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Analysis of a practical surgical skills laboratory for nerve sparing radical prostatectomy

  • Emma Clarebrough
  • Daniel Christidis
  • Uri Lindner
  • Kimberly Fernandes
  • Neil Fleshner
  • Nathan Lawrentschuk
Original Article

Abstract

Purpose

With the rapidly expanding anatomical and technical knowledge surrounding nervesparing radical prostatectomy (NSRP), anatomical and operative textbooks have failed to keep pace with the literature. A surgical skill laboratory (SSL) was designed to educate urology trainees on surgical anatomy and techniques for NSRP. The objective was to assess the validity of a SSL program.

Methods

A low-fidelity, anatomically accurate prostate model with its appropriate fascial coverings and location of the neurovascular bundle was created. Participants were surveyed prior to a SSL workshop for their knowledge of NSRP focusing on clinical and anatomical considerations. An interactive 2-h tutorial and workshop was then undertaken outlining the clinical and anatomical nuances for NSRP, with participants then practising an intra and inter-fascial NSRP on the model. Participants were resurveyed immediately after the workshop and at 6 months.

Results

Thirty participants completed the NSRP workshop. Significant differences (p < 0.0001) in anatomical and clinical knowledge were noted after the workshop with improvements for both junior and senior trainees. The knowledge was retained at 6 months following the workshop.

Conclusions

A low-fidelity bench-top model is a feasible and reproducible technique for improving the understanding of periprostatic anatomy and the different surgical approaches for NSRP. The SSL is useful and knowledge gained appears to be retained by workshop participants. SSL workshops are a valid hands-on approach to teaching surgical skills and should remain an integral part of urology training.

Keywords

Prostate cancer Neurovascular bundle Anatomical models Surgical skills laboratory Nerve-sparing prostatectomy 

Notes

Author contribution

EC: Manuscript writing/editing. DC: Manuscript writing/editing. UL: Project/protocol development, Data collection/management. KF: Data analysis, Data collection/management. EJ: Data collection/management. AF: Data collection/management. NF: Project/protocol development, Data collection/management. NL: Project/protocol development, Manuscript writing/editing

Funding

No funding was received for this research.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors have no conflict of interest to declare.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryRoyal Melbourne HospitalMelbourneAustralia
  2. 2.Young Urology Researchers Organisation (YURO)MelbourneAustralia
  3. 3.Department of SurgeryAustin HealthMelbourneAustralia
  4. 4.Department of Urology and Surgical Oncology, Princess Margaret HospitalUniversity of TorontoTorontoCanada
  5. 5.Department of Surgery, Austin HealthUniversity of MelbourneMelbourneAustralia
  6. 6.Olivia Newton John Cancer Research InstituteAustin HealthMelbourneAustralia
  7. 7.Division of Cancer SurgeryPeter MacCallum Cancer CentreMelbourneAustralia

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