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TUR-P phantom for resident surgical training: food-based design as a human mimicking model of the prostate

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

This study would like to develop a novel model similar to human prostate in terms of its texture profile, sensation upon resection, and anatomical hallmarks for resident transurethral resection of the prostate (TUR-P) training.

Methods

Ten phantom designs were proposed, using broadly available ingredients and a homemade protocol. Three steps of evaluation and development were done: objective measurement measuring texture profile (e.g. hardness, elasticity, cohesiveness/consistency, and adhesiveness/stickiness) using TA-XT2i Texture Analyzer (Llyod Instruments, Ametek Inc) to compare the designs with human prostate, finding the most similar design to prostate; expert consensus by a panel of urologist/senior residents comparing the simulation of TUR-P on the selected design with pre-existing control phantom; and anatomical design development using 3D printing for molding.

Results

Texture profile analysis for mean hardness, elasticity, cohesiveness/consistency, and adhesiveness/stickiness of human prostate was 3753.4 ± 673.4, 85 ± 1.9, 0.7 ± 0.03, and 0, respectively, and design IX was the most similar to human prostate (3660.7 ± 465.6, 87.0 ± 2.5, 0.6 ± 0.05, 0). Furthermore, expert consensus showed superiority of design IX compared with pre-existing control phantom (16.95 ± 1.36 vs 8.86 ± 3.10; P < 0.001). Most of the respondents agreed that the texture, consistency, and phantom ability to mimic human prostate upon resection were similar with human prostate, though hallmarks of the prostate e.g. veromontanum, and lobes were lacking. We used these feedbacks to develop a mold, designed to produce these important anatomical hallmarks.

Conclusion

This study developed a cost-effective prostate model from a food-based design that is similar to human prostate in terms of its texture and sensation upon TUR-P resection provided with important anatomical hallmarks.

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Funding

There is no external funding done for this study. All expenses were covered by the institution and authors.

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Authors and Affiliations

  1. Department of Urology, Cipto Mangunkusumo General Hospital-Universitas Indonesia, Jl. Diponegoro 71, Senen, Central Jakarta, DKI Jakarta, 10430, Indonesia

    Nur Rasyid, Harun Wijanarko Kusumo Putra, Ponco Birowo, Irfan Wahyudi, Chaidir Arif Mochtar & Agus Rizal A. H. Hamid

Authors
  1. Nur Rasyid
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  2. Harun Wijanarko Kusumo Putra
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  3. Ponco Birowo
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  4. Irfan Wahyudi
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  5. Chaidir Arif Mochtar
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  6. Agus Rizal A. H. Hamid
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Contributions

NR: project design, project development, data collection, and manuscript writing. HWKP: data collection and manuscript writing. PB: manuscript writing and supervision. IW: data collection and supervision. CAM: data analysis and supervision. ARAHH: project design, supervision, and manuscript editing.

Corresponding author

Correspondence to Agus Rizal A. H. Hamid.

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Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (The Ethics Committee of the Faculty of Medicine, University of Indonesia; Ethical Approval number 0224/UN2.F1/ETIK/2018) and with the 1964 Helsinski declaration and its later amendments or comparable ethical standards.

Informed consent

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

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Rasyid, N., Putra, H.W.K., Birowo, P. et al. TUR-P phantom for resident surgical training: food-based design as a human mimicking model of the prostate. World J Urol 38, 2907–2914 (2020). https://doi.org/10.1007/s00345-020-03085-3

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  • DOI: https://doi.org/10.1007/s00345-020-03085-3

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