Skip to main content

Advertisement

SpringerLink
Log in

Cadaveric Models for Renal Transplant Surgery Education: a Comprehensive Review

  • Kidney Diseases (G Ciancio, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To evaluate the utility of cadaveric models for kidney transplant (KT) surgery training.

Recent Findings

Medline® and PubMed® databases were searched for English and Spanish language articles published describing different learning models used in KT formation. We evaluated the use of cadavers preserved by Thiel’s embalming method (TEM) as KT simulation models. Students were divided in groups of 4 people: four trainees mentored by an expert in KT surgery. Among the trainees were surgical residents and low-experience surgeons. A total of 39 TEM preserved bodies were used, of which 75 viable renal grafts were obtained. In each cadaver, two complete transplantation processes were performed, each consisting of en bloc nephrectomy with the trunk of aorta and inferior vena cava, bench surgery and perfusion with saline of the organ, and KT surgery.

Summary

As with any surgical procedure, learning KT surgery is a stepwise process that requires years of dedication. The models available for the surgical simulation of KT surgery allow to practice and achieve dexterity in performing the procedure in a safe and reproducible way. Training on TEM-preserved corpses offers a highly realistic model for the surgical simulation of KT surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11(10):2093–109.

    Article  CAS  Google Scholar 

  2. Newsletter transplant. International figures on donation and transplantation 2018. 2018; 99.

  3. •• Cabello R, González C, Quicios C, Bueno G, García JV, Arribas AB, et al. An experimental model for training in renal transplantation surgery with human cadavers preserved using W. Thiel’s Embalming Technique. J Surg Educ. 2015;72(2):192–7. Explains more details about the KT simulation model in cadavers embalmed with TEM.

    Article  Google Scholar 

  4. Golriz M, Hafezi M, Garoussi C, Fard N, Arvin J, Fonouni H, et al. Do we need animal hands-on courses for transplantation surgery? Clin Transpl. 2013;27:6–15.

    Article  Google Scholar 

  5. Kapadia MR, DaRosa DA, MacRae HM, Dunnington GL. Current assessment and future directions of surgical skills laboratories. J Surg Educ. 2007;64(5):260–5.

    Article  Google Scholar 

  6. Hamdorf JM, Hall JC. Acquiring surgical skills. Br J Surg. 2000;87(1):28–37.

    Article  CAS  Google Scholar 

  7. Goff BA. Changing the paradigm in surgical education. Obstet Gynecol. 2008;112(2 Pt 1):328–32.

    Article  Google Scholar 

  8. Burnand H, Mutimer J. Surgical training in your hands: organising a skills course. Clin Teach. 2012;9(6):408–12.

    Article  Google Scholar 

  9. Golriz M, Fonouni H, Nickkholgh A, Hafezi M, Garoussi C, Mehrabi A. Pig kidney transplantation: an up-to-date guideline. Eur Surg Res Eur Chir Forsch Rech Chir Eur. 2012;49(3–4):121–9.

    CAS  Google Scholar 

  10. Holland JP, Waugh L, Horgan A, Paleri V, Deehan DJ. Cadaveric hands-on training for surgical specialties: is this back to the future for surgical skills development? J Surg Educ. 2011;68(2):110–6.

    Article  Google Scholar 

  11. • Aydin A, Shafi AMA, Shamim Khan M, Dasgupta P, Ahmed K. Current status of simulation and training models in urological surgery: a systematic review. J Urol. 2016;196(2):312–20. Reviews currently available training models for urological surgery, their status of validation and the evidence behind each model.

    Article  Google Scholar 

  12. Breda A, Budde K, Figueiredo A, Lledo E. EAU-Guidelines-on-Renal-Transplantation-2019.pdf [Internet]. 2019. Available from: www.uroweb.org.

  13. Burgos FJ, Alcaraz A, Castillón I, González Martín M, Lledó E, Matesanz R, et al. Present and future of kidney transplantation. Actas Urol Esp. 2002;26(10):731–58.

    Article  CAS  Google Scholar 

  14. Cabello-Benavente R, González-Enguita C. Residency in urology and training in kidney transplantation. Results of a national survey. Actas Urol Esp. 2015;39(5):303–9.

    Article  CAS  Google Scholar 

  15. Sutherland LM, Middleton PF, Anthony A, Hamdorf J, Cregan P, Scott D, et al. Surgical simulation: a systematic review. Ann Surg. 2006;243(3):291–300.

