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. 2020 Nov 10;12(11):e11427.
doi: 10.7759/cureus.11427.

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

Vatche Melkonian  1 , Tess Huy  2 , Chintalapati R Varma  1 , Mustafa Nazzal  1 , Henry B Randall  1 , Minh-Tri J Nguyen  3
Affiliations

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

Vatche Melkonian et al. Cureus. .

Abstract

Introduction Resident inexperience during time-sensitive vascular anastomoses of a kidney transplant can negatively impact outcomes. In light of this, we created a low-cost bench-top kidney transplant surgery simulator to help residents practice vascular anastomoses. Methods We searched for inexpensive materials to design an iliac fossa and kidney allograft. Eighteen residents with real-life kidney transplant experience trialed the simulator and scored its fidelity and educational utility on a 0-100 visual analog scale (VAS) survey. Results A 35.9 x 19.4 x 12.4 cm plastic box mimicked the iliac fossa. Hooks attached to the box's sidewall held under tension 1.27 and 0.64 cm diameter Penrose drains to replicate the external iliac vein and artery. A modified kidney-shaped stress ball with 1.27 x 4, 0.64 x 4, and 0.64 x 15 cm Penrose drains replicated a kidney allograft with its vein, artery, and ureter, respectively. Residents performed and assisted in vascular anastomoses on the simulator. The iliac fossa and allograft cost $20.20 and each practice run cost $7.20. Residents thought that the simulator was less difficult than real-life procedure, had acceptable fidelity levels, and they highly rated its educational utility. Conclusion Our novel low-cost bench-top kidney transplant surgery simulator focusing on vascular anastomoses received positive educational feedback from residents.

Keywords: kidney transplantation; medical education; residency; simulation training; surgical anastomosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The 10-question feedback survey on the fidelity and educational utility of the novel bench-top kidney transplant surgery simulator
The answers were recorded and scored using a 0-100 visual analog scale PGY: post-graduate year
Figure 2
Figure 2. Bench-top kidney transplant surgery simulator design
The images show the design replicating A) the recipient right iliac fossa and B) a left kidney transplant allograft
Figure 3
Figure 3. Two residents work together on the bench-top kidney transplant surgery simulator
The images show residents performing the A) venous and B) arterial vascular anastomoses operative steps of a real-life kidney transplant. C) An alternative technique to the venous anastomosis is demonstrated in which the back wall is performed from inside the lumen
Figure 4
Figure 4. Mean 0-100 visual analog scale scores provided by PGY 1-5 general surgery residents for survey questions on the fidelity and educational utility of the novel bench-top kidney transplant surgery simulator
See this image and copyright information in PMC

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