The Creation of a Novel Low-Cost Bench-Top Kidney Transplant Surgery Simulator and a Survey on Its Fidelity and Educational Utility

Vatche Melkonian; Tess Huy; Chintalapati R Varma; Mustafa Nazzal; Henry B Randall; Minh-Tri J Nguyen

doi:10.7759/cureus.11427

The Creation of a Novel Low-Cost Bench-Top Kidney Transplant Surgery Simulator and a Survey on Its Fidelity and Educational Utility

Cureus. 2020 Nov 10;12(11):e11427. doi: 10.7759/cureus.11427.

Authors

Vatche Melkonian¹, Tess Huy², Chintalapati R Varma¹, Mustafa Nazzal¹, Henry B Randall¹, Minh-Tri J Nguyen³

Affiliations

¹ Surgery, Abdominal Transplant Center, Saint Louis University Hospital, St. Louis, USA.
² Surgery, University of California Los Angeles, Los Angeles, USA.
³ Transplant Surgery, Transplant Institute, Loma Linda University Medical Center, Loma Linda, USA.

Abstract

Introduction Resident inexperience during time-sensitive vascular anastomoses of a kidney transplant can negatively impact outcomes. In light of this, we created a low-cost bench-top kidney transplant surgery simulator to help residents practice vascular anastomoses. Methods We searched for inexpensive materials to design an iliac fossa and kidney allograft. Eighteen residents with real-life kidney transplant experience trialed the simulator and scored its fidelity and educational utility on a 0-100 visual analog scale (VAS) survey. Results A 35.9 x 19.4 x 12.4 cm plastic box mimicked the iliac fossa. Hooks attached to the box's sidewall held under tension 1.27 and 0.64 cm diameter Penrose drains to replicate the external iliac vein and artery. A modified kidney-shaped stress ball with 1.27 x 4, 0.64 x 4, and 0.64 x 15 cm Penrose drains replicated a kidney allograft with its vein, artery, and ureter, respectively. Residents performed and assisted in vascular anastomoses on the simulator. The iliac fossa and allograft cost $20.20 and each practice run cost $7.20. Residents thought that the simulator was less difficult than real-life procedure, had acceptable fidelity levels, and they highly rated its educational utility. Conclusion Our novel low-cost bench-top kidney transplant surgery simulator focusing on vascular anastomoses received positive educational feedback from residents.

Keywords: kidney transplantation; medical education; residency; simulation training; surgical anastomosis.