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model with participants giving the model an average score of 4.17 on a 5-point
Likert scale for anatomical accuracy of the renal pelvis, ureter, and UPJ obstruc-
tion. Scores of 4.42 and 4.33 were given for the model reproducing skills for the
anastomotic suturing and reproducing the skills of spatulation, respectively (con-
tent validity). Construct validity was shown as those who had experience in per-
forming a LPP in the previous 5 years performed better than those who had not in
terms of increased patency (p < 0.05), decreased twisting (p < 0.05), and decreased
leakage (p < 0.10) [ 51 ].
A simpler model is the “latex glove” laparoscopic pyeloplasty model set forth by
Raza et al. [ 53 ]. The authors used a standard latex glove with a knot tied at the base
of one of the fingers to create a model in which the knot represents a strictured UPJ
and the palm represents the dilated renal pelvis (Fig. 24.5). The model was placed
within a standard laparoscopic box trainer, and a laparoscopic dismembered pyelo-
plasty was then performed. In their small study of five participants ranging from an
experienced surgeon (>20 laparoscopic pyeloplasties) to an inexperienced medical
student, Raza et al. touted construct validity for this model. The more experienced
participants were found to perform the procedure in significantly less time (47 vs
160 min, p = 0.043) and with better suturing [ 53 ]. Further studies into the applica-
bility of this model into urological training are yet to be seen.
Yang et al. have set forth a benchtop model for the simulation of a retro-
peritoneal laparoscopic dismembered pyeloplasty [ 54 ]. The model consists of a
kidney made of commercially available plastic clay (such as Play-Doh®) with
the middle part of the model being imbedded with a metal clip, allowing for the
attachment of a carp swim bladder, to simulate a dilated renal pelvis. A separate
10 cm portion of porcine ureter is used as the model ureter, with it already being
Fig. 24.5 Ex vivo porcine kidney wrapped in full-thickness skin flap [ 165 ]
W. Baas et al.