Development and Validation of a Novel and Cost-Effective Animal Tissue Model for Training Transurethral Resection of the Prostate

Objectives: To develop and validate a new and cost-effective animal tissue training model for practicing resection skills of TransUrethral Resection of the Prostate (TURP).
Methods and Materials: A porcine kidney was prepared and restructured to simulate the relevant anatomy of the human prostate. The restructured prostate was connected to an artificial urethra and bladder. Face, content, and construct validity of the model was carried out using a five-point Likert scale questionnaire and comparison in task performance between participants and experts using Observational Clinical Human Reliability Analysis (OCHRA).
Results: 24 participants and 11 experts practiced TURP skills on this model from October 2014 to December 2015 were recruited. The mean score on specific feature of the anatomy and colour, sensation of texture and feeling of resection, conductibility of current, efficacy and safety of the model were 4.34±0.37, 4.51±0.63, 4.13±0.53, 4.35±0.71 respectively by participants while they were 4.22±0.23, 4.30±0.48, 4.11±0.62, 4.56±0.77 respectively by the experts on a scale of 1(unrealistic) to 5(very realistic). Participants committed more technical errors than the experts (11 vs 7, p < 0.001), produced more instruments movements (51 vs 33, p< 0.001), and required longer operating time (11.4 minutes vs 6.2minutes, p < 0.001).
Conclusions: A newly developed restructured animal tissue model for training TURP was reported. Validation study on the model demonstrates that this is a very realistic and effective model for skills training of TURP. Trainees committed more technical errors, more unproductive movements, and required longer operating time.