Validation of a novel, tissue-based simulator for robot-assisted radical prostatectomy.
OBJECTIVE
To create a tissue-based simulator that allows practice of key steps of robot-assisted radical prostatectomy (RARP) in a sequential fashion.


METHODS
A model was created from female porcine genitourinary tract tissue to represent the male pelvic genitourinary anatomy. The following steps of RARP were simulated: dorsal venous complex ligation, division of bladder neck, seminal vesicle dissection, prostatic pedicle ligation with nerve sparing, urethral division, bladder neck reconstruction, and vesicourethral anastomosis. Ten novices and 10 experts performed RARP on the model. Face validity was calculated by ratings of realism. Content validity was calculated by experts' rating of usefulness of the model as a training tool. Construct validity was calculated by comparison of time to complete the simulator and rating of performance on the objective structured assessment of technical skill (OSATS) questionnaire, between novices and experts.


RESULTS
The model was determined to have good face and content validity with an average score of 3.7/5 and 4.8/5, respectively. The mean time for completion of the simulator was 121.5 minutes for the novice and 62 minutes for the expert group (P<0.001), and the mean overall OSATS performance ratings were 4.6/5 for experts and 2.6/5 for novices (P<0.001), yielding good construct validity.


CONCLUSIONS
We created and validated a realistic, tissue-based simulator to allow for training of key surgical steps of RARP in a sequential fashion. Ultimately, this simulator could be incorporated into urology training, credentialing, and facilitate surgeon transitioning from open prostatectomy to RARP.
1 Department of Urology, University of Southern California , Los Angeles, California.
Mehrdad
M
Alemozaffar
Ramkishen
R
Narayanan
Andrew A
AA
Percy
Brian B
BB
Minnillo
Peter
P
Steinberg
George
G
Haleblian
Shiva
S
Gautam
Kai
K
Matthes
Andrew A
AA
Wagner
D000328:Adult; D000818:Animals; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D008953:Models, Anatomic; D061646:Operative Time; D011468:Prostatectomy / Q000193:education* / Q000379:methods*; D015203:Reproducibility of Results; D012371:Robotics / Q000193:education / Q000379:methods*; D011795:Surveys and Questionnaires; D013552:Swine; D014572:Urology / Q000193:education