Journal of Surgical Simulation 2022; 9: 107 - 111
Published: 12 September 2022
A new porcine training phantom for percutaneous nephrostomy insertion
Background: The aim of the study was to create a simple phantom for radiology trainees to develop skills to perform a percutaneous nephrostomy, using a combination of ultrasonography and fluoroscopy.
Methods: A porcine kidney was tied off at the renal pelvis and was submerged in a gelatine-based phantom. The renal collecting system was accessed under ultrasonographic guidance with an 18G or 21G needle, the renal collecting system was opacified with iodinated contrast medium, wire inserted, and a 5 Fr pigtail was inserted under direct fluoroscopy.
Results: The porcine model was used to place several nephrostomies, and key steps such as ultrasonography-guided caliceal puncture, renal collecting system opacification, wire and catheter manipulation can be performed repeatedly.
Conclusions: A porcine–gelatine phantom is a simple, cheap and useful training tool to provide nephrostomy training. This not only provides repeated familiarization of technical steps and psychomotor skills but also allows trainees to lay robust interventional groundwork without jeopardizing patient safety.
nephrostomy; simulation; interventional; urology; radiology
Supplementary Video 1. Guidewire1: insertion of 0018 guidewire into the renal pelvis. Available from: https://youtube.com/shorts/NLd9SiTmroU
Supplementary Video 2. Catheter pop: fluoroscopic capture of catheter insertion. Characteristic ‘pop’ on entry into the collecting system shown. Available from: https://youtube.com/shorts/JY_sxxILkII
Supplementary Video 3. Guidewire2: insertion of a second 0018 guidewire into the renal pelvis with the first nephrostomy catheter in situ. Available from: https://www.youtube.com/shorts/cBrKuBir6_I