Holmium Laser Enucleation of the Prostate Simulation: Analysis of Realism and Level of Difficulty by Holmium Laser Enucleation of the Prostate-naïve Urologists.

Objective: To evaluate the opinion of Holmium laser enucleation of the prostate (HoLEP)-naïve urologists about a surgical simulator and the level of difficulty at each step.Materials and Methods: We evaluated 40 HoLEP-naïve urologists in a course involving 4 steps: lecture introducing Holmium laser...

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Publicado en:Urology Vol. 125; pp. 34 - 40
Autores principales: Antunes, Alberto A., Iscaife, Alexandre, Barbosa, João Arthur B.A., dos Anjos, Gabriel, Nahas, William C., Srougi, Miguel
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2019
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.urology.2018.10.055
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        134821289
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        atl: Holmium Laser Enucleation of the Prostate Simulation: Analysis of Realism and Level of Difficulty by Holmium Laser Enucleation of the Prostate-naïve Urologists.
      aug:
        au:
          Antunes, Alberto A.
          Iscaife, Alexandre
          Barbosa, João Arthur B.A.
          dos Anjos, Gabriel
          Nahas, William C.
          Srougi, Miguel
        affil: Division of Urology, Hospital das Clínicas, University of Sao Paulo Medical School, Cerqueira Césa, São Paulo, Brazil
      sug:
        subj:
          Prostatectomy Education
          Attitude of Health Personnel
          Urology Education
          Lasers Therapeutic Use
          Prostatectomy Methods
          Aged
          Middle Age
          Adult
          Prospective Studies
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
      ab: Objective: To evaluate the opinion of Holmium laser enucleation of the prostate (HoLEP)-naïve urologists about a surgical simulator and the level of difficulty at each step.Materials and Methods: We evaluated 40 HoLEP-naïve urologists in a course involving 4 steps: lecture introducing Holmium laser basics and technique; live surgery; video explaining prostate enucleation using simulators; and simulator trial. A survey was applied to evaluate content validity and face validity of the simulator. Subjects also ranked the level of difficulty of each surgical step.Results: All urologists agreed on the importance of a validated HoLEP simulator in training; 95% agreed that simulation-based training is essential for patient safety. The mean rate of face validity of all analyzed components was 8.4 (8.1-9.0). Instrumentation was considered the most realistic component, followed by laser-tissue interaction. Positioning the fiber and bladder neck incisions (BNIs) at 5 and 7-o'clock were the easiest steps. Detaching the median lobe from the bladder neck, BNI at 12, dividing the mucosal bridge distally, and joining the upper and lower incisions were the most difficult steps. Residents found more difficulty in joining the BNIs distally (3.6 vs 2.4, P = .006) and in dividing the mucosal bridge distally (4.0 vs 3.0, P = .038) when compared to specialists.Conclusion: HoLEP-naïve urologists found this simulator useful and important for patient safety. Most components were considered realistic. Simulation was able to reproduce the levels of difficulty usually found in real life cases. The level of expertise may influence the learning process of some steps.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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