A novel biological model for training in percutaneous renal access

Area of Science:

• Urology
• Medical Education
• Surgical Simulation

Background:

• Percutaneous renal access (PRA) is a critical skill in urology.
• Traditional training models lack realistic tactile feedback.
• Developing cost-effective, valid simulation models is essential for surgical training.

Purpose of the Study:

• To develop and validate a novel ex vivo biological model using a bovine kidney in a chicken carcass for percutaneous renal access (PRA) training.
• To compare the effectiveness of this new biological model against a traditional non-biological mannequin model.
• To assess trainee performance and subjective feedback on both models.

Main Methods:

• The study involved 20 urology residents with limited prior PRA experience.
• Content and construct validity of the biological model were established.
• Participants performed PRA on both the biological and mannequin models.
• Key performance metrics included time to puncture, attempts for success, and fluoroscopy time.
• Subjective feedback was collected via questionnaires.

Main Results:

• The ex vivo biological model exhibited both content and construct validity.
• No statistically significant differences were found between the biological and mannequin models in terms of time to puncture, fluoroscopy exposure, or number of attempts.
• Trainees reported a superior overall assessment, better tissue feel, and increased confidence with the biological model.
• The mannequin model was rated higher for ease of puncture and preparation.

Conclusions:

• The developed bovine kidney and chicken carcass model is an inexpensive, valid, and feasible option for fluoroscopy-guided PRA training.
• While technical outcomes were similar to mannequin models, the biological model offers enhanced realism and confidence-building.
• This ex vivo model provides a valuable adjunct to traditional training methods in urology.