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Training Model In Endourology. Retrograde Approach
Posted in Lectures on 17 April 2019

Federico Soria, Julia de la Cruz-Conty, Cristina Sousa-Cervera, María Soto, Francisco Miguel Sánchez Margallo.
Jesus Uson Minimally Invasive Surgery Centre Foundation. Caceres (Spain).


Endourological techniques currently involve a long, sequential learning curve and take up significant learning time, so young urologists sometimes have little opportunity to develop and refine their skills in daily clinical practice. The possibility of carrying out different stages of training through validated simulation programs brings great advantages: it is carried out in a stress-free environment, it allows for step-by-step training of techniques, self-evaluation, it allows for standardization of training, it has proven to be cost-effective and positive for increasing both technical and non-technical skills, such as leadership, complication management, stress management, strengthens teamwork, etc.
The aim of this study is to show and validate our endourology retrograde approach training model with full immersion in OR. It is based on three modules, which combines the use of bench models and a porcine animal model.
-Module I. Acquisition of basic knowledge in retrograde Endourology
-Module II. Practice in bench models in OR.
-Module III. Practice in porcine animal model
We evaluated 356 trainees who have gone through our Endourology training activities following this realistic and organized model.


The final parameter to take into account in any training programme is its validation. Training programmes must be validated to show that they are useful to increase and measure the acquisition of technical skills.
Trainees’ satisfaction with the face and content validity of our Training program in Retrograde Endourology is high.
Construct validity is used to determine how well a test measures what it is supoosed to measure. In our case, statistical analisys showed differences between experienced urologists and trainees.
Our trainees increase their technical skills by 20 to 44%.


We believe that training using these models has great value in the initial steps before contact with a patient and to refine techniques and skills.
Moreover, the integration of simulators into the surgical training CV allows urologist to acquire basic surgical skills, which would otherwise stretchen on the time.
Our “realistic enviroment” endourology training model allows the acquisition of technical knowledge and skills, as face, content and constructive validation show. A structured use of non-biological and biological simulators, as well as the use of animal models lead to an increase in endourology skills.