E106 A glove model for learning of calyx puncture in percutaneous renal surgery

Abstract

The glove model is simple to set up, with a preparation time of about a few minutes. It is economical, by using widely available material. It can be performed in the operating room, since it is a non-biological model, so there is no risk of biologic contamination, nor any hygiene or sterilization issue. Percutaneous puncture and limited dilation were possible in all the fingers and with the same techniques used in our real percutaneous access [8, 9]. The needle mobilization and puncture of the glove’s fingertip are similar to the of the calyx puncture. The fingers have to be tightly filled, in order to be firm to the needle puncture. Otherwise, if the finger is flaccid the needle will push the fingertip without puncturing it. Moreover, dilation and Amplatz sheath insertion are difficult or impossible; the finger is pushed by the dilator. It is a non-biological model so there is a limitation in terms of tissue feeling and for anatomic relations. In addition, ultrasound-imaging guidance cannot be used. Evaluations submitted by training session participants revealed a high degree of satisfaction with model effectiveness in the application of percutaneous calyx puncture. Also, for learning of calyx puncture we have a model without using radiation exposure that can be used in the classroom; it is using a retroprojector with the principle of Chinese-shadows. Introduction The most difficult step of percutaneous renal surgery is to obtain an appropriate access to the renal cavities, which reduces the risk of vascular injury and leads to a better stone-free rate [1-3]. Model-based training that provides experience in percutaneous renal access may reduce the learning curve associated with the procedure and increase the safety profile for beginners as they gain experience on patients [2, 3]. Thus, many biological models with porcine kidney and virtual reality simulator have been developed, to facilitate the learning and training of percutaneous renal surgery [3, 4-7]. We present a cheaper and easily available model using a latex glove for percutaneous calyx puncture.