Ewald Jonathan Mark, Cheng Julie Won-Ching, Engelhart Shawn Michael, Wilkinson Michael Chevalier, Hajiha Mohammad, Wagner Hillary, Baldwin D Duane
Loma Linda University School of Medicine, Loma Linda California, California, USA.
Department of Urology, Loma Linda University, Loma Linda California, California, USA.
Turk J Urol. 2019 Jan 1;45(1):31-36. doi: 10.5152/tud.2018.43569. Print 2019 Nov.
The purpose of this study was to design and implement a realistic, durable, and low-cost training model for percutaneous renal access.
Ballistic gelatin mixed with radiographic contrast was poured into surgical gloves to create a radio-dense renal collecting system. The collecting system model was then embedded in a pure ballistic gelatin block resting upon a clear acrylic glass base. Finally, the model was covered by a visually opaque polyurethane foam cover with chalk sticks positioned to simulate ribs. Experienced attending urologists and interventional radiologists, urology residents, and medical students used the model to access the upper, middle, and lower renal calyces under fluoroscopic guidance. Outcomes included model durability, realism rated by participants on a visual analogue scale, and cost.
The ballistic gelatin model was durable and anatomically realistic. Each model sustained over 200 needle punctures with no significant compromise in structural integrity or any contrast leakage. Attending and resident physicians considered it to provide an accurate simulation of renal access and medical students and residents considered the model to be a practical training modality (residents 8.4/10 vs. medical students 9.4/10). The total cost for one model was $60.
The ballistic gelatin collecting system provided a realistic, durable, and low-cost renal access training model. This could allow trainees to develop skills without compromising patient safety.
本研究的目的是设计并实施一种用于经皮肾穿刺通道建立的逼真、耐用且低成本的训练模型。
将混有放射造影剂的弹道明胶倒入手术手套中,制成放射性致密的肾集合系统。然后将该集合系统模型嵌入置于透明丙烯酸玻璃底座上的纯弹道明胶块中。最后,用视觉上不透明的聚氨酯泡沫覆盖该模型,并放置粉笔棒以模拟肋骨。经验丰富的泌尿外科主治医生、介入放射科医生、泌尿外科住院医师和医学生在荧光透视引导下使用该模型穿刺上、中、下肾盏。结果包括模型耐用性、参与者在视觉模拟量表上评定的逼真度以及成本。
弹道明胶模型耐用且解剖结构逼真。每个模型能承受超过200次针刺,结构完整性无明显受损,也无造影剂泄漏。主治医生和住院医师认为它能准确模拟肾穿刺通道建立,医学生和住院医师认为该模型是一种实用的训练方式(住院医师评分为8.4/10,医学生评分为9.4/10)。一个模型的总成本为60美元。
弹道明胶集合系统提供了一种逼真、耐用且低成本的肾穿刺通道建立训练模型。这可以让受训人员在不危及患者安全的情况下培养技能。