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一种用于超声引导经皮肾穿刺通路的低成本明胶基模型。

A Low-Cost Gelatin-Based Model for Ultrasound-Guided Percutaneous Renal Access.

作者信息

Pulido-Contreras Enrique, Gonzalez-Villegas Hedler Olaf, Lopez-Hernandez Jorge Alejandro, Medrano-Sanchez Javier, Garcia-Padilla Miguel Angel

机构信息

Department of Urology, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Guanajuato, México.

Department of Urology, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social and Department of Medicine and Nutrition, Universidad de Guanajuato, Guanajuato, México.

出版信息

Urol Res Pract. 2025 Jun 4;51(2):54-60. doi: 10.5152/tud.2025.24018.

Abstract

Objective: The aim of this study was to develop and validate a low-cost and reproducible training model using gelatin that can be useful for acquiring the necessary skills for successful ultrasound-guided access in percutaneous nephrolithotomy without exposing patients to clinical risks. Methods: A prospective and analytical study involving 12 urology residents was conducted to validate the model using content and construct validation systems. The study consisted of 2 parts: content validation through expert opinion surveys and construct validation through resident skill assessments before and after training on the model. This model imitates the calyx to puncture and was developed using pitted olives in dense gelatin. The model was constructed for a total cost of $29.7 per unit with an easy and reproducible construction. Each model can be used to perform approximately 40 punctures before the image quality deteriorates. Results: Globally, this training model increased skills. Puncture time decreased from 106 to 40.5 seconds after training (P = .002). The study found that the model was accepted by 71.4% of urologists as a safe training alternative and provided a risk-free environment for practicing the 2 skills required for a successful puncture: adjusting the ultrasound machine for an adequate image of the target and surrounding tissues and needle-probe alignment. Conclusion: This model is easy to build, reproducible, and cost-effective. It enhances the residents' skills to increase success and safety when performing ultrasound-guided percutaneous access.

摘要

目的

本研究的目的是开发并验证一种使用明胶的低成本且可重复的训练模型,该模型有助于在不使患者面临临床风险的情况下,获取经皮肾镜取石术中成功进行超声引导穿刺所需的技能。方法:进行了一项涉及12名泌尿外科住院医师的前瞻性分析研究,以使用内容和结构验证系统来验证该模型。该研究包括2个部分:通过专家意见调查进行内容验证,以及通过在模型上训练前后对住院医师技能评估进行结构验证。该模型模仿肾盏穿刺,是用密集明胶中的去核橄榄制作而成。该模型的构建总成本为每单位29.7美元,构建过程简便且可重复。每个模型在图像质量变差之前可用于进行约40次穿刺。结果:总体而言,该训练模型提高了技能。训练后穿刺时间从106秒降至40.5秒(P = .002)。研究发现,71.4%的泌尿外科医生认可该模型为一种安全的训练替代方法,并为练习成功穿刺所需的两项技能提供了无风险环境:调整超声机器以获得目标及周围组织的合适图像,以及针与探头对齐。结论:该模型易于构建、可重复且具有成本效益。它提高了住院医师在进行超声引导经皮穿刺时的成功率和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7943/12208923/9c2cbc3b5bb6/urp-51-2-54_f001.jpg

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