V01-10: NON-BIOLOGICAL 3D PRINTED SIMULATOR FOR PERCUTANEOUS NEPHROLITHOTRIPSY
The aim of this study was to develop a non-biological 3D printed simulator for percutaneous nephrolithotripsy (PCNL) training and preoperative planning, which would allow doctors to master new skills and perform all stages of the procedure under ultrasound and fluoroscopy guidance.
A 3D model was constructed based on data of multispiral computed tomography (MSCT) of patients with kidney stones. The simulator consists of two parts: a non-biological 3D printed soft model of the kidney with reproduced intrarenal vascular and collecting systems and a printed 3D model of a human body. With the use of fluoroscopy and ultrasound, PCNL was performed in the interventional radiology operating room. To determine the utility of this model, five residents of the 3D Model group (group A) passed a questionnaire (psychometric Likert scale) in which it was proposed to evaluate their skills in understanding of collecting system’s anatomy, definition of stone localization, shape and position, selection of correct calyx for punction and the ability to puncture the kidney from 0 to 10 points. Another five residents passed the same questionnaire after the training on PERC-Mentor (group B).
The designed 3D printed model of the kidney completely reproduced individual features of intrarenal structures of a particular patient. During the training, all main stages of PCNL were performed successfully: puncture, dilation of the nephrostomy tract, endoscopic examination and intrarenal lithotripsy. Mean score of the group A was 41/50, group B – 35,4/50. The biggest difference was in such parameters: ability to punctate the kidney (7/10 in group A, 5/10 in group B), ability to define stone shape and orientation (8/10 in group A, 6/10 in group B).
Our 3D printed simulator launches with packs of key surgical procedure simulations in the area of kidney stone disease. In compare with PERC Mentor, new 3D model is simulator not only for renal puncture, but it also provides an accurate information for preoperative planning and training difficult percutaneous access procedures. This promising development is intended to reduce the frequency of endourological complications associated with urolithiasis. Initial data supports the value of 3D printed kidney models although further educational validation is required.