Category: Education, Simulation & Virtual Reality

MP19-18 - Development of a novel percutaneous nephrolithotomy simulator with the application of microcontrollers and rapid prototyping

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

 Percutaneous nephrolithotomy is often associated with a steep learning curve, requiring a respectable number of training for procedural competency and proficiency, a reality which is has been impacted from transformations in contemporary employment legislation and the resultant decrease in a trainee surgeon’s working hours and opportunities. In light of this, surgical simulation is becoming an important adjunct to traditional training. We aim to produce a novel, cost-effective percutaneous simulator with the addition of microcontrollers for simulator control and data collection, for the implementation in international urolithiasis curricula.


Methods :

Preliminary opinion research was carried out at the European Association of Urology (EAU) 33rd Annual Congress. Experts were recruited from hospitals and institutions across Europe, North America and Asia, to attain a consensus on the features currently missing in PCNL simulation. Subsequent development began at Guy’s Hospital, London.


Results :

Of the 17 experts, 88.2% (n = 15) described puncture as the most technically challenging step of PCNL. Further, 88.2% (n = 15) agreed that puncture was the most hazardous step. A second consensus, formed of 18 experts, described features missing in current PCNL simulation. 33.3% (n = 6) of experts agreed that full imaging capabilities (Ultrasound, Fluoroscopy) and Accurate tactile properties of material respectively were missing in current simulators. Accurate anatomy (22.2%, n = 4), Full procedural simulation (11.1%, n = 2), respiratory-induced movement (11.1%, n = 2) and radiation-free simulation (5.5%, n = 1) were also listed by experts as features currently missing. A novel percutaneous simulator, consisting of four primary modules was successfully developed, including a synthetic human flank and mold-casted kidney, respiratory movement simulator, fluoro-less C-arm and capacitive sensor box. The majority of parts were produced in-house using rapid prototyping, with the exception of some metal structural implements. Preliminary kidney parenchyma material was validated for face validity.


Conclusions :

We have been successful in developing a cost-effective percutaneous nephrolithotomy simulator with the implementation of microcontrollers. Our design and development process affords us the opportunity to easily modify the simulator components based on future validation studies.

Brandon G. Smith

Medical Student
Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom
Strood, England, United Kingdom

Abdullatif Aydin

The Urology Foundation Simulation Research Fellow
MRC Centre for Transplantation, Guy's Hospital, King's College London
London, England, United Kingdom

Francesca E C. Kum

Urology Registrar
Guy's and St. Thomas' Hospitals, London
London, England, United Kingdom

Francesca Kum, ST3 Urology Registrar in London, currently working at St George's Hospital

Kate Quirke

Medical Student
Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom
Solihull, England, United Kingdom

Muhammad SHAMIM.. Khan

4. Division of Transplantation, Immunology & Mucosal Biology, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, London, England, SE1 1UL, United Kingdom
London, England, United Kingdom

Prokar Dasgupta

MRC Centre for Transplantation, King's College London
London, England, United Kingdom

Kamran Ahmed

MRC Centre for Transplantation, King's College London
London, England, United Kingdom