Multi Institutional Experience with the GreenLight Simulator
DOI:
https://doi.org/10.17140/UAOJ-1-101Keywords:
Minimally invasive surgery, Transurethral resection of the prostate, Greenlight simulatorAbstract
Introduction: The objective of this study was to evaluate the GreenLight Laser SimTM for resident education in a multi institutional study using a structured curriculum.
Materials and Methods: Residents from two tertiary care hospitals participated in this study. The curriculum included four SIM modules and four SIM cases on the GreenLight Laser SimTM. Participants of various training levels were evaluated by grams of tissue vaporized in allotted time, average sweep speed, blood loss, and average laser-tissue distance throughout the study.
Results: 20 residents, PGY1-PGY6, completed 331 trials on the simulator. Increased number of trials on the simulator was associated with a statistically significant increase in vaporization efficiency and reduced laser distance. No significant difference was noted between training level or simulator trial number when examining blood loss.
Conclusions: This study demonstrates that use of the GreenLight Laser SimTM is associated with improved vaporization efficiency. The simulator is a useful tool in resident education and instruction of important safety principles and procedural techniques and can help improve vaporization efficiency.
References
Kuntzman RS, Malek RS, Barrett DM, Bostwick DG. Potas-sium-titanyl-phosphate laser vaporization of the prostate: a com-parative functional and pathologic study in canines. Urology. 1996; 48(4): 575-583. doi: 10.1016/S0090-4295(96)00247-6
Woods E. Laser ablation of the prostate: a safe effective treat-ment of obstructive benign prostatic disease. Cuaj-Canadian Urological Association Journal. 2010; 4(5): 344-346.
Palter VN, Grantcharov TP. Simulation in surgical education. Canadian Medical Association Journal. 2010; 182(11): 1191- 1196.
Gallagher AG, Ritter EM, Champion H, et al. Virtual real-ity simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005; 241(2): 364-372. doi: 10.1097/01.sla.0000151982.85062.80
Ahmed K, Jawad M, Abboudi M, et al. Effectiveness of pro-cedural simulation in urology: a systematic review. J Urol. 2011; 186(1): 26-34. doi: 10.1016/j.juro.2011.02.2684
Brewin J, Ahmed K, Challacombe B. An update and review of simulation in urological training. International Journal of Sur-gery. 2014; 12(2): 103-108. doi: 10.1016/j.ijsu.2013.11.012
Khan R, Aydin A, Khan MS, Dasgupta P, Ahmed K. Simula-tion-based training for prostate surgery. BJU Int. 2014; 16(4): 665-674. doi: 10.1111/bju.12721
Shen Y, Konchada V, Zhang N, et al. Laser surgery simulation platform: toward full-procedure training and rehearsal for be-nign prostatic hyperplasia (BPH) therapy. Stud Health Technol Inform. 2011; 163: 574-580. doi: 10.3233/978-1-60750-706-2-
Zhou X, Zhang N, Shen Y, Burke D, Konchada V, Sweet R. Phenomenological model wof laser-tissue interaction with appli-cation to Benign Prostatic Hyperplasia (BPH) simulation. Stud Health Technol Inform. 2011; 163: 749-755. doi: 10.3233/978- 1-60750-706-2-749
Herlemann A, Strittmatter F, Buchner A, et al. Virtual re-ality systems in urologic surgery: an evaluation of the Green-Light simulator. European Urology. 2013; 64(4): 687-688. doi: 10.1016/j.eururo.2013.06.008
Seki N, Nomura H, Yamaguchi A, Naito S. Evaluation of the learning curve for photoselective vaporization of the pros-tate over the course of 74 cases. Journal of Endourology. 2008; 22(8): 1731-1735. doi: 10.1089/end.2007.0368
Misrai V, Faron M, Guillotreau J, et al. Assessment of the learning curves for photoselective vaporization of the prostate using GreenLight (TM) 180-Watt-XPS laser therapy: defin-ing the intra-operative parameters within a prospective cohort. World Journal of Urology.2014; 32(2): 539-544. doi: 10.1007/ s00345-013-1163-7
Aydin A, Muir GH, Graziano ME, et al. Validation of the greenlight simulator and development of a training curriculum for photoselective vaporisation of the prostate. British Journal of Urology International. 2014; 115(6): 994-1003.
Muir G, Sancha FG, Bachmann A, et al. Techniques and training with GreenLight HPS120-W laser therapy of the pros-tate: position paper. European Urology Supplements. 2008; 7(4): 370-377. doi: 10.1016/j.eursup.2008.01.012
Sancha FG, Bachmann A, Choi BB, Tabatabaei S, Muir GH. Photoselective vaporization of the prostate (GreenLight PV): lessons learnt after 3500 procedures. Prostate Cancer Prostatic Dis. 2007; 10(4): 316-322. doi: 10.1038/sj.pcan.4500989
Raza SJ, Froghi S, Chowriappa A, et al. Construct validation of the key components of fundamental skills of robotic surgery (fsrs) curriculum-a multi-institution prospective study. J Surg Educ. 2014; 71(3): 316-324. doi: 10.1016/j.jsurg.2013.10.006
Stegemann AP, Ahmed K, Syed JR, et al. Fundamental skills of robotic surgery: a multi-institutional randomized controlled trial for validation of a simulation-based curriculum. Urology. 2013; 81(4): 767-774. doi: 10.1016/j.urology.2012.12.033
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Urology and Andrology (UA) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.