VirtaMed TURPSim – TURP Simulator

VirtaMed offers urologists a comprehensive educational solution for transurethral resection of the prostate (TURP). Basic skill tasks provide initial hands-on experience.

Training includes mastering instruments and managing complications, aimed at completing TURP procedure practice without involving live patients.

Didactic Tutorials for Every TURP Skill

For best learning success, the training of complete virtual interventions is supplemented with practical teaching tutorials.

Didactic content and movies exemplify the best core procedural techniques, e.g. visualization of landmarks (sphincter, verumontanum, ureteral orifices, bladder surface) or safe resection without capsule perforation.

Training Modules for Basic Skills and TURP Full Procedures

TURP Basic Skills

This module contains different basic tasks to acquire all skills necessary to safely perform a complete TURP procedure.

The module also provides a training curriculum relying on self practice until reaching the desired proficiency level.

Learning objectives:

Gain experience in identifying the anatomical landmarks
Develop knowledge in cystoscopy

Handle the loop electrode, adjust to the fulcrum effect and 30° angled scope
Acquire depth perception and hand-eye coordination
Understand the BPH pathologic prostate
Acquire safe resection techniques and become proficient in using a resectoscope
Control bleeding and efficiently manage complications during the procedure

TURP Full Procedure

The VirtaMed TURPSim features a set of 12 different virtual patients in varying levels of difficulty.

Cases include small to large prostates with hypertrophies of both lateral and median lobes, presenting challenges such as difficult access and heavy bleeding.

Learning objectives:

Establish clear viewing conditions
Identify anatomical landmarks and obtain a clear 3D mental image of the anatomy
Efficiently observe pathology
Safely handle resectoscope and loop electrode
Perform resection of the different lobes
Coagulate bleeding sources
Perform a safety inspection at the end of the procedure

Emergency Scenarios for All Relevant Complications

Training in virtual reality offers the chance to exercise not only general interventions but also very special cases and complications. Emergency scenarios can either be triggered by an action of the trainee or remotely by the trainer on the controlling terminal. VirtaMed TURPSim is able to simulate all relevant complications that may occur during TURP procedures.

Bleeding control

Establishing and maintaining clear view is an essential challenge in TURP surgery.

The handling of distention fluid with the in- and out-valve as well as the detection and coagulation of bleeding sources can be safely trained.

Capsule perforation

Perforation of the capsule is one of the most serious complications that can occur during TURP procedures.

The resection map clearly shows if a cut went too deep into the capsule (orange) or if there is more prostatic tissue to be resected (blue). Green tissue means that there should not be resected anymore.

Verumontanum or sphincter resection

Unintentional resection of the verumontanum or the sphincter has an irreversible negative effect on the future life of the patient.

With the TURP simulator, surgeons can learn to safely resect without risk for the patient.

Objective Feedback for Best Learning Results

For the structured learning of surgical skills, objective feedback is crucial. Virtual reality simulators can be used for the assessment of surgical skills and have been reported to be superior to traditional methods such as direct observation, animal models, videotapes, and procedure logs in terms of reliability and validity.

Visualized landmarks (sphincter, verumontanum, ureteral orifices, bladder surface)
Economy (procedure time, camera path, amount of fluid used, quantity of removed prostate)
Safety measures (number of non-coagulated bleeding, resection depth, visibility)
Complication handling (capsule perforations, heavy bleeding, verumontanum or sphincter resections)

The objective feedback including scores, images and movies is archived and therefore always accessible to both trainee and trainer.

The movie of the complete intervention can be replayed for discussion and review.

Facts & Figures

VirtaMed® Platform

An adapted, original resectoscope is used to provide a complete simulation experience and to facilitate familiarization with instruments. As in real life, the resectoscope features:
- In- and outlet valves for fluid handling
- Three virtual cameras: 0º, 12º and 30º including focus wheel
- Working element for electro surgery
Foot pedals for electrosurgical cutting and coagulation in simulated procedures
Patient replacement robot with or without force feedback
High-end PC with 2 screens and monitor stand
Mouse and keyboard
Height-adjustable display cart

Training Software

VirtaMed TURPSim Training Software

8 virtual patients for TURP Basic Skills
- Visualization
- Bleeding control
- Resection
- Partial TURP
8 virtual patients for TURP Full Procedures