Use of a vegetable model as a training tool for PCNL puncture

Sinha, Maneesh; Krishnamoorthy, Venkatesh

doi:10.4103/0970-1591.152922

Cited by 14 publications

(3 citation statements)

References 5 publications

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“…One study used a vegetable model; Sinha and Krishnamoorthy used a ‘bottle gourd’ or ‘calabash’ to mimic the abdominal wall with cotton pledges soaked in intravenous contrast spaced at intervals to simulate calyces. Eight expert participants trialled the simulator, 3 of whom were consultants and 5 of whom were residents [ 22 ]. Construct validity was shown using reverse validation with senior consultants obtaining a score of 99 and residents scoring a mean of 555.…”

Section: Resultsmentioning

confidence: 99%

Low-cost simulation models in Urology: a systematic review of the literature

Pelly

Shanmugathas

Bowyer

et al. 2020

Cent european J Urol

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Introduction Simulation models have been found to be effective and valid for training in Urology. Due to increasing costs of surgical training, there is a need for low-cost simulation models to enable Urology trainees to improve their skills Material and methods A literature review was performed using the PubMed and Embase databases until March 2020. A total of 157 abstracts were identified using the search criteria, of which 20 articles were identified describing simulation models for Urology training. Articles reviewed described simulation models created from materials costing less than $150. Data was extracted from the relevant articles in order to critically assess each paper for validity, ease of construct and educational impact. Results Models were found pertaining to suprapubic catheterization (6), cystoscopy (3), percutaneous nephrolithotomy (5), scrotal examination (1), circumcision (1), ureteroscopy (1), transurethral resection of the prostate and bladder (2), and open prostatectomy (1). 18/20 (90%) assessed for either face, content, or construct validity. None of the papers evaluated assessed for transferability of skills to performance in real patients. Conclusions A plethora of low-cost simulation models for urological procedures are described in the literature, many of which can be easily constructed from cheap and accessible materials. However there is a need for further efforts to validate or assess for transferability of skills to clinical practice.

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Section: Resultsmentioning

confidence: 99%

Low-cost simulation models in Urology: a systematic review of the literature

Pelly

Shanmugathas

Bowyer

et al. 2020

Cent european J Urol

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“…[12] This was followed by learning PCNL via an apprenticeship method where the first 30 cases were explicitly supervised with a trainer scrubbed along with the trainee, and help available for remainder cases. Cases were awarded with tendency to give simpler cases in beginning based on the subjective decision of trainer.…”

Section: Methodsmentioning

confidence: 99%

Stepwise case selection using Guy's stone score reduces complications during percutaneous nephrolithotomy training

et al. 2017

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Introduction:Traditional percutaneous nephrolithotomy (PCNL) training involved subjective award of cases to the trainee. We restructured this according to the Guy's stone score (GSS) such that each trainee stepwise completed 25 cases of each grade before progressing. This study compares the outcomes of training with traditional versus stepwise approach.Methods:Four hundred consecutive cases equally distributed for two trainees in each group were compared in terms of complications (Clavien-Dindo), stone free rate (SFR), operative and fluoroscopy time. External comparison was also done against a benchmark surgeon. Multivariable regression model was created to compare SFR and complications while adjusting for comorbidity, Amplatz size, access tract location, number of punctures, body mass index, stone complexity, and training approach.Results:The distribution of cases in terms of calculus complexity was similar. Overall, in comparison to traditional training, stepwise training had significantly shorter median operative time (100 vs. 120 min, P < 0.05), fluoroscopy time (136 vs. 150 min, P < 0.05) and fewer overall (29.5% vs. 43.5%, P < 0.005) as well as major complications (3% vs. 8.5%, P - 0.029), though initial SFR was higher but not statistically significant (77% vs. 71.5%). On multivariable analyses, stepwise training was independently associated with lower complications (odds ratio 0.46 [0.20–0.74], P - 0.0013) along with GSS grade, number of punctures, and Amplatz size. Stepwise training had similar fluoroscopy time, major complications and final clearance rate compared to expert surgeon.Conclusions:PCNL has a learning curve specific for each grade of calculus complexity and stepwise training protocol improves outcomes.

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“…In countries where medical simulators remain largely unaffordable, such low-cost innovations can potentially transform training. [ 8 ]…”

mentioning

confidence: 99%