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Annual Meeting 2019 Presentations

TOTBV-08: ROBOTIC SIMULATION USING PATIENT SPECIFIC 3D PRINTED HYDROGEL MODELS OF LIVING DONOR TRANSPLANT NEPHRECTOMY FOR SURGICAL TRAINEES
Ankit Patel, MD; University of Rochester

 

What problem in education is addressed by this work?:
The minimally invasive surgical landscape has markedly changed with the adaptation of robotic surgery, and this has introduced a new challenge for General Surgery trainees to master. Robotic-assisted kidney transplantation is an innovative application of the robotic surgery platform applied at our institution. Using 3D printing technology and polymer research, anatomically accurate hydrogel models have allowed us to develop a high-fidelity simulation of the kidney donor operative experience. Our simulation model allows for supervised and interactive training sessions in a stress-free environment to facilitate the adaptation of skills and application of technique in robotic surgery.

Describe the intervention:
A structured training curriculum was developed for General Surgery and Urology trainees rotating on the Transplant Surgery service. A combination of 3D printing and hydrogel molding creates anatomically accurate kidney models based on computerized tomography imaging of donor candidates and these models are used to simulate the operation of a robotic living donor transplant nephrectomy. Assessment of simulated tasks will be graded on a scale of 1-5. Performance metrics will be based on suspected vascular injury (to the gonadal vein, adrenal vein, lumbar vein, renal vein, renal artery), injury to the colon, mesocolon or Gerotas’ fascia. An objective review will include respect of tissue, appropriate exposure and retraction, optimization of the field of view, and flow of operation. Video of the simulation will be recorded for a post-simulation feedback session.

Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome:
Our simulation model allows for supervised and interactive training sessions in a stress-free environment to facilitate the adaptation of skills and application of technique in robotic surgery. Due to its anatomical accuracy of patient anatomy, the hydrogel models have allowed us to develop a high-fidelity simulation of the kidney donor operative experience and will prepare trainees to operate on live patients. This model can increase the competence of trainees in numerous operations, and even without access to a robotic system, can be reproduced across different types of laparoscopic surgeries.

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