Robotic minimally-invasive reconstructive surgery of the ureter: investigation of new surgical techniques and technologies, 3d models applications and development of a structured training program.

Main goal of this project was to develop a 3D model that could be useful for young surgeons in their early training career, to practice surgical skills in a safe pre-clinical environment. For this goal the model had to be as likely and faithful as possible to the human anatomy. A secondary goal was to obtain an effective tool to assess the trainee’s progression and to evaluate its surgical competence. The uretero-pelvic junction (UPJ) was chosen for simplicity reasons, given the relatively elementary anatomy to be reproduced and the various techniques of reconstructive surgeries described. A 3D printed UPJ silicon model was realized, sized exactly as a human renal pelvis and its lumbar ureter, with a millimetric ureteral lumen patent from the distal end to the renal pelvis. Thicknesses of walls resulted to be different, being the renal pelvis wall slightly more robust than the ureteral wall. The surface and the shape of every model is irregular, characteristic due to the technique of production, evaluated as positive to show some degree of variation between each model while maintaining all the important parameters standardized. Our silicon model is therefore easy to produce, has sufficient resemblance to the anatomy and has optimal surgical manipulation characteristics.