Talyshinskii Ali, Zeeshan Hameed B M, Ravinder Prajwal P, Naik Nithesh, Adhikari Kinju, Zhanbyrbekuly Ulanbek, Somani Bhaskar K
Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan.
Department of Urology, Father Muller Medical College of Mangalore, Karnataka, India.
Cent European J Urol. 2024;77(3):486-493. doi: 10.5173/ceju.2024.34.R1. Epub 2024 Sep 23.
The market for virtual reality simulators designed to simulate retrograde intrarenal kidney stone (RIRS) surgery, utilising flexible ureteroscopes, is highly limited and dominated by a handful of simulators. The objective of our research is to carry out a pilot study and to provide a description of Endoflex, a transportable virtual flexible ureterorenoscopy simulator for kidney stone treatment.
Seventeen novices were recruited, and each performed a virtual ureterorenoscopy with lithotripsy and lithoextraction. The cavity and location of the stone were determined randomly using the random.org portal. The same scenario was used after an educational week, to define changes in metrics. The time taken for the entire simulation, lasing time, fluoroscopic time, stone-free rate, novices' opinions regarding the usefulness of such a simulator in their training, and its impact on their motivation to continue learning endourological skills were evaluated. Three experienced endourologists were asked about the face and content validity.
There was a significant decrease in simulation time, activated laser time, and fluoroscopy time. The number of novices who fully cleared the pelvicalyceal system increased from 11 to 15 (out of 17). All participants found the Endoflex simulator to be useful for their education. The face and content validity estimated was 4 each for face and content validity.
Endoflex is a promising VR-simulator that can be implemented in urological simulation-based training. However, further improvements are necessary for its full-fledged training of RIRS.
旨在利用可弯曲输尿管镜模拟逆行性肾内肾结石（RIRS）手术的虚拟现实模拟器市场非常有限，且由少数几款模拟器主导。我们研究的目的是开展一项初步研究，并对用于肾结石治疗的可移动虚拟可弯曲输尿管肾镜模拟器Endoflex进行描述。
招募了17名新手，每人进行一次虚拟输尿管肾镜碎石取石术。使用random.org网站随机确定结石的位置和所在腔隙。在经过一周的培训后，使用相同的场景来确定各项指标的变化。评估了整个模拟过程所需的时间、激光照射时间、透视时间、结石清除率、新手对这种模拟器在其培训中的有用性的看法，以及它对新手继续学习腔内泌尿外科技术的积极性的影响。向三位经验丰富的腔内泌尿外科医生询问了表面效度和内容效度。
模拟时间、激活激光时间和透视时间均显著减少。完全清除肾盂肾盏系统的新手人数从11人增加到15人（共17人）。所有参与者都认为Endoflex模拟器对他们的学习很有用。表面效度和内容效度的评估结果均为4分。
Endoflex是一种有前景的虚拟现实模拟器，可用于基于模拟的泌尿外科培训。然而，要对RIRS进行全面培训，还需要进一步改进。
