Training ultrasound-guided percutaneous nephrostomy technique with porcine model

• Published in: Investigative and clinical urology Vol. 65; no. 1; pp. 62 - 68
• Main Authors: Jeong, Jae Yong, Jun, Dae Young, Moon, Young Joon, Kang, Dong Hyuk, Jung, Hae Do, Jeon, Seung Hyun, Lee, Joo Yong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Urological Association 01.01.2024; Korean Urological Association; 대한비뇨의학회
• Subjects: Animals; Humans; Kidney; nephrolithotomy; Nephrostomy, Percutaneous; Original; percutaneous; Punctures; radiation; Swine; teaching; Ultrasonography; Ultrasonography, Interventional; 비뇨기과학; Nephrolithotomy, percutaneous; Radiation; Ultrasonography; Teaching
• ISSN: 2466-0493; 2466-054X; 2466-054X
• DOI: 10.4111/icu.20230298

There is increasing interest in the use of ultrasound for endoscopic and percutaneous procedures. Access can be achieved without radiation exposure under ultrasound guidance. Our aim was to develop a porcine-based training model for ultrasound-guided percutaneous renal access that could also be personalized to a specific patient. The Institutional Animal Care and Use Committee of Severance Hospital approved the study protocol. An anesthetized pig was placed in the dorsal lithotomy position. For the nephrostomy puncture, a Chiba biopsy needle with an echo tip was used under ultrasound guidance. Eight residents and three consultants in urology participated. Puncture time was defined as the nephrostomy time to confirm the flow of irrigation via the needle. After training, satisfaction survey results for clinical usability and procedural difficulty were evaluated. The 5-point Likert scale satisfaction survey for clinical usability and procedural difficulty found mean results of 4.64 and 4.09 points, respectively. There were no differences between residents and consultants for either variable. For all participants combined, there was a significant difference for nephrostomy time between the first and second trials (278.8±70.6 s vs. 244.5±47.0 s; p=0.007). The between-trial difference was greater for residents (291.5±71.2 s vs. 259.1±41.9 s; p=0.039). The difference for the consultant was not significant (245.0±69.4 s vs. 205.7±42.5 s; p=0.250). We developed a porcine-based ultrasound-guided nephrostomy puncture training model. Satisfaction survey results indicated high clinical usability and procedural difficulty. For nephrostomy time, the model was more effective for urology residents than for consultants.