Holmium Laser Enucleation of the Prostate Simulation: Analysis of Realism and Level of Difficulty by Holmium Laser Enucleation of the Prostate-naive Urologists

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author ANTUNES, Alberto A. FMUSP-HC
ISCAIFE, Alexandre FMUSP-HC
BARBOSA, Joao Arthur B. A. FMUSP-HC
ANJOS, Gabriel dos FMUSP-HC
NAHAS, William C. FMUSP-HC
SROUGI, Miguel FMUSP-HC
dc.date.issued 2019
dc.identifier.citation UROLOGY, v.125, p.34-38, 2019
dc.identifier.issn 0090-4295
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/31077
dc.description.abstract OBJECTIVE To evaluate the opinion of Holmium laser enucleation of the prostate (HoLEP)-naive urologists about a surgical simulator and the level of difficulty at each step. MATERIALS AND METHODS We evaluated 40 HoLEP-naive urologists in a course involving 4 steps: lecture introducing Holmium laser basics and technique; live surgery; video explaining prostate enucleation using simulators; and simulator trial. A survey was applied to evaluate content validity and face validity of the simulator. Subjects also ranked the level of difficulty of each surgical step. RESULTS All urologists agreed on the importance of a validated HoLEP simulator in training; 95% agreed that simulation-based training is essential for patient safety. The mean rate of face validity of all analyzed components was 8.4 (8.1-9.0). Instrumentation was considered the most realistic component, followed by laser-tissue interaction. Positioning the fiber and bladder neck incisions (BNIs) at 5 and 7-o'clock were the easiest steps. Detaching the median lobe from the bladder neck, BNI at 12, dividing the mucosal bridge distally, and joining the upper and lower incisions were the most difficult steps. Residents found more difficulty in joining the BNIs distally (3.6 vs 2.4, P = .006) and in dividing the mucosal bridge distally (4.0 vs 3.0, P = .038) when compared to specialists. CONCLUSIONS HoLEP-naive urologists found this simulator useful and important for patient safety. Most components were considered realistic. Simulation was able to reproduce the levels of difficulty usually found in real life cases. The level of expertise may influence the learning process of some steps. (C) 2019 Elsevier Inc.
dc.language.iso eng
dc.publisher ELSEVIER SCIENCE INC
dc.relation.ispartof Urology
dc.rights restrictedAccess
dc.subject.other urinary-tract symptoms; learning-curve; hyperplasia; outcomes
dc.title Holmium Laser Enucleation of the Prostate Simulation: Analysis of Realism and Level of Difficulty by Holmium Laser Enucleation of the Prostate-naive Urologists
dc.type article
dc.rights.holder Copyright ELSEVIER SCIENCE INC
dc.description.group LIM/55
dc.identifier.doi 10.1016/j.urology.2018.10.055
dc.identifier.pmid 30615893
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author ANTUNES, Alberto A.:FM:MCG
hcfmusp.author ISCAIFE, Alexandre:HC:ICHC
hcfmusp.author BARBOSA, Joao Arthur B. A.:HC:ICHC
hcfmusp.author ANJOS, Gabriel dos:FM:
hcfmusp.author NAHAS, William C.:FM:MCG
hcfmusp.author SROUGI, Miguel:FM:MCG
hcfmusp.origem.id WOS:000459863100009
hcfmusp.origem.id 2-s2.0-85060288644
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1527-9995
hcfmusp.citation.scopus 0
hcfmusp.citation.wos 0


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