Assistant Professor Nagoya city University graduate school of Medical Sciences
Introduction: In recent years, advancement in endoscopic technology has led to the increase in the number of retrograde intrarenal surgery using a flexible ureteroscope (fURS). The treatment performance of fURS are affected by the technique of the surgeon. However, educating non-experts therefore serves as an important challenge. For this reason, since 2015, we have been hosting fURS hands-on seminars using the actual device. In this study, we reviewed the questionnaires issued to the seminar students to evaluate the usefulness of the training.
Methods: Of the 82 seminar students who have attended the seminars since 2015, we evaluated 22 individuals (5 experts and 17 non-experts), using the questionnaires completed prior to training, and 3 months post-training. After attending the lecture concerning URS, to function as hands-on training, the students practiced the fURS skills using the scope trainer (Figure 1a). Hands-on training included four processes (1: Device-setting and observation from ureter to the renal pelvis, 2: Observation from renal pelvis to each renal calix, 3: Practice of manipulating basket forceps in the renal pelvis, and 4: Catch and release of stones in the pelvicaliceal system). In principle, the training was involved holding the endoscope in the left hand and extracting stones with the right hand (one-person stone extraction; Figure 1b).
Results: All urologists indicated that the hands-on training was more useful than the lecture. Among the four processes, the most common positive feedbacks showed that 60% of non-experts found “Observation from renal pelvis to each renal calix” being effective, while 37% of experts found “Device-setting and observation from ureter to the renal pelvis” being effective. After training, 7 students (50%) switched to the approach of performing endoscopic manipulations using the left hand; only 3 students (21%) switched to the one-person stone extraction approach. The most common change after the seminar was the change in the method of guiding one’s juniors (7 people: 50%), followed by less damages to the ureteroscope (6 people: 44%).
Conclusions: The fURS hands-on seminar was demonstrated to not only help to familiarize students with the basic manipulation of the ureteroscope, but was also useful in establishing a method in guiding juniors. Source of