ABSTRACT
@#In the field of Urology, flexible ureterorenoscopy (fURS) remains a challenging skill for junior residents to develop due to its steep learning curve. Hence, training models were incorporated into simulation-based training to allow for novice trainees to overcome the learning curve without potentially compromising patient outcomes and minimize complications.@*OBJECTIVE@#To describe the design and test the validity of a non-biological three-dimensional (3D) model of the pelvocalyceal system as a tool for simulation-based training for flexible ureterorenoscopy.@*METHODS@#This was a prospective, quasi-experimental, surgical innovation research stage 2a study conducted in a tertiary government hospital. The retrograde intrarenal surgery (RIRS) box was composed of four siliconized pelvocalyceal systems which were 3D printed using computed tomography urograms of actual patients. Thirty-two urologists were asked to perform flexible ureteroscopy using the RIRS box and were given a questionnaire to assess face and content validity using the Likert scale.@*RESULTS@#The RIRS Box training model showed good face and content validity. The 3D printed pelvocalyceal system was judged to have a close anatomical resemblance to an actual calyceal system. While performing fURS, the RIRS box provided similar pelvocalyceal visualization and instrument handling as in an actual procedure. Majority of participants considered the training model useful for training (75%) and believed that it may improve the RIRS technique (46.8%).@*CONCLUSION@#The RIRS Box training model may help urologists improve the manner in which they acquire technical knowledge and skills necessary in performing fURS.
Subject(s)
Ureteroscopy , Ureteroscopes , Printing, Three-DimensionalABSTRACT
@#In the field of Urology, flexible ureterorenoscopy (fURS) remains a challenging skill for junior residents to develop due to its steep learning curve. Hence, training models were incorporated into simulation-based training to allow for novice trainees to overcome the learning curve without potentially compromising patient outcomes and minimize complications. OBJECTIVE: To describe the design and test the validity of a non-biological three-dimensional (3D) model of the pelvocalyceal system as a tool for simulation-based training for flexible ureterorenoscopy METHODS: This was a prospective, quasi-experimental, surgical innovation research stage 2a study conducted in a tertiary government hospital. The retrograde intrarenal surgery (RIRS) box was composed of four siliconized pelvocalyceal systems which were 3D printed using computed tomography urograms of actual patients. Thirty-two urologists were asked to perform flexible ureteroscopy using the RIRS box and were given a questionnaire to assess face and content validity using the Likert scale. RESULTS: The RIRS Box training model showed good face and content validity. The 3D printed pelvocalyceal system was judged to have a close anatomical resemblance to an actual calyceal system. While performing fURS, the RIRS box provided similar pelvocalyceal visualization and instrument handling as in an actual procedure. Majority of participants considered the training model useful for training (75%) and believed that it may improve the RIRS technique (46.8%). CONCLUSION: The RIRS Box training model may help urologists improve the manner in which they acquire technical knowledge and skills necessary in performing fURS.
Subject(s)
Ureteroscopy , Ureteroscopes , Printing, Three-DimensionalABSTRACT
Until recently almost exclusively clinicochemical urine parameters have been used to determine the risk of urinary stone formation, because the urinary stone disease is considered as one of metabolic disorders. But the morpholgy of renal pelvocalyceal system also affects on the formation of stone particle and its growth, mainly by establishing urinary stasis. We reviewed 163 excretory urograms retrospectively, and pelvocalyceal systems of healthy persons and urinary stone formers were compared with regard to their morphology. In summary of the study, the majority of pelvocalyceal systems of urinary stone formers showed (1) an increased number of papillae; (2) a greater cranial and caudal exlension of pelvocalyceal sysrem:(3) an increased circular radius of the pelvocalyceal system and hence an increased pelvocalyceal system volume ;(4) an increased pelvic area, especially an enlarged total calyx area and hence a larger total area. (5) a higher degree of ramification and a higher number of branches in the calyx groups ; (6) a more sharp angle between the most caudally situated calyx neck and the direction of pelvic outlet :(7) a highly situated origin or the ureter more frequently ;(8) more frequent ampullary patterns of pelvocalyceal system. But the number of major calyx, the total calyx angle and the angle between the direction of pelvic outlet and the main direction of the ureter showed no statistically significant difference between the urinary stone formers and the healthy persons. The results indicate that the study on the morphology of the renal pelvocalyceal system by excretory urography may be used as a screening test to determine the risk of urinary stone formation.