V02-08 CREATION AND VALIDATION OF A SIMPLE TRAINING MODEL FOR PERCUTANEOUS RENAL ACCESS

Abstract

You have accessJournal of UrologyCME1 Apr 2023V02-08 CREATION AND VALIDATION OF A SIMPLE TRAINING MODEL FOR PERCUTANEOUS RENAL ACCESS Ala'a Farkouh, Tyler Humphries, Matthew Buell, Akin S. Amasyali, Alphie Rotinsulu, Rose Leu, Kanha Shete, and D. Duane Baldwin Ala'a FarkouhAla'a Farkouh More articles by this author , Tyler HumphriesTyler Humphries More articles by this author , Matthew BuellMatthew Buell More articles by this author , Akin S. AmasyaliAkin S. Amasyali More articles by this author , Alphie RotinsuluAlphie Rotinsulu More articles by this author , Rose LeuRose Leu More articles by this author , Kanha SheteKanha Shete More articles by this author , and D. Duane BaldwinD. Duane Baldwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003232.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Establishing renal access remains the most challenging aspect during percutaneous nephrolithotomy. Adequate training of urology residents is essential, as improper access can lead to increased morbidity and potential mortality. The purpose of this video was to demonstrate the design, creation, and validation of a simple training model for renal access. METHODS: Using commercially available software, a mold of the renal parenchyma and collecting system was created from a patient’s CT Urogram and then 3D-printed. A silicone kidney model was created from this mold, giving a coronally bisected right kidney with a calyceal system. This model was embedded in ballistic gelatin, which simulated the surrounding muscles and subcutaneous tissue. The final position of the kidney and surrounding gelatin simulated prone PCNL of the right kidney. A small metal ring was used as the target for renal access and was placed in the upper calyx upon a grid to allow measurement of distance from target. A piece of calcium carbonate was embedded into the gelatin over the upper pole of the kidney and simulated a palpable 12th rib. The entire model was covered with an opaque sheet to simulate skin and fluoroscopy was used to guide renal access. Five urologists and 15 novices took part in establishing renal access following training. The primary endpoint was validation of this training model. Construct validity was evaluated by comparing the distance from the target between urologists and novices using the Mann–Whitney U test. Participants were then asked to fill out a survey about the training model to evaluate its face validity. RESULTS: All 5 urologists successfully entered the ring, corresponding to a 0 mm distance from the target. Of the novices, 67% missed the ring, with an average distance of 3.07 mm from the target (p=0.025). When asked if they felt the model is an accurate representation of the anatomy surrounding renal access, 90% answered yes and 10% were unsure. All felt that working on this model will increase their understanding of obtaining renal access. 75% were extremely likely to recommend it for training. CONCLUSIONS: This video demonstrates design, creation, and validation of a simple training model for renal access. Furthermore, it is simple, inexpensive, does not contaminate, and does not raise ethical concerns. Such models should be widely available for trainees to practice and comprehend the principle of obtaining renal access before their attempt in the operating room. Use of models like this could increase the skill of trainees and subsequently reduce patient morbidity. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e170 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ala'a Farkouh More articles by this author Tyler Humphries More articles by this author Matthew Buell More articles by this author Akin S. Amasyali More articles by this author Alphie Rotinsulu More articles by this author Rose Leu More articles by this author Kanha Shete More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement PDF downloadLoading ...