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    Korean J Urol. 2008 Oct;49(10):868-873. Korean.
    Published online Oct 31, 2008.
    https://doi.org/10.4111/kju.2008.49.10.868
    Copyright © 2008 The Korean Urological Association
    Original Article

    The Impact of Using a Porcine Model in Laparoscopic Partial Nephrectomy Training

    Sung Yul Park, Byung Hyun Soh, Koon Ho Rha, Seung Choul Yang and Woong Kyu Han
      • Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
    • Email: hanwk@yuhs.ac
    Received March 07, 2008; Accepted August 13, 2008.

    Abstract

    Purpose

    We assessed the impact of using a porcine model on the training of laparoscopic partial nephrectomy (LPN) and compared the training effectiveness between surgeons with and without previous laparoscopic experience.

    Materials and Methods

    Surgeon A had previous laparoscopic experience, with the exception of LPN, while surgeon B had no prior laparoscopic experience. A tumor model was created by subcapsular injection of liquid plastic (Smooth-Cast 320) in the kidney. We recorded the total operation time, the bowel dissection time, the renal pedicle dissection time, the warm ischemic time, the mass resection time, the suture time, and the presence of major complications for each surgeon.

    Results

    The mean operation time was significantly shorter for surgeon A compared to surgeon B (49.1±4.5 and 63.6±8.4 minutes, respectively, p< 0.001). Although the mass resection time was significantly shorter for surgeon A as well, there were no significant differences between the two surgeons in terms of warm ischemia time and suture time. As the training progressed, surgeon B improved in all surgical steps and surgeon A showed improvement in time for warm ischemia and suturing the defect. Five complications occurred (two cases by surgeon A and three cases by surgeon B).

    Conclusions

    A porcine model improved the skills needed for LPN, including shortening the warm ischemia and suture times. LPN is a procedure requiring technically-demanding skills that can be improved by training using a animal model, regardless of the previous laparoscopic experiences.

    Keywords
    Laparoscopy; Training; Nephrectomy

    Figures

    Fig. 1
    In vivo laparoscopic appearance of the tumor model (arrow).

    Fig. 2
    Clamped renal pedicle by a Satinsky clamp.

    Fig. 3
    Tumor resection model.

    Fig. 4
    Suturing a renal defect.

    Fig. 5
    The learning curves of two surgeons for each steps; total operation time (A), bowel mobilization time (B), renal pedicle dissection time (C), warm ischemic time (D), mass resection time (E) and suture time (F).

    Tables

    Table 1
    Comparison of training results between surgeons A and B

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