Training for renal ablative technique using an agarose-based renal tumour-mimic model

Area of Science:

• Urology
• Surgical Training
• Medical Device Development

Background:

• Increasing diagnosis of small renal masses necessitates nephron-sparing treatments like radiofrequency ablation (RFA).
• Mastering RFA techniques for renal masses can be challenging due to the required precision.

Purpose of the Study:

• To evaluate a novel porcine tumor-mimic model for training in RFA of renal masses.
• To assess the model's utility in improving ultrasound-guided (US-guided) ablative techniques.

Main Methods:

• Tumor mimics were created using an agarose mixture injected into porcine kidneys, forming 1-cm hyperechoic lesions.
• Ex vivo and in vivo experiments involved US-guided RFA of these mimics, with ablation diameters set at 15 mm.
• Data collected included lesion size, ablation diameter, and accuracy of needle placement and ablation completion.

Main Results:

• Accurate US-guided needle placement into intraparenchymal or endophytic mimics proved challenging initially.
• The ex vivo model required approximately 15 ablations for consistent needle placement.
• The in vivo model showed improvement, with initial positive margins decreasing from 5 to 0 in subsequent ablations.

Conclusions:

• The agarose-based tumor mimic serves as an effective training model for learning and refining US-guided RFA techniques.
• This animal model aids surgeons in assessing targeting accuracy for renal mass ablation.
• Further research is warranted to establish the model's role as a clinical training aid.