Building a Low-Cost and Low-Fidelity Kidney Transplant Model: A Technical Report on the San Antonio Kidney Transplant Model

Patnaik, Ronit; Khan, Mustafa; Yamaguchi, Seiji; Fritze, D. M.

doi:10.7759/cureus.23883

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…Inanimate tissue models serve as a cost-effective and more accessible means to provide task-speci c simulation training [34]. Tam et al argue that virtual reality trainers are best for gaining familiarity to the platform, while biotissue tissue exercises like the one presented teach critical skills such as tissue handling, suturing, camera control, and electrocautery [35].…”

Section: Discussionmentioning

confidence: 99%

Intentional enterotomies: validation of a novel robotic surgery training exercise

et al. 2023

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Purpose: While laparoscopic simulation-based training is a well-established component of general surgery training, no such requirement or standardized curriculum exists for robotic surgery. Furthermore, there is a lack of high-delity electrocautery simulation training exercises in the literature. Using Messick's validity framework, we sought to determine the content, response process, internal content and construct validity of a novel inanimate tissue model that utilizes electrocautery for potential incorporation in such curricula.Methods: Multi-institutional, prospective study involving medical students (MS) and general surgery residents (PGY1-3). Participants performed an exercise using a biotissue bowel model on the da Vinci Xi robotic console during which they created an enterotomy using electrocautery followed by approximation with interrupted sutures. Participant performance was recorded and then scored by crowd-sourced assessors of technical skill along with three of the authors. Construct validity was determined via difference in Global Evaluative Assessment of Robotic Skills (GEARS) score, time to completion and total number of errors between the two cohorts. Upon completion of the exercise, participants were surveyed on their perception of the exercise and its impact on their robotic training to determine content validity.Results: 31 participants were enrolled and separated into two cohorts: MS + PGY1 vs PGY2-3. Time spent on the robotic trainer (0.8 vs 8.13 hours, p=0.002), number of bedside robotic assists (5.7 vs 14.8, p<0.001), and number of robotic cases as primary surgeon (0.3 vs 13.1, p<0.001) were statistically signi cant between the two groups. Differences in GEARS scores (18.5 vs 19.9, p=0.001), time to completion (26.1 vs 14.4 min, p<0.001), and total errors (21.5 vs 11.9, p=0.018) between the groups were statistically signi cant as well. Of the 23 participants that completed the post-exercise survey, 87% and 91.3% reported improvement in robotic surgical ability and con dence, respectively. On a 10-point Likert scale, respondents rated the realism of the exercise 7.5, educational bene t 9.1, and effectiveness in teaching robotic skills 8.7. Controlling for the upfront investment of certain training materials, each exercise iteration cost ~$30.Conclusions: This study con rmed the content, response process, internal structure and construct validity of a novel, high-delity and cost-effective inanimate tissue exercise which successfully incorporates electrocautery. Consideration should be given to its addition to robotic surgery training programs.

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Section: Discussionmentioning

confidence: 99%

Intentional enterotomies: validation of a novel robotic surgery training exercise

et al. 2023

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“…While the task trainers discussed above address some of the technical skills required by anesthesiologists managing liver transplant patients, they do not address the unique anatomy and physiology of end-stage liver disease patients. For this reason, there is a need to develop low-cost task trainer models designed to simulate the unique challenges posed by liver transplant patients [ 26 - 27 ]. Furthermore, while technical skills and medical management are crucial for improved patient outcomes, an aspect of simulation that should not be overlooked is multidisciplinary team training.…”

Section: Reviewmentioning

confidence: 99%

Simulation in Perioperative Liver Transplant Anesthesia: A Systematic Review

Oh¹,

Patnaik²,

Buckner³

et al. 2022

Cureus

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Due to the complexity of liver transplant patients and the variability in exposure to transplantation by anesthesia trainees, simulation is often required as an adjunct to clinical experience. This systematic review identifies current simulation models in the literature that pertain to perioperative liver transplant anesthesia. Data were collected by performing an electronic search of the PubMed and Scopus databases for articles describing simulation in transplant anesthesia. Abstracts were screened using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Three reviewers analyzed 16 abstracts found in the search and agreed upon articles that met the inclusion criteria for the systematic review. A total of five publications met the inclusion criteria; they could be grouped as cognitive skills and technical skills simulators. Cognitive skills simulators utilized high-fidelity mannequins and animal models combined with traditional educational material to enhance pattern recognition of critical complications during liver transplantation. One manuscript focused on a technical skills acquisition by utilizing transesophageal echocardiography (TEE) to identify intraoperative pathologies. There is a heterogeneity in the exposure to liver transplant care during anesthesia training. Simulation provides low-stakes exposure to the high-stakes skills required in the operating room. Hence, it can be used as an adjunct to improve both cognitive and technical skill acquisition for perioperative transplant anesthesia. The goal of these simulation programs is to improve patient outcomes and produce more capable anesthesiologists.

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