Premium
Development of a human cadaver model for training in laparoscopic donor nephrectomy
Author(s) -
Sutton Erica R. H.,
Billeter Adrian,
Druen Devin,
Roberts Henry,
Rice Jonathan
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12979
Subject(s) - medicine , nephrectomy , cadaver , dissection (medical) , perioperative , laparoscopy , renal hilum , surgery , learning curve , kidney , computer science , operating system
Background The organ procurement network recommends a surgeon record 15 cases as surgeon or assistant for laparoscopic donor nephrectomies ( LDN ) prior to independent practice. The literature suggests that the learning curve for improved perioperative and patient outcomes is closer to 35 cases. In this article, we describe our development of a model utilizing fresh tissue and objective, quantifiable endpoints to document surgical progress, and efficiency in each of the major steps involved in LDN . Materials and Methods Phase I of model development focused on the modifications necessary to maintain visualization for laparoscopic surgery in a human cadaver. Phase II tested proposed learner‐based metrics of procedural competency for multiport LDN by timing procedural steps of LDN in a novice learner. Results Phases I and II required 12 and nine cadavers, with a total of 35 kidneys utilized. The following metrics improved with trial number for multiport LDN : time taken for dissection of the gonadal vein, ureter, renal hilum, adrenal and lumbrical veins, simulated warm ischemic time ( WIT ), and operative time. Conclusion Human cadavers can be used for training in LDN as evidenced by improvements in timed learner‐based metrics. This simulation‐based model fills a gap in available training options for surgeons.