The Creation of a Novel Low-Cost Bench-Top Kidney Transplant Surgery Simulator and a Survey on Its Fidelity and Educational Utility

Melkonian, Vatche; Huy, Tess; Varma, Chintalapati; Nazzal, Mustafa; Randall, Henry B.; Nguyen, M.

doi:10.7759/cureus.11427

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…We highlight the item “Reproduces feelings of a hemorrhage scenario”, with agreement of 100%, since attempts at creating reliable environments are constant in teaching practices 5 , 6 , 8 , 13 , 14 , which allow the reproduction of stress emotions and physiological reactions, especially in adverse and emergency scenarios. Thus, a great potential application of the simulator is the training of non-technical skills in crisis situations.…”

Section: Discussionmentioning

confidence: 99%

“…After the simulation, we applied a questionnaire with ten questions that dealt with reproducibility, surgical technique, educational usefulness, and experiences lived in the simulator by the research subject, with answers based on a modified Likert scale, graduated from one to four. Faced with the absence of a validated form that met the specific objectives of the study, the applied instrument was developed by the authors based on minimum expected skills and similar published works 5 , 13 .…”

Section: Methodsmentioning

confidence: 99%

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Low-cost simulator for intra-abdominal bleeding

Fernandes,

Rodrigues,

Amaral

et al. 2023

Rev. Col. Bras. Cir.

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Background: training in critical surgical situations is crucial for a safe outcome. The use of simulators is well established, although many are quite expensive, requiring the search for financially viable solutions for training centers. Methods: we built a low-cost simulator for intra-abdominal bleeding with inexpensive materials, such as a manikin chest, latex tubes, silicone rubber, and waterproof fabric, seeking to mimic the abdominal viscera and vessels and their anatomical correlations. An IV infusion set allowed simulated blood to flow under pressure, and the blood flowed freely during simulation. After obtaining a functional model, we selected general surgeons to validate the simulator and its use in teaching surgery. We used the content validity index (CVI), with a cutoff of 0.9. Results: the cost of building the prototype was US$71,00 in 2021, accounting for the purchase of the various necessary materials. Twelve raters participated in the validation tests. The results obtained from the feedback survey showed a good evaluation of all items, especially the recognition of the injured vessel, access to the vascular injury, hemostasis by manual compression, and hemostatic suturing. Conclusion: the proposed simulator obtained good results in scenarios of intra-abdominal bleeding from large vessels, as well as for hemostasis by manual compression and suturing. It proved to be a useful tool for training in critical intra- abdominal bleeding situations, while maintaining a low cost of building.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Low-cost simulator for intra-abdominal bleeding

Fernandes,

Rodrigues,

Amaral

et al. 2023

Rev. Col. Bras. Cir.

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“…In kidney transplantation specifically, previously proposed low-fidelity models consisted of various iterations utilizing small plastic boxes to mimic the iliac fossa and Penrose drains to mimic the vessels and ureter [19]. While these models are affordable and have proven to be useful in improving technical skills, they did not have the ability to represent the varying degrees of challenges associated with performing an anastomosis at increasing depth.…”

Section: Discussionmentioning

confidence: 99%

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

Patnaik¹,

Khan²,

Yamaguchi³

et al. 2022

Cureus

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One of the most challenging aspects of the kidney transplant operation is performing vascular anastomoses in the confines and depths of the iliac fossa. General surgery residents need to be adequately trained in this skill to maximize their intraoperative experience during their transplant surgery rotation. While several kidney transplant models have been developed, they are limited in their ability to simulate the challenges of performing anastomoses at varying depths and in confined spaces. Furthermore, they may be expensive or require specialized equipment, such as three-dimensional printers, to build. In this technical report, we describe how to build a low-fidelity, low-cost, and portable kidney transplant model capable of simulating vascular anastomoses at varying depths. Our model can be easily replicated for less than 30 USD using materials available in local stores. It uses inexpensive and reusable parts, allowing trainees a high volume of repetitions.

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“…These centers are mostly from developed countries with high costs. However, novel models have been introduced to reduce the cost issues[ 59 , 61 ]. On the other hand, many experiments in developing countries reported the presence of deficient numbers of nephrologists with expertise in KT.…”

Section: Challenges Against Kidney Transplantation Programsmentioning

confidence: 99%

“…They have been shown to have a direct relationship with the development of important negative outcomes such as delayed graft function, graft loss, and mortality. The regular training rounds or rotations of surgery are mostly insufficient to provide the required levels of experience for young transplant surgeons or urologists[ 61 , 81 , 82 ]. This complexity of KT procedures may indicate further training programs for practicing with self-confidence and expertise sufficient to guarantee surgical safety for the donors and recipients.…”

Section: Challenges Against Kidney Transplantation Programsmentioning

confidence: 99%

Challenges to establishing and maintaining kidney transplantation programs in developing countries: What are the coping strategies?

Gadelkareem,

Abdelgawad,

Mohammed

et al. 2024

World J Methodol

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Kidney transplantation (KT) is the optimal form of renal replacement therapy for patients with end-stage renal diseases. However, this health service is not available to all patients, especially in developing countries. The deceased donor KT programs are mostly absent, and the living donor KT centers are scarce. Single-center studies presenting experiences from developing countries usually report a variety of challenges. This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries. The financial challenges hamper the infrastructural and material availability, coverage of transplant costs, and qualification of medical personnel. The sociocultural challenges influence organ donation, equity of beneficence, and regular follow-up work. Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice, intense potential psychosocial burdens, complex qualification protocols, and low productivity or compensation for KT practice. Low medical literacy about KT advantages is prevalent among clinicians, patients, and the public. The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems, absent national KT programs and registries, uncoordinated job descriptions and qualification protocols, uncoordinated on-site investigations with regulatory constraints, and the prevalence of commercial KT practices. These challenges resulted in noticeable differences between KT services in developed and developing countries. The coping strategies can be summarized in two main mechanisms: The first mechanism is maximizing the available resources by increasing the rates of living kidney donation, promoting the expertise of medical personnel, reducing material consumption, and supporting the establishment and maintenance of KT programs. The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices. The second mechanism is recruiting external resources, including financial, experience, and training agreements.

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The Creation of a Novel Low-Cost Bench-Top Kidney Transplant Surgery Simulator and a Survey on Its Fidelity and Educational Utility

Cited by 7 publications

References 19 publications

Low-cost simulator for intra-abdominal bleeding

Low-cost simulator for intra-abdominal bleeding

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

Challenges to establishing and maintaining kidney transplantation programs in developing countries: What are the coping strategies?

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