Presented by: Dae Young Jun MD
Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

Introduction

In recent years, there has been increasing interest in the use of ultrasound guidance for endoscopic and percutaneous procedures. Our aim was to develop a training model for ultrasound-guided percutaneous renal access that can also be personalized to a specific patient in porcine model.

Materials

The Institutional Animal Care and Use Committee of our institute approved the study protocol. A female pig aged 6 months (weight, 48 kg) acclimated for 7–10 days in our animal facility was used for the training model. An anesthetized animal was placed in the dorsal lithotomy position. Before training, cystoscopic insertion of guidewire was performed under fluoroscopic guidance and retrograde irrigation to intrarenal space with 100 cmH₂O was established. For nephrostomy puncture, a Chiba biopsy needle with an echo tip was used under ultrasound guidance. Eight urologic residents and three urologic consultants participated this study. Puncture time was defined as the nephrostomy time to confirm the flow of irrigation via a Chiba needle.

Results

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All participants performed nephrostomy puncture under ultrasound-guidance successfully. In satisfaction survey for clinical usability using 5-point Likert scale, mean point was 4.64 and there was no difference between two groups (P=0.903). Satisfaction survey for procedural difficulty showed that mean point was 4.09 and there was no difference between two groups (Table 1). In nephrostomy time, there was a significant difference between the first and second trials in all participants (278.8±70.6 vs. 244.5±47.0; P=0.007). Especially, in residents, there was also a difference between two trials (P=0.039), however, there was no difference in consultants (P=0.250) (Table 2).

Conclusion

We developed a porcine model to train the nephrostomy puncture under ultrasound-guidance. In nephrostomy time, this training model can be more effective for urologic residents than for consultants.

Funding

The research was supported (in part) by the Korean Society for Urologic Ultrasonograph Grant 2020.

Co-Authors

Jae Yong Jeong, MD
Department of Urology, National Health Insurance Service Ilsan Hospital

Young Joon Moon, MD
Department of Urology, Kyungpook National University Hospital

Dong Hyuk Kang, MD
epartment of Urology, Inha University College of Medicine

Hae Do Jung, MD
Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine

Seung Hyun Jeon, MD,PHD
Kyung Hee University Medical Center, Kyung Hee University School of Medicine

Joo Yong Lee, MD,PHD
Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine