Design and Validation of a Low-Cost, High-Fidelity Model for Urethrovesical Anastomosis in Radical Prostatectomy

Brett A. Johnson, Matthew Timberlake, Ryan L. Steinberg, Matthew Kosemund, Bradly Mueller, Jeffrey C. Gahan

Research output: Contribution to journalArticle

Abstract

Objective: We sought to develop and validate a low-cost, high-fidelity robotic surgical model for the urethrovesical anastomosis component of the robot-assisted laparoscopic radical prostatectomy. Materials and Methods: A novel simulation model was constructed using a 3D-printed model of the male bony pelvis from CT scan data and silicone molds to recreate the soft tissue aspects. Using a da Vinci Si surgical robot, urology faculty and trainees performed simulated urethrovesical anastomosis. Each participant was given 12 minutes to complete the simulation. A survey established face validity, content validity, and acceptability. Simulation runs were evaluated by three blinded reviewers. The anastomosis was graded by two reviewers for suture placement accuracy and anastomosis quality. These factors were compared with robotic experience to establish construct validity. Results: Twenty participants took part in the initial validation of this model. Groups were defined as experts (surgical faculty), intermediate (fellows and chief residents), and novices (junior residents). Likert scores (1-5 scale, top score 5) examining face validity, content validity, and acceptability were 3.49 ± 0.43, 4.15 ± 0.23, and 4.02 ± 0.19, respectively. Construct validity was excellent based on the model's ability to stratify groups. All evaluated metrics were statistically different between the three levels of training. Total material cost was $2.50 per model. Conclusions: We developed a novel low-cost robotic simulation of the urethrovesical anastomosis for robot-assisted radical prostatectomy. The model discerns robotic skill level across all levels of training and was found favorable by participants showing excellent face, content, and construct validities.

Original languageEnglish (US)
Pages (from-to)331-336
Number of pages6
JournalJournal of Endourology
Volume33
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Robotics
Prostatectomy
Costs and Cost Analysis
Reproducibility of Results
Anatomic Models
Urology
Silicones
Pelvis
Sutures
Fungi

Keywords

  • da Vinci robotic surgery
  • robotic prostatectomy
  • Surgical simulation
  • urethrovesical anastomosis

ASJC Scopus subject areas

  • Urology

Cite this

Design and Validation of a Low-Cost, High-Fidelity Model for Urethrovesical Anastomosis in Radical Prostatectomy. / Johnson, Brett A.; Timberlake, Matthew; Steinberg, Ryan L.; Kosemund, Matthew; Mueller, Bradly; Gahan, Jeffrey C.

In: Journal of Endourology, Vol. 33, No. 4, 01.04.2019, p. 331-336.

Research output: Contribution to journalArticle

Johnson, Brett A. ; Timberlake, Matthew ; Steinberg, Ryan L. ; Kosemund, Matthew ; Mueller, Bradly ; Gahan, Jeffrey C. / Design and Validation of a Low-Cost, High-Fidelity Model for Urethrovesical Anastomosis in Radical Prostatectomy. In: Journal of Endourology. 2019 ; Vol. 33, No. 4. pp. 331-336.
@article{66e8ef0262454bb69f6f824c828cba14,
title = "Design and Validation of a Low-Cost, High-Fidelity Model for Urethrovesical Anastomosis in Radical Prostatectomy",
abstract = "Objective: We sought to develop and validate a low-cost, high-fidelity robotic surgical model for the urethrovesical anastomosis component of the robot-assisted laparoscopic radical prostatectomy. Materials and Methods: A novel simulation model was constructed using a 3D-printed model of the male bony pelvis from CT scan data and silicone molds to recreate the soft tissue aspects. Using a da Vinci Si surgical robot, urology faculty and trainees performed simulated urethrovesical anastomosis. Each participant was given 12 minutes to complete the simulation. A survey established face validity, content validity, and acceptability. Simulation runs were evaluated by three blinded reviewers. The anastomosis was graded by two reviewers for suture placement accuracy and anastomosis quality. These factors were compared with robotic experience to establish construct validity. Results: Twenty participants took part in the initial validation of this model. Groups were defined as experts (surgical faculty), intermediate (fellows and chief residents), and novices (junior residents). Likert scores (1-5 scale, top score 5) examining face validity, content validity, and acceptability were 3.49 ± 0.43, 4.15 ± 0.23, and 4.02 ± 0.19, respectively. Construct validity was excellent based on the model's ability to stratify groups. All evaluated metrics were statistically different between the three levels of training. Total material cost was $2.50 per model. Conclusions: We developed a novel low-cost robotic simulation of the urethrovesical anastomosis for robot-assisted radical prostatectomy. The model discerns robotic skill level across all levels of training and was found favorable by participants showing excellent face, content, and construct validities.",
keywords = "da Vinci robotic surgery, robotic prostatectomy, Surgical simulation, urethrovesical anastomosis",
author = "Johnson, {Brett A.} and Matthew Timberlake and Steinberg, {Ryan L.} and Matthew Kosemund and Bradly Mueller and Gahan, {Jeffrey C.}",
year = "2019",
month = "4",
day = "1",
doi = "10.1089/end.2018.0871",
language = "English (US)",
volume = "33",
pages = "331--336",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "4",

}

TY - JOUR

T1 - Design and Validation of a Low-Cost, High-Fidelity Model for Urethrovesical Anastomosis in Radical Prostatectomy

AU - Johnson, Brett A.

AU - Timberlake, Matthew

AU - Steinberg, Ryan L.

AU - Kosemund, Matthew

AU - Mueller, Bradly

AU - Gahan, Jeffrey C.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objective: We sought to develop and validate a low-cost, high-fidelity robotic surgical model for the urethrovesical anastomosis component of the robot-assisted laparoscopic radical prostatectomy. Materials and Methods: A novel simulation model was constructed using a 3D-printed model of the male bony pelvis from CT scan data and silicone molds to recreate the soft tissue aspects. Using a da Vinci Si surgical robot, urology faculty and trainees performed simulated urethrovesical anastomosis. Each participant was given 12 minutes to complete the simulation. A survey established face validity, content validity, and acceptability. Simulation runs were evaluated by three blinded reviewers. The anastomosis was graded by two reviewers for suture placement accuracy and anastomosis quality. These factors were compared with robotic experience to establish construct validity. Results: Twenty participants took part in the initial validation of this model. Groups were defined as experts (surgical faculty), intermediate (fellows and chief residents), and novices (junior residents). Likert scores (1-5 scale, top score 5) examining face validity, content validity, and acceptability were 3.49 ± 0.43, 4.15 ± 0.23, and 4.02 ± 0.19, respectively. Construct validity was excellent based on the model's ability to stratify groups. All evaluated metrics were statistically different between the three levels of training. Total material cost was $2.50 per model. Conclusions: We developed a novel low-cost robotic simulation of the urethrovesical anastomosis for robot-assisted radical prostatectomy. The model discerns robotic skill level across all levels of training and was found favorable by participants showing excellent face, content, and construct validities.

AB - Objective: We sought to develop and validate a low-cost, high-fidelity robotic surgical model for the urethrovesical anastomosis component of the robot-assisted laparoscopic radical prostatectomy. Materials and Methods: A novel simulation model was constructed using a 3D-printed model of the male bony pelvis from CT scan data and silicone molds to recreate the soft tissue aspects. Using a da Vinci Si surgical robot, urology faculty and trainees performed simulated urethrovesical anastomosis. Each participant was given 12 minutes to complete the simulation. A survey established face validity, content validity, and acceptability. Simulation runs were evaluated by three blinded reviewers. The anastomosis was graded by two reviewers for suture placement accuracy and anastomosis quality. These factors were compared with robotic experience to establish construct validity. Results: Twenty participants took part in the initial validation of this model. Groups were defined as experts (surgical faculty), intermediate (fellows and chief residents), and novices (junior residents). Likert scores (1-5 scale, top score 5) examining face validity, content validity, and acceptability were 3.49 ± 0.43, 4.15 ± 0.23, and 4.02 ± 0.19, respectively. Construct validity was excellent based on the model's ability to stratify groups. All evaluated metrics were statistically different between the three levels of training. Total material cost was $2.50 per model. Conclusions: We developed a novel low-cost robotic simulation of the urethrovesical anastomosis for robot-assisted radical prostatectomy. The model discerns robotic skill level across all levels of training and was found favorable by participants showing excellent face, content, and construct validities.

KW - da Vinci robotic surgery

KW - robotic prostatectomy

KW - Surgical simulation

KW - urethrovesical anastomosis

UR - http://www.scopus.com/inward/record.url?scp=85064203175&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064203175&partnerID=8YFLogxK

U2 - 10.1089/end.2018.0871

DO - 10.1089/end.2018.0871

M3 - Article

C2 - 30734578

AN - SCOPUS:85064203175

VL - 33

SP - 331

EP - 336

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 4

ER -