International Journal of Medical Sciences

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24 October 2017

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Int J Med Sci 2013; 10(8):1047-1052. doi:10.7150/ijms.6099

Research Paper

Ureteral Obstruction Swine Model through Laparoscopy and Single Port for Training on Laparoscopic Pyeloplasty

Idoia Díaz-Güemes Martín-Portugués1, ✉, Laura Hernández-Hurtado1, Jesús Usón-Casaús2, Miguel Angel Sánchez-Hurtado1, Francisco Miguel Sánchez-Margallo1

1. Minimally Invasive Surgery Center Jesús Usón. Crta. N-521, Km 41,8. 10071 Cáceres (Spain);
2. Medicine and Animal Surgery Department. University of Extremadura. Av. Universidad s/n. 10003. Cáceres (Spain).

Abstract

This study aims firstly to assess the most adequate surgical approach for the creation of an ureteropelvic juntion obstruction (UPJO) animal model, and secondly to validate this model for laparoscopic pyeloplasty training among urologists.

Thirty six Large White pigs (28.29±5.48 Kg) were used. The left ureteropelvic junction was occluded by means of an endoclip. According to the surgical approach for model creation, pigs were randomized into: laparoscopic conventional surgery (LAP) or single port surgery (LSP). Each group was further divided into transperitoneal (+T) or retroperitoneal (+R) approach. Time needed for access, surgical field preparation, wound closure, and total surgical times were registered. Social behavior, tenderness to the touch and wound inflammation were evaluated in the early postoperative period. After ten days, all animals underwent an Anderson-Hynes pyeloplasty carried out by 9 urologists, who subsequently assessed the model by means of a subjective validation questionnaire.

Total operative time was significantly greater in LSP+R (p=0.001). Tenderness to the touch was significantly increased in both retroperitoneal approaches, (p=0.0001). Surgeons rated the UPJO porcine model for training on laparoscopic pyeloplasty with high or very high scores, all above 4 on a 1-5 point Likert scale.

Our UPJO animal model is useful for laparoscopic pyeloplasty training. The model created by retroperitoneal single port approach presented the best score in the subjective evaluation, whereas, as a whole, transabdominal laparoscopic approach was preferred.

Keywords: swine, training, laparoscopic pyeloplasty, single port surgery.

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How to cite this article:
Díaz-Güemes Martín-Portugués I, Hernández-Hurtado L, Usón-Casaús J, Sánchez-Hurtado MA, Sánchez-Margallo FM. Ureteral Obstruction Swine Model through Laparoscopy and Single Port for Training on Laparoscopic Pyeloplasty. Int J Med Sci 2013; 10(8):1047-1052. doi:10.7150/ijms.6099. Available from http://www.medsci.org/v10p1047.htm