V06-03: Retroperitoneal Lymph Node Dissection: Learning Module for Trainees
Retroperitoneal lymph node dissection (RPLND) is a relatively uncommon procedure for the treatment of suspected metastatic testis cancer and requires specific and specialized skills. Currently, no widely available teaching modules exist in order to train medical students and urologic residents for the procedure. We report the first widely available video-assisted online teaching module for RPLND geared towards urologic trainees.
The patient used for our module is a 21-year old male with a diagnosis of clinical stage 1 non-seminoma. The primary orchiectomy specimen contained 80% embryonal cancer, 15% yolk sack and 5% teratoma without lymphovascular invasion. Post-orchiectomy tumor markers were negative. After discussing the risks, benefits and alternative of each treatment option and after providing written consent, we performed and recorded a primary, open, nerve-sparing RPLND. The recorded procedure was then edited into short segments that display its individual components and then uploaded to an online teaching module.
The following components were identified: incision, exposure of retroperitoneum, control of small bowel, identification of dissection landmarks, node dissection with nerve-sparing procedure (including split and roll technique), excision of spermatic cord, closure. Screenshots and video clips were added for each step. In additions, pitfalls and rescue maneuvers were explained with accompanying video examples. Finally, low-fidelity simulation techniques were provided in order to exemplify the specific surgical skills associated with each step. The online module can be found at: http://www.cevlforhealthcare.org/cevl/cevl_ver_2/MENU_UROLOGY/menus_by_institution/cleveland_clinic/ccf_rplnd/story_html5.html
We describe the first online RPLND teaching module geared towards medical students and urologic trainees. We hope that this module will assist trainees in familiarizing themselves with the specific steps and skillset required for this rare procedure.