A Simple, Non - Biological Model for Percutaneous Renal Access Training

Ahsen Karagozlu Akgul, Dursun Unal, Murat Demirbas, Sedat Oner, Murat Ucar, Korhan Akgul, Muhammet Guzelsoy, Murat Aydos

Abstract


409

Purpose: Percutaneous renal puncture (PRP) is one of the most important and critical step of urology, especially while performing percutaneous nephrostomy and percutaneous nephrolithotomy (PCNL). In the learning period of this procedures, there is a need for validated, effective, economical models for such training. This study describes a simple non - biological model for learning PRP. The aim was to determine the effectivity of this model as a training and assessment tool, and to assess its cost relative to other models.
Materials and Methods: We designed a training box, made of foam and rubber with two open sides and performed radiopaque pelvicalyceal system maquettes to insert inside it. Experts in PCNL (i.e., > 100 cases) and
novices (i.e., pediatric surgeons and urologists without PCNL experience) performed percutaneous renal puncture. Novices performed a pre -test and a post - test (i.e., after 2 hour training). Data recorded were total procedure time, X - ray exposure time, and number of puncture attempts. Experts who performed PRP successfully were asked to
rate the model using a questionnaire.
Results: Five experts and 21 novices completed the study. Four experts rated the model as an "excellent" (score 5) training and assessment tool; one expert rated these as "very good" (score 4). Comparisons of novices' pre - and post - test median results revealed significant skill acquisition with shorter procedure time, less X - ray exposure, and fewer attempts for successful puncture (all P < .001).
Conclusion: This new non - biological training model is an effective training tool that helps learners improve skills in PRP. The model is simple to construct, economical, and highly re-useable compared to others. It provides good visibility and imaging, is portable, and could be used widely in training centres.

Full Text:

PDF

146

References


Rosette JJMCH, Laguna MP, Rassweiler JJ, Conort P. Training in Percutaneous Nephrolithotomy—A Critical Review. EAU 2008;54:994–1001.

Watterson JD, Soon S, Jana K. Access related complications during percutaneous nephrolithotomy: urology versus radiology at a single academic institution. J Urol. 2006 Jul;176(1):142-5.

Schilling D, Gakis G, Walcher U, Stenzl A, Nagele U. The learning curve in minimally invasive percutaneous nephrolitholapaxy: a 1-year retrospective evaluation of a novice and an expert. World J Urol 2011;29:749–53.

Palter VN. Comprehensive training curricula for minimally invasive surgery. J Grad Med Educ 2011;3:293-8.

Stern J, Zeltser IS, Pearle MS. Percutaneous renal access simulators. J Endourol 2007;21:270-3. Review.

Mishra S, Jagtap J, Sabnis RB, et al. Training in percutaneous nephrolithotomy. Current Opinion Urolithiasis 2013; 23(2):147–51.

Zang Y, Yu CF, Jin SH, Li NC, Na YQ. Validation of a novel non biological bench model for the training of percutaneous renal access. Int Braz J Urol 2014;40:87-92.

Scott DJ, Cendan JC, Pugh CM, Minter RM, Dunnington GL and Kozar RA. The changing face of surgical education: simulation as the new paradigm. J Surg Res 2008;147:189-93.

Wignall GR, Denstedt JD, Preminger GM, et al. Surgical simulation: a urological perspective. Urol 2008;179:1690-9.

Turney BW. A new model with an anatomically accurate human renal collecting system for training in fluoroscopy-guided percutaneous nephrolithotomy access. J Endourol 2014;28:360-3.

Bruyère F, Leroux C, Brunereau L, Lermusiaux P. Rapid prototyping model for percutaneous nephrolithotomy training. J Endourol 2008;22:91-6.

Radecka E, Brehmer M, Holmgren K, Palm G, Magnusson P, Magnusson A. Pelvicaliceal biomodeling as an aid to achieving optimal access in percutaneous nephrolithotripsy. J Endourol 2006;20:92-101.

Gill JD, Stewart LF, George NJR, Eardley I. Operative experience of urological trainees in the UK. BJU Int 2012;109:1296-301.




DOI: http://dx.doi.org/10.22037/uj.v0i0.3805


Creative Commons License 
This work is licensed under a Creative Commons Attribution 3.0 License