Use of a vegetable model as a training tool for PCNL puncture

Area of Science:

• Medical Simulation
• Surgical Training
• Urology

Background:

• Traditional training for percutaneous nephrolithotomy (PCNL) punctures faces challenges due to the lack of suitable inanimate models.
• Ethical concerns and high costs limit the use of animal models and virtual reality simulators.
• There is a growing need for effective and accessible simulation tools in surgical education.

Purpose of the Study:

• To develop and evaluate an inexpensive, ethically acceptable inanimate model for PCNL puncture training.
• To assess the model's utility in teaching depth perception during PCNL procedures.
• To provide a practical simulation tool for surgical residents.

Main Methods:

• A bottle gourd was utilized to simulate the posterior abdominal wall, with contrast-dipped cotton pledgets as targets.
• Surgeons of varying experience performed fluoroscopy-guided punctures targeting the cotton pledgets.
• Puncture accuracy and fluoroscopy time were recorded to calculate a performance score.

Main Results:

• An experienced surgeon scored 99, while the average score for five residents was 555.
• The scoring system penalized longer fluoroscopy times and less accurate punctures.
• The results indicate a difference in performance based on experience levels using the model.

Conclusions:

• The bottle gourd model is an ethically sound, cost-effective, and easily reproducible training tool for PCNL punctures.
• This model addresses the need for accessible simulation in urological surgical training.
• It offers a viable alternative for residents to practice and improve their puncture skills.