Is there a model to teach and practice retroperitoneoscopic nephrectomy?
BACKGROUND
Although the retroperitoneal approach has been the preferred choice for open urological procedures, retroperitoneoscopy is not the preferred approach for laparoscopy. This study aims to develop a training model for retroperitoneoscopy and to establish an experimental learning curve.


METHODS
Fifteen piglets were operated on to develop a standard retroperitoneoscopic nephrectomy (RPN) training model. All procedures were performed with three ports. Intraoperative data (side, operative time, blood loss, peritoneal opening) were recorded. Animals were divided into groups A, the first eight, and B, the last seven cases. Data were statistically analyzed.


RESULTS
We performed fifteen RPNs. The operative time varied from 15 to 50 minutes (median 30 minutes). Blood loss varied from 5 to 100 mL (median 20 mL). We experienced five peritoneal openings; we had two surgical vascular complications managed laparoscopically. There was statistical difference between groups A and B for peritoneal opening (p = 0.025), operative time (p = 0.0037), and blood loss (p = 0.026).


CONCLUSIONS
RPN in a porcine model could simulate the whole procedure, from creating the space to nephrectomy completion. Experimental learning curve was eight cases, after statistical data analysis.


CONCLUSIONS
RPN in a porcine model is feasible and could be very useful for teaching and practicing retroperitoneoscopy.
CEPEC Vicky Safra, University of São Paulo, Division of Urology , São Paulo, SP. marcelohisano@hotmail.com
Marcelo
M
Hisano
Ricardo Jordão
RJ
Duarte
José Roberto
JR
Colombo
Miguel
M
Srougi
D000818:Animals; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D023421:Models, Animal; D009392:Nephrectomy / Q000193:education* / Q000379:methods; D061646:Operative Time; D012187:Retroperitoneal Space / Q000601:surgery*; D013552:Swine