Percutaneous intrarenal surgery can be a challenging skill to teach due to the paucity of readily available models to use for simulation.
These educators described a biological porcine kidney model that they have used successfully for this teaching strategy. A large pig kidney is wrapped in the full thickness skin flap with subcutaneous fascia and muscle and then fixed to a wooden board with two nails. This allows the ureter to be catheterized for injection of contrast material or saline during the training session. The model can be positioned at a 30 degree angle within the skin flap thereby allowing percutaneous renal needle access, catheter replacement and tract dilation under radiographic or ultrasound guidance.
Using this model, 42 urologists were trained during a 3-day endourology techniques training course. Thirty-nine of these urologists had partial or less than partial experience in percutaneous renal access. Of the 42 trainees, 33 (79%) practiced the percutaneous renal access technique on the model and of these, 20 (61%) successfully performed the whole percutaneous procedure.
The majority of the course participants considered the porcine kidney model for this simulation to be a beneficial learning experience.
The authors indicated that the advantage of this model is its ease of construction and cost effectiveness, with an average cost of $25.00. The only limitation of this model in the United States may be the inability to acquire the skin and fascial flap of pig tissue which may be federally regulated due to bovine spongiform encephalopathy (BSE) concerns.