy Training

“…There is a great variety of procedural simulators and/or models available for urological procedures including for ureterenoscopy [5], transurethral resection and related laser procedures [6,[11][12][13], laparoscopy [6,14] and robotic surgery [15,16].…”

Virtual and Augmented Reality in Medical Education

“…It has been extensively validated and shown face and construct validity. This is the only model to have shown concurrent validity with other assessment tools in studies with large numbers of participants [47,48].…”

“…It simulates endoscopic movement and allows users to perform resection, coagulation, and also complete TURP operations. It can be adjusted to different levels of difficulty and has advanced metrics tools [47,48].…”