"Homemade" TUR-simulator for less than $40 U.S.? The "Tupper" experience.
BACKGROUND
Transurethral surgery is important in daily urologic life. In training residents it is important to develop resection skills. We introduce a homemade simulator to improve capabilities for the training of transurethral procedures.


METHODS
Material consists of 7 cm of a 30F garden hose, a suprapubic tube, a Tupperware box (Frankfurt, Germany), three catheter plugs, and silicone gel. Cost of materials is below $40 U.S. Transurethral procedures such as mono- and bipolar resection and RevoLix laser vaporesection were carried out. Different meat types were tested to develop a close to real resection feeling. Further, flexible cystoscopy was trained with the simulator. Multiple markings were placed inside the box. These markings had to be identified by flexible cystoscopy. The time to completion of this task was recorded.


RESULTS
Transurethral resection and flexible cystoscopy is feasible. Pork and beef lead to a realistic feeling compared with transurethral resection. For laser surgery, pork and chicken seem to be most realistic. Further, confidence in flexible cystoscopy could be obtained. During the flexible cystoscopy task, an average time reduction of 50.96% could be achieved.


CONCLUSIONS
This cheap and simple resection simulator allows easy training of lower urinary tract procedures. It helps young urologists to acquire basic endourologic skills. It may be beneficial for residents in the process of learning lower urinary tract surgery. Further, new techniques can be trained and may lead to a decreased risk for the patients.
Bach
Thorsten
T
Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany. t.bach@asklepios.com
Geavlete
Bogdan
B
Herrmann
Thomas R W
TR
Gross
Andreas J
AJ
D000818:Animals; D003558:Cystoscopy; D006801:Humans; D007834:Lasers; D018583:Pliability; D014481:United States; D013520:Urologic Surgical Procedures / Q000191:economics* / Q000193:education* / Q000295:instrumentation; D014572:Urology / Q000191:economics / Q000193:education* / Q000295:instrumentation