Validation of a Pulsatile Model for Laparoscopic Partial Nephrectomy: NEFPAR Model.

Abstract

Background: Laparoscopic and robotic-assisted partial nephrectomy are the gold standard for treating small renal tumors. To improve training while adhering to animal welfare regulations, the NEFPAR pulsatile model was developed as a nonliving alternative for surgical simulation. This study aimed to validate NEFPAR as a realistic and effective training tool. Methods: The NEFPAR model was constructed using porcine tissue used in other simulations, a pulsatile pump, and standard laparoscopic instruments. Eleven participants (4 urologists and 7 urology residents) were recruited for validation. They performed simulated laparoscopic partial nephrectomies using the model, and their performance was evaluated through a survey assessing the realism, educational impact, and comparison to other simulation models. Data were analyzed using Fisher's exact test, with significance set at P < .05. Results: Most participants (72.7%) rated the NEFPAR model as realistic for key procedural steps, such as tumor resection and renal hilum dissection. The bleeding component was deemed essential for learning by 100% of participants. The NEFPAR model was superior to nonpulsatile animal models in replicating surgical bleeding and was comparable to cadaveric models in external appearance and tissue texture. However, cadaveric models were rated higher for replicating all procedural steps. No significant differences in responses were found between urologists and residents. Conclusions: The NEFPAR model effectively simulates key aspects of laparoscopic partial nephrectomy and offers an ethical, cost-effective alternative for surgical training. It was well-received for its educational value, especially for simulating surgical bleeding. Further refinements could enhance tissue consistency and tumor positioning, but the model has strong potential to be integrated into urology training programs to improve surgical skills and reduce reliance on animal models.