Percutaneous renal surgery: new model for learning and training

Abstract

Introduction: Aiming at promoting and facilitating learning and training in percutaneous renal surgery, we have created an easy to assemble, reproducible and cheap laboratory model. The model was built using pig kidney, foam layer, plastic catheter, linen or cotton holding sutures, and wide scotch tape.Surgical Technique: The kidney with catheterized ureter is fixed and involved in a foam layer. It stays hidden, and is visible only through radioscopy. This model is positioned and fixed to a radiological table in such a way that it simulates the patient's lumbar region. After that, contrast medium is injected through the ureter, and the urinary system is examined through radioscopy. All percutaneous maneuvers can be accomplished, from the puncture, tract dilation, insertion of Amplatz sheath, and introduction of nephroscope, allowing lithotripsy and endopielotomy, as well as other types of percutaneous surgeries.Comments: The great advantage of this model is its easy construction, by using very cheap and widely available material. Foam can be several times washed and reused. After treatment, the model can be immediately open, and a critical analysis can be made, being then possible to verify if the place of renal puncture was well chosen, if dilation was correctly accomplished, and if the collecting system has been preserved. Therefore, this model can represent a great advance for the learning and training in percutaneous surgery.

Anatomical study of the renal excretory system in pigs. A review of its characteristics as compared to its human counterpart

“…The importance of characterising the excretory system in pigs resides in the use of this species for teaching-learning processes in compared anatomy, and as an experimental model for surgical procedures of the kidney and renal physiology [4,5,8,10,13,14,16,19,23,33]. This work intends to generate meaningful information on these renal structures through the evaluation of a sample of commercial pigs within the context of comparative anatomy between human and porcine kidneys.…”

Renal pathology associated with kidney stones in two buffaloes

“…This paper intent to highlight some prominent changes having bearing on structural and functional unit of kidney owing to stone formation or other ancillary processes which can be extrapolated for other bovine as well as veterinary patients. It is noteworthy to include the fact, that adult bovine kidney(s) is also considered as one of the model for certain urologic procedures to study the human renal complications, with some special considerations [9], besides pig kidneys which frequently served as a model of research and training in nephrolithotomy [10,11]. The present study on natural occurrence of kidney stones in buffalo endeavoured to elucidate the probable cascading development of lesions to understand the in-depth matrix and probable aetiology.…”

New ex-vivo organ model for percutaneous renal surgery

“…Porcine kidneys have been wrapped in a foam layer, embedded in silicon, enclosed in chicken carcasses and in porcine thoracic/abdominal walls. Radiologic and ultrasound guidance were applied for percutaneous renal access guidance (13)(14)(15)(16)(17).…”

“…In contrast to other models (13,14), the kidney is not fixed to the surrounding structures in the skin-flap compartment, providing a sufficient and realistic mobility of the kidney, mimicking in-vivo circumstances. Comparing to organ models with porcine kidneys embedded in chicken carcasses (15), this model sufficiently avoids interferences in x-ray or ultrasound based puncture, usually caused by the chicken skeleton.…”