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Development and assessment of an ex-vivo bench model aimed at laparoscopic ureteric reconstructive techniques

      Summary

      Introduction/Background

      Reconstructive and ablative urologic techniques require special technical mastery, especially the intracorporeal suturing.

      Objective

      To report the subjective evaluation of a versatile ex-vivo model aimed to practice laparoscopic ureteric reconstructive techniques (LURT) on box-trainer.

      Study design

      The model is a continuous portion of porcine urinary bladder (“dilated pelvis”), the vesico-ureteral joint (“stenosis”) and healthy ureter. All 127 participants (n = 119 urologists and n = 8 paediatric surgeons) performed on the model laparoscopic Anderson-Hynes dismembered pyeloplasty, and then, in the animal model, different LURT procedures (ureteroneocystostomy, ureteric reimplantation and/or dismembered pyeloplasty). The model was subjectively evaluated (face and content validity), through a 12 items questionnaire, based on a Likert scale (1–5 points) and a global question (1–10 points).

      Results

      The total mean rating for 11/12 items was very high (>4points). Only one was rated under 3 points. The overall total mean rating from 1 to 10 points was very high (9.19 ± 0.82 points). In 10/12 items, expert's feedback (content validity) prevailed over non-experts (face validity).

      Discussion/conclusion

      Summary figure
      Graphical AbstractA) LURT organic model arranged on an angled platform (±45°) for the practice of dismembered pyeloplasty. Note the simple assembly of the model inside the physical simulator is shown. B) Suture line correctly performed by an expert. C) An incorrect apposition of the edges can be seen. Besides, some fatty tissue is incorrectly included in the suture line.

      Keywords

      Abbreviations:

      LURT (laparoscopic ureteric reconstructive techniques)
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