    Article  Google Scholar 

  16. Sáenz Medina J, Asuero de Lis MS, Correa Gorospe C, Cuevas B, Gómez Dos Santos V, Linares Quevedo AI, et al. Experimental models for research and training in renal transplant. Actas Urol Esp. 2008;32(1):83–90.

    Article  Google Scholar 

  17. Kobayashi E, Hishikawa S, Teratani T, Lefor AT. The pig as a model for translational research: overview of porcine animal models at Jichi Medical University. Transpl Res. 2012;1(1):8.

    Article  Google Scholar 

  18. Bestard Vallejo JE, Raventós Busquets CX, Celma Doménech A, Rosal Fontana M, Esteve M, Morote RJ. Pig model in experimental renal transplant surgery. Actas Urol Esp. 2008;32(1):91–101.

    Article  CAS  Google Scholar 

  19. Prasad Rai B, Tang B, Eisma R, Soames RW, Wen H, Nabi G. A qualitative assessment of human cadavers embalmed by Thiel’s method used in laparoscopic training for renal resection. Anat Sci Educ. 2012;5(3):182–6.

    Article  Google Scholar 

  20. Wedel T, Ackermann J, Hagedorn H, Mettler L, Maass N, Alkatout I. Educational training in laparoscopic gynecological surgery based on ethanol-glycerol-lysoformin-preserved body donors. Ann Anat. 2019;221:157–64.

    Article  Google Scholar 

  21. Menon M, Abaza R, Sood A, Ahlawat R, Ghani KR, Jeong W, et al. Robotic kidney transplantation with regional hypothermia: evolution of a novel procedure utilizing the IDEAL guidelines (IDEAL phase 0 and 1). Eur Urol. 2014;65(5):1001–9.

    Article  Google Scholar 

  22. He B, Mou L, De Roo R, Musk GC, Hamdorf JM. Evaluation of three-dimensional versus conventional laparoscopy for kidney transplant procedures in a human cadaveric model. Exp Clin Transplant. 2017;15(5):497–503.

    PubMed  Google Scholar 

  23. Eltemamy M, Garisto J, Miller E, Wee A, Kaouk J. Single port robotic extra-peritoneal dual kidney transplantation: initial pre-clinical experience and description of the technique. Urology. 2019.

  24. Sharma M, Macafee D, Horgan AF. Basic laparoscopic skills training using fresh frozen cadaver: a randomized controlled trial. Am J Surg. 2013;206(1):23–31.

    Article  Google Scholar 

  25. •• Ottone N, Vargas C, Fuentes R, Del Sol M. Walter Thiel’s embalming method. Review of solutions and applications in different fields of biomedical research. Int J Morphol. 2016;34(4):1442–54. Reviews in detail other uses for surgical simulation of cadavers embalmed with TEM.

    Article  Google Scholar 

  26. Wolff K-D, Kesting M, Mücke T, Rau A, Hölzle F. Thiel embalming technique: a valuable method for microvascular exercise and teaching of flap raising. Microsurgery. 2008;28(4):273–8.

    Article  Google Scholar 

  27. Okada R, Tsunoda A, Momiyama N, Kishine N, Kitamura K, Kishimoto S, et al. Thiel’s method of embalming and its usefulness in surgical assessments. Nihon Jibiinkoka Gakkai Kaiho. 2012;115(8):791–4.

    Article  Google Scholar 

  28. Nielsen GD, Larsen ST, Wolkoff P. Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment. Arch Toxicol. 2017;91(1):35–61.

    Article  CAS  Google Scholar 

  29. Thiel W. The preservation of the whole corpse with natural color. Ann Anat. 1992;174(3):185–95.

    Article  CAS  Google Scholar 

  30. Thiel W. Supplement to the conservation of an entire cadaver according to W. Thiel. Ann Anat. 2002;184(3):267–9.

    Article  Google Scholar 

  31. Liao P-Y, Wang Z-G. Thiel-embalming technique: investigation of possible modification in embalming tissue as evaluation model for radiofrequency ablation. J Biomed Res. 2019.

  32. Pichler W, Tesch NP, Grechenig W, Tanzer K, Grasslober M. Anatomical variations of the flexor hallucis longus muscle and the consequences for tendon transfer. A cadaver study. Surg Radiol Anat SRA. 2005;27(3):227–31.

