Development of a continuously perfused ex vivo kidney training model for laparoscopic partial nephrectomy: validity and efficiency

Abstract

Background: Suture hemostasis is essential for laparoscopic partial nephrectomy (LPN). This study aimed to develop, validate, and test the efficacy of a continuously perfused training model (CPTM) in LPN with high-level simulated bleeding. Materials and methods: The CPTM was constructed using fresh porcine kidneys with renal arteries continuously perfused with red-dyed liquid gelatin. Twenty-nine participants with expert, intermediate, or novice laparoscopic experience levels were recruited. The expert and intermediate participants evaluated the CPTM, and the novice participants were randomly assigned to one of two groups to complete training on a CPTM or dry box training model (DBTM). Messick’s framework criteria were utilized to assess the validity and training efficacy of the model. The data were analyzed using the Mann–Whitney U, Kruskal–Wallis, and Friedman tests. A value of P<0.05 was considered statistically significant. Results: Positive comments were provided by all experts and intermediates for the Content. The Relationships with other variables demonstrated significant differences among novices, intermediates, and experts in all metrics (P<0.05). The Consequences showed that the CPTM helped novices acquire LPN skills. The training efficacy was significantly better than that of the DBTM (P<0.05). There were no significant differences between the final performances of the novices and the initial performances of the experts (P>0.05). Synthesizing all metrics, the LPN skills learned using CPTMs were significantly improved in the 12th round of training. Conclusion: The CPTM offered a high-level simulation of bleeding with realistic tissue texture for acquiring LPN skills. Training of no fewer than 12 rounds is recommended for a novice’s LPN training on the CPTM.