title: Validation of a patient-specific simulator for laparoscopic renal surgery.
abstract: OBJECTIVE
  To describe and to validate a novel patient-specific virtual-reality based simulator for laparoscopic surgery.
  
  
  METHODS
  Three surgeons carried out 13 preoperative simulations at Yokohama City University Hospital, Yokohama, Kanagawa, Japan, from 2011 to 2012. The procedures included seven nephrectomies, four partial nephrectomies and two pyeloplasties. We evaluated whether the anatomies reproduced by the simulator matched those encountered during the actual operations. Furthermore, the surgeons were asked to use visual analog scales (from 1 to 5; higher scores are better) to evaluate the anatomical integrity and utility of the simulations, and their intraoperative confidence during the subsequent surgical procedures.
  
  
  RESULTS
  The simulator reproduced the patients' anatomies almost perfectly. Only a few minor mistakes were identified. Regarding the surgeons' evaluations of the system, the mean scores for the anatomical integrity and utility of the simulations, and the surgeons' intraoperative confidence were 3.4, 4.2 and 4.1, respectively. In all 13 cases, the surgeons were able to carry out preoperative training with ease, and they stated that the simulator was useful for producing preoperative images.
  
  
  CONCLUSIONS
  A patient-specific simulator for laparoscopic renal surgery has been successfully developed. This system correctly reproduces anatomical structures, and it seems to be a useful preoperative training tool.
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Ueno
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Kimito
authors.initials: K
authors.lastname: Ohsaka
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Sano
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakaigawa
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yao
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology* / Q000601:surgery*; D010535:Laparoscopy / Q000193:education; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D066230:Patient-Specific Modeling; D014584:User-Computer Interface
keywords: kidney; laparoscopy; patient-specific; simulator; validation