Virtual reality simulator for developing spatial skills during retrograde intrarenal pyeloscopy

Abstract

Introduction. Currently, several virtual reality (VR) simulators have been described for the upper urinary tract stone surgery skill development, including retrograde or antegrade nephroscopy. However, their high cost and the lack of a detailed reconstruction of the intraluminal pelvicalyceal system (PCS) appearance limit their implementation into educational process and clinical practice.Objectives. To develop the approach for VR-reconstruction of the intraluminal appearance of the PCS via head mounted device (HMD), as well as estimate its usefulness for novices to improve spatial orientation during retrograde flexible nephroscopy.Materials & methods. Five residents without experience in self-performing retrograde flexible nephroscopy participated in a 7-day training course on the VR simulator developed, during which each novice studied six variants of the PCS. For the procedure simulation, a silicone kidney model was created with the stone placed in the calyx which was selected randomly in each case. Before and after VR-course, each resident assisted the experienced urologist during simulated retrograde nephroscopy to find the stone placed according to random selection. The nephroscopy time and the number of errors in stone-finding during retrograde flexible nephroscopy were analysed.Results. There was a statistically significant decrease in nephroscopy time (on avg by 17.6 minutes, p = 0.043) and errors to find targeted calyx, which was observed once after the training one resident only.Conclusion. The described VR simulator does not require significant time, technical and financial costs, and is available for wide implementation in the training of young specialists.