Category: Education, Simulation & Virtual Reality

MP19-8 - Design and Validation of a Low-cost, High-fidelity Model for Robotic Prostatectomy Urethrovesical Anastomosis

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

Introduction & Objective :

Surgical simulation is a critical component of surgical training. Trainees lack procedure-specific simulation models which allow repetitive practice of robotic skills. We sought to develop and validate a low-cost, high-fidelity robotic surgical simulator for the urethrovesical anastomosis component of robotic assisted laparoscopic radical prostatectomy.


Methods :

A novel urethrovesical anastomosis simulation model was constructed with silicone molds and a 3D-printed model of the male boney pelvis (figure 1). Using a DaVinci Si surgical robot, urology faculty and trainees performed the simulated urethral-vesical anastomosis. Each participant was given 12 minutes to complete the simulation. A survey was issued to establish face validity, content validity, and acceptability. Simulation runs were evaluated by three blinded reviewers, and assigned a GEARS (global evaluative assessment of robotic skills) and PACE (prostatectomy assessment and competency evaluation) score. The anastomosis was graded by two reviewers for suture accuracy and anastomosis quality. These factors were compared to robotic experience to establish construct validity.


Results :

Nineteen participants took part in the initial validation of this model (2 faculty, 4 fellows, 3 chief residents, and 10 residents). Median console experience was 10 years, 4.0 years, 1.7 years, and 0.5 years for faculty, fellows, chief residents, and residents, respectively. Likert (1-5) scores for face validity, content validity, and acceptability were 3.5 ± 0.4, 4.2 ± 0.2, and 4.1 ± 0.2, respectively. Construct validity was excellent: mean time to completion, mean percent completion, mean anastomosis inspection score, mean GEARS score, and mean PACE score all correlated to robotic experience (p < 0.001, table 1). Total material cost was $2.50 per model.


Conclusions :

We present a novel high-fidelity, low-cost robotic simulation of the urethrovesical anastomosis for radical prostatectomy. The model is able to discern robotic skill level across all levels of training and was found very favorable by participants showing good face, content and construct validity.

Ryan L. Steinberg

Endourology Fellow
UT Southwestern
Dallas, Texas

Ryan L. Steinberg MD is a fellow in Endourology and Minimally Invasive Surgery at the University of Texas Southwestern.

Brett Johnson

Endourology Fellow
UT Southwestern
Dallas, Texas

Brett Johnson, is the current second-year Endourology fellow at University of Texas Southwestern with Drs. Jeffrey Cadeddu and Margret Pearle. He completed residecny in Urology at the University of Wisconson.

Matthew Timberlake

Dallas, Texas

Igor Sorokin

Dallas, Texas

Jeffrey A. Cadeddu

Professor of Urology
UT Southwestern
Dallas, Texas

Jeffrey Gahan

Assistant Professor of Urology
UT Southwestern
Dallas, Texas