Description and Validation of a Modular Training System for Laparoscopic Nephrectomy

Abstract

Mentees matched the median British Association for Urological Surgeons (BAUS) registry operative time (LN, 120-180 min, LNU, 180-240 min) and had lower conversion rates (2.9% vs 6.4% for BAUS). Mentees matched median BAUS database reported blood loss (LN and LNU <500 mL) and length of stay (LN-4 days, LNU-5 days). This modular training program allows urologists to become independent in LN after a short period of focused training in the training center followed by a short period of mentoring in the mentee's own center.

Matched-Pair Analysis of Open versus Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Cell Carcinoma

“…Surgery was conducted by 9 consultant surgeons and all patients underwent uniform surgical approaches (as previously described [10,21]) with standardised post-operative care and follow-up. As demonstrated by the large percentage of cases undertaken laparoscopically (75% of the total pool), this was the standard approach in our centre.…”

“…Surgery was undertaken by 9 different consultant urologists. LNU was performed via a transperitoneal approach, as previously described [10,21]. Patients undergoing both ONU and LNU had preliminary mobilisation of their kidney and proximal ureter before extra- or trans-vesical mobilisation of the lower ureter and bladder cuff.…”

A Generation of Laparoscopic Nephrectomy: Stage-Specific Surgical and Oncologic Outcomes for Laparoscopic Nephrectomy in a Single Center

“…This may be particularly true when sequential mentoring with modular training is in place, because this allows efficient and effective training, as we have reported. 7 Despite the improved surgical outcomes seen in LRN for localized disease, this was not mirrored with LRN for locally advanced disease. There was no significant difference in blood loss, transfusion rate, or operative time with increased experience.…”

Training in minimally invasive surgery in urology: European Association of Urology/International Consultation of Urological Diseases consultation

“…The current literature includes a number of studies proposing and evaluating MTS in laparoscopic and robot‐assisted urological surgery . The majority of studies are on training in radical prostatectomy, and only one publication describes an MTS for laparoscopic nephrectomy . The MTSs in radical prostatectomy have significant differences in the number of steps into which the procedure is divided, the level and evaluation of the trainees as well as the prior training before initiating the MTS.…”

“…All training programmes for LRP and RALP included the use of some form of simulation before the initiation of the MTS . The use of animal laboratory training courses has been frequently applied in the MTSs for RALP .…”