    Article  Google Scholar 

  33. Kappler UA, Constantinescu MA, Büchler U, Vögelin E. Anatomy of the proximal cutaneous perforator vessels of the gracilis muscle. Br J Plast Surg. 2005;58(4):445–8.

    Article  CAS  Google Scholar 

  34. Saito T, Yoshimoto M, Yamamoto Y, Miyaki T, Itoh M, Shimizu S, et al. The medial branch of the lateral branch of the posterior ramus of the spinal nerve. Surg Radiol Anat SRA. 2006;28(3):228–34.

    Article  Google Scholar 

  35. Desroches J, Grabs U, Grabs D. Selective ultrasound guided pectoral nerve targeting in breast augmentation: how to spare the brachial plexus cords? Clin Anat. 2013;26(1):49–55.

    Article  Google Scholar 

  36. González-Arnay E, Jiménez-Sánchez L, García-Simón D, Valdés-Vilches L, Salazar-Zamorano CH, Boada-Pié S, et al. Ultrasonography-guided anterior approach for axillary nerve blockade: an anatomical study. Clin Anat. 2019.

  37. Szűcs Z, László CJ, Baksa G, László I, Varga M, Szuák A, et al. Suitability of a preserved human cadaver model for the simulation of facemask ventilation, direct laryngoscopy and tracheal intubation: a laboratory investigation. Br J Anaesth. 2016;116(3):417–22.

    Article  Google Scholar 

  38. De Crop A, Bacher K, Van Hoof T, Smeets PV, Smet BS, Vergauwen M, et al. Correlation of contrast-detail analysis and clinical image quality assessment in chest radiography with a human cadaver study. Radiology. 2012;262(1):298–304.

    Article  Google Scholar 

  39. Pilsl U, Rosmarin W, Anderhuber F. The premaxillary space: a location for filler injection? Dermatol Surg. 2014;40(3):301–4.

    Article  CAS  Google Scholar 

  40. McLeod H, Cox BF, Robertson J, Duncan R, Matthew S, Bhat R, et al. Human Thiel-embalmed cadaveric aortic model with perfusion for endovascular intervention training and medical device evaluation. Cardiovasc Intervent Radiol. 2017;40(9):1454–60.

    Article  Google Scholar 

  41. Lim R, Tay SC, Yam A. Radial nerve injury during double plating of a displaced intercondylar fracture. J Hand Surg. 2012;37(4):669–72.

    Article  Google Scholar 

  42. Peuker ET, Werkmeister R, Pera F, Joos U, Filler TJ. Surgical procedures in mouth, jaw and facial surgery in Thiel embalmed body donors. Mund- Kiefer- Gesichtschirurgie MKG. 2001;5(2):141–3.

    Article  CAS  Google Scholar 

  43. Ruiz-Tovar J, Prieto-Nieto I, García-Olmo D, Clascá F, Enriquez P, Vilallonga R, et al. Correction to: Training courses in laparoscopic bariatric surgery on cadaver Thiel: results of a satisfaction survey on students and professors. Obes Surg. 2019 Jul 1 [cited 2019 Oct 7]; Available from: http://link.springer.com/10.1007/s11695-019-04050-9.

  44. Eisma R, Mahendran S, Majumdar S, Smith D, Soames RW. A comparison of Thiel and formalin embalmed cadavers for thyroid surgery training. Surg J R Coll Surg Edinb Irel. 2011;9(3):142–6.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Urology Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain

    Lidia Coloma, Ramiro Cabello, Carmen González, Cristina Quicios, Gonzalo Bueno & Juan Vicente García

  2. Vascular Surgery Department, Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid, Madrid, Spain

    Ana Begoña Arribas

  3. Anatomy, Histology and Neuroscience Department, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Francisco Clascá

Authors
  1. Lidia Coloma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ramiro Cabello
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carmen González
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cristina Quicios
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gonzalo Bueno
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juan Vicente García
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ana Begoña Arribas
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Francisco Clascá
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ramiro Cabello.

Ethics declarations

Conflict of Interest

Lidia Coloma, Ramiro Cabello, Carmen González, Cristina Quicios, Gonzalo Bueno, Juan Vicente García, Ana Begoña Arribas, and Francisco Clascá each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Kidney Diseases

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Coloma, L., Cabello, R., González, C. et al. Cadaveric Models for Renal Transplant Surgery Education: a Comprehensive Review. Curr Urol Rep 21, 10 (2020). https://doi.org/10.1007/s11934-020-0961-x

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-020-0961-x

Keywords

Search

Navigation