OBJECTIVE: To identify and review the currently available simulators and explore the evidence supporting their efficacy for training in prostate surgery.
MATERIALS AND METHODS: A review of the current literature was performed between 1999 and 2013. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, TURP, simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves. Furthermore, relevant abstracts from the AUA, EAU, BAUS and WCE meetings, between 1999 and 2013, were included. Only studies related to prostate surgery simulators were included and studies regarding other urological simulators were excluded.
RESULTS: A total of 22 studies were identified, which carried out a validation study. Five validated models and/or simulators were identified for transurethral resection of the prostate (TURP), one for GreenLight laser therapy, three for laparoscopic radical prostatectomy (LRP) and four for robotic surgery. Of the TURP simulators, all five demonstrated content validity, three demonstrated face validity and four construct validity. The GreenLight laser simulator demonstrated face, content and construct validities. All three animal models for LRP demonstrated construct validity whilst The Chicken Skin Model was also content valid. Only two robotic simulators were identified with relevance to robot-assisted laparoscopic prostatectomy (RALP), both of which demonstrated construct validity.
CONCLUSIONS: A wide range of different simulators are available for prostate surgery including synthetic bench models, virtual-reality platforms, animal models, human cadavers, distributed simulation and advanced training programmes and modules. The currently validated simulators may be used by healthcare organisations to provide supplementary training sessions for trainee surgeons. Further research should be conducted to validate simulated environments, determine which simulators have greater efficacy than others, assess the cost effectiveness of the simulators and the transferability of skills learnt. However, with surgeons investigating new possibilities for easily reproducible and valid methods of training, simulation offers a great scope to be implemented alongside traditional methods of training.
Khan R, Aydin A, Khan MS, Dasgupta P, Ahmed K. Are you the author?
King's College London - MRC Centre for Transplantation, London, United Kingdom.
Reference: BJU Int. 2014 Mar 4. Epub ahead of print.
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