You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment/Ureteroscopy II1 Apr 20121504 SPONGE TRAINER A NOVEL SIMPLE TRAINING MODEL FOR PERCUTANEOUS RENAL ACCESS Ahmad Tawfik, Mohamed Gaber, Osama El-Gamal, Yasser Farahat, Ahmad Ramadan, Abdelhamid El-Bahnasy, and Mohamed Rasheed Ahmad TawfikAhmad Tawfik Tanta, Egypt More articles by this author , Mohamed GaberMohamed Gaber Tanta, Egypt More articles by this author , Osama El-GamalOsama El-Gamal Tanta, Egypt More articles by this author , Yasser FarahatYasser Farahat Tanta, Egypt More articles by this author , Ahmad RamadanAhmad Ramadan Tanta, Egypt More articles by this author , Abdelhamid El-BahnasyAbdelhamid El-Bahnasy Tanta, Egypt More articles by this author , and Mohamed RasheedMohamed Rasheed Tanta, Egypt More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1271AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The co-ordination of fluoroscopic guidance and spatial movement of the puncture needle is the most demanding and steady step in learning curve for percutaneous renal access (PRA). Unlike laparoscopic box trainer, there is no currently available cheap training model for PRA. Either animal models or virtual trainers are expensive training solutions which are not usually available in many centers. This study was designated to evaluate the efficacy of our novel sponge trainer to provide junior urologists with initial skills for PRA. METHODS • Trainer design: Three sheets of 10cm thick sponge (60x70cm) were arranged horizontally over each other. A rectangular perforation was done just lateral to the midline of the middle sheet. The upper sheet was thinned out at both sides to simulate human back with radiopaque bands (simulating human ribs) are fixed to its surface. All sheets were fixed together on fluoroscopic table. • Training schedule: Single then multiple small metal balls were fixed in the hole of the middle sheet and covered with the upper one. Under perpendicular and oblique fluoroscopic control, every trainee was asked to pass Chiba needle from a surface puncture point (selected by a supervisor PCNL expert) to the selected metal ball. After success, he was asked to pass the needle through a horizontal then vertical metal ring (instead of the ball) and finally to pass the needle through a plastic model of the kidney filled with radio-opaque solution and pass a guidewire through its ureter. Twelve junior urologists were included in this study. Training sessions were done every other day for 10 sessions. After last session, all trainees were asked to describe their experience with this model on 5-points scale. Trainees who could get successful first trial in all models at last session were shifted to a single supervised patients' trial. RESULTS The median number of trials required to touch a single ball, one of multiple balls, pass the needle in horizontal then vertical ring and put the wire in the plastic models decreased from 6, 9, 8, 10 and 9 trials at the first training session to 1, 1, 2, 2 and 3 trials at the last session respectively. Nine of the trainees described the experience gained as “excellent”, while the other three described it as “very good”. Four out five trainees (80%), who had successful first trial in all models, could successfully achieve PRA on their first trial in PCNL patients. CONCLUSIONS Sponge trainer is a simple, cheap and effective mean for PRA training. It applies the necessary navigation and hands-eye coordination skills to deal with PCNL puncture needles under fluoroscopic guidance. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e609 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmad Tawfik Tanta, Egypt More articles by this author Mohamed Gaber Tanta, Egypt More articles by this author Osama El-Gamal Tanta, Egypt More articles by this author Yasser Farahat Tanta, Egypt More articles by this author Ahmad Ramadan Tanta, Egypt More articles by this author Abdelhamid El-Bahnasy Tanta, Egypt More articles by this author Mohamed Rasheed Tanta, Egypt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Read full abstract