Hands on wet lab and live surgery training in PCNL: Any impact to surgical skills of attending surgeons?

The clinical value and efficiency of hands-on training courses in percutaneous nephrolithotomy (PCNL) remains undocumented. During the last 9 years, a two-day international intensive hands-on training course in fluoroscopic guided prone PCNL is taking place in our department on a monthly basis. Course includes wet lab training in the porcine model and live surgery training. In this work we report the outcomes of a survey send to course participants questioning the impact of the course to their clinical practice. A survey consisting of 26 questions was distributed online to a total of 91 trainees that had completed the course. Comparison of pre and post course surgical practices was performed using the "N-1" Chi-squared test. A total of 64 trainees responded to our online survey with 55.6% and 41.3% reporting a modest or major impact to their practice accordingly. Notable changes in puncture and dilation technique were evidenced while a uniform reduction in puncture and operative times was documented. 79.4% responded that the course increased the safety of their procedure, 73% that it reduced operating times, 39.7% that increased their stone free rates, 23.8% that reduced their complications and 23.8% that induced to change their instrumentation with respect of that they were using in the past. Subgroup analysis including only well experienced surgeons revealed a similar impact to their practice. In the proper setting, an intensive hands-on PCNL course can have a significant impact on attending physicians. Participation to such events even for experienced surgeons should be encouraged.