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Thiel‐embalmed cadavers as a novel training model for ultrasound‐guided supine endoscopic combined intrarenal surgery
Author(s) -
Veys Ralf,
Verpoort Pieter,
Van Haute Carl,
Wang Zhan Tao,
Chi Thomas,
Tailly Thomas
Publication year - 2020
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14954
Subject(s) - supine position , medicine , percutaneous nephrolithotomy , surgery , percutaneous , endoscopy , radiology
Objective To evaluate Thiel‐embalmed cadavers (TEC) as a training model for percutaneous nephrolithotomy (PCNL), more specifically for ultrasound (US)‐guided supine endoscopic combined intrarenal surgery (ECIRS). Subjects and Methods Thirteen urologists (nine experienced endourologists, four fellows/residents) performed an US‐guided supine ECIRS procedure on a TEC. The model was evaluated by way of a questionnaire (5‐point Likert scale). Descriptive statistical analysis was performed and results were graphically presented using divergent bar graphs. Results US images were appreciated as lifelike in all aspects. Although distention of the collecting system was not ideal in one out of three TEC, US visualisation of the distended calyces during puncture was good. Skin penetration was more difficult and less realistic in TEC, while kidney puncture and dilatation were deemed very realistic. Ureteric and collecting system anatomy and consistency were similar to real life, although the mucosa appeared paler. US needle guidance was perceived as excellent. Overall, needle puncture assessment was realistic and useful as a training tool. Overall quality and satisfaction of TEC in US‐guided supine ECIRS was good to excellent and comparable to a real‐life procedure. Overall appropriateness of the TEC model was considered excellent for both initial and advanced supine PCNL training. Conclusion Despite the minor drawbacks of tough skin and non‐ideal collecting system dilatation during ureteroscopy, the TEC model was considered good to excellent as a training model for US‐guided PCNL, in particular, US‐guided needle puncture of the kidney during supine ECIRS.