Mp73-03 Flexible Ureteroscopy Skill Development: A Pilot Comparative Study Using Motion-Tracking Simulation With Tip Tracking

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment (MP73)1 May 2024MP73-03 FLEXIBLE URETEROSCOPY SKILL DEVELOPMENT: A PILOT COMPARATIVE STUDY USING MOTION-TRACKING SIMULATION WITH TIP TRACKING Ihtisham Ahmad, Jonguk Lee, Kai-Ho Fok, Jessica Trac, Sufyan Shaikh, Amir Hamzeh, Zizo Al-daqqaq, Brian Carillo, and Monica Farcas Ihtisham AhmadIhtisham Ahmad , Jonguk LeeJonguk Lee , Kai-Ho FokKai-Ho Fok , Jessica TracJessica Trac , Sufyan ShaikhSufyan Shaikh , Amir HamzehAmir Hamzeh , Zizo Al-daqqaqZizo Al-daqqaq , Brian CarilloBrian Carillo , and Monica FarcasMonica Farcas View All Author Informationhttps://doi.org/10.1097/01.JU.0001009564.26544.1c.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Instrument motion tracking in surgical simulation is implemented as a teaching and evaluation tool. Our group developed a synchronized motion-tracking simulation system for flexible ureteroscopy (fURS). The aim of this study was to compare kinematic parameters between novices and experts during fURS simulation. METHODS: Our system consisted of a 3D-printed kidney model within a URS simulation box. Motion tracking sensors (6 degrees of freedom) were attached to the main body and the distal tip of a ureteroscope. The body sensors tracked the surgeon's movements while the tip sensor tracked the location and movement of the intrarenal scope tip. A potentiometer was attached to the control lever to measure deflection, tracked as percentage of maximum. We recruited 10 participants, 6 PGY2s and 2 PGY3s (novices), and 2 endourology fellows (experts). The task was to map the kidney by traversing all its calyxes. A staff endourologist rated participant performance out of 20 with the standard URS global rating scale (Goldenberg, 2020). RESULTS: The mean URS rating was 10 for novices and 16 for experts (p=0.04). The mean path length for the intrarenal tip was 2182±613 mm for novices and 1164±290 mm for experts (p=0.03), while its mean speed was 12.2±2.1 mm/s and 9.8±0.3 mm/s respectively (p=0.01). Visualizing the tip path showed that novices traversed less renal area, especially for lateral calyxes (Fig. 1A). Visualizing scope body movement showed that experts moved in a predictable wing-shaped pattern while novices moved relatively randomly (Fig. 1B). The average lever deflection magnitude was 5.7% ± 2.4% for novices compared to 10.8% ± 0.67% for experts (p=0.001). CONCLUSIONS: This is the first study that incorporated intrarenal tip tracking during fURS motion analysis. Our findings set the stage for adaptive and personalized learning. By evaluating the visual differences in tip path and scope body movement, novices can access on-demand feedback. Comparing to experts' parameters, they can modify their technique to enhance maneuvering efficiency and calyceal access. Our preliminary findings emphasize that experts show more limited but more predictable scope body movement, greater lever deflection, and more effective tip movement. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1182 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ihtisham Ahmad More articles by this author Jonguk Lee More articles by this author Kai-Ho Fok More articles by this author Jessica Trac More articles by this author Sufyan Shaikh More articles by this author Amir Hamzeh More articles by this author Zizo Al-daqqaq More articles by this author Brian Carillo More articles by this author Monica Farcas More articles by this author Expand All Advertisement PDF downloadLoading ...