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You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment1 Apr 2011

1491 DESIGNING A HIGH-FIDELITY LAPAROSCOPIC PARTIAL NEPHRECTOMY BENCH MODEL: DETERMINING THE TEAR STRENGTH AND RESISTANCE OF A SYNTHETIC SILICONE COMPOSITION

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    INTRODUCTION AND OBJECTIVES

    Teaching and learning laparoscopic partial nephrectomy (LPN) is challenging. A bench model that simulates tissue handling and fidelity to a real kidney would be highly valued. We previously studied and measured the tear strength and tissue resistance of human kidneys. The objective of this study was to assess the tear strength and tissue resistance of various synthetic silicone compositions to develop a LPN bench model with high-fidelity tissue handling characteristics.

    METHODS

    Different silicone samples were made by adding varying percentages of platinum silicone additive (0%, 5%, 10%, 15% and 16%). This resulted in samples with different consistency and texture. Using ten samples of each composition, the tear strength was measured by placing a 2/0 vicryl through each sample, which was attached to a strain gauge fixed within a standardized traction applying apparatus. The tear strength reading was taken at the moment the suture began tearing the material. The resistance of the silicone samples was measured using a commercial Durometer fixed to a Keith needle. The tear strength and resistance values from these samples were compared to readings from human kidneys. Kruskal-Wallis non-parameteric statistics were utilized.

    RESULTS

    The median tear strength for the 0%, 5%, 10%, 15%, 16% and human kidney samples were 1900, 645, 665, 460, 210, 445 grams respectively. Post-hoc analysis showed there was no difference between the 15% sample and the human kidney (p=0.97). The median resistance values for the same samples were 80, 62, 112, 85, 89 and 26 units respectively. There were statistically significant differences noted (p<0.05) and none of the silicone samples was found to have similar resistance values to the human kidney.

    CONCLUSIONS

    We found that the 15% silicone sample had similar tear strength to that of human kidneys. All of the silicone samples, including the 15%, had needle resistance much greater than the human kidney. However, we feel tear strength of tissue is essential for teaching suturing and suture tying, as this is a critical construct of learning LPN. The next phase of our study will be the development of the final LPN model using the 15% platinum silicone composition and validation.

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