A novel training model for laparoscopic pyeloplasty using chicken crop.

Purpose: To create a model for laparoscopic pyeloplasty training using the crop and esophagus of a chicken. The model can be used to simulate the steps taken during laparoscopic pyeloplasty and to help trainees practice laparoscopic suturing skills.

Materials And Methods: The chicken crop and esophagus were used to simulate the renal pelvis and ureter, respectively. These were exposed by reflecting the skin overlying the neck and thorax. The crop was thoroughly cleaned and filled with water via the esophageal end to simulate the dilated renal pelvis. The chicken was positioned within an indigenously made laparoscopic training box. Laparoscopic pyeloplasty was performed using the dismembered Anderson Hynes technique. The model was used over a period of 1 month by three urology trainees in their final year of training. They were assessed with respect to time needed to complete anastomosis and quality of anastomosis.

Results: The mean operative time showed a marked reduction from the second to the fourth attempt. There was also a significant improvement in the quality of anastomosis from the first to the fourth attempt. At the end of four attempts, all trainees were able to satisfactorily complete a good quality ureteropelvic anastomosis in a mean time of 67.7 minutes (range 62-76 min).

Conclusion: Laparoscopic suturing skills require effective training and constant practice to perfect the technique. Adequate practice on this chicken model shortens the learning curve, makes the trainee more confident of his or her skills, and improves his operative performance.