Introduction of an ex-vivo pig model for teaching percutaneous nephrolithotomy access techniques

  • Connor M. Forbes University of British Columbia
  • Jonathan Lim University of British Columbia
  • Justin Chan University of British Columbia
  • Ryan F. Paterson University of British Columbia
  • Mantu Gupta
  • Ben H. Chew University of British Columbia
  • Kymora Scotland University of British Columbia
Keywords: Percutaneous nephrolithotomy, simulation, education


Introduction: In North America, obtaining access for percutaneous nephrolithotomy (PCNL) is not often performed by urologists. Hands-on training sessions help to ensure this skill continues within the urological community. An ex-vivo pig kidney model was developed for simulation. This model uses porcine tissues with a fluoroscopic C-arm and standard PCNL equipment. The bullseye or triangulation techniques are both possible. We propose this as a high-fidelity tool for teaching PCNL access.

Methods: The pig kidney, fat, ribs, flank, and skin were arranged anatomically on a table with fluoroscopy. Hands-on training was provided to residents and urologists using the ex-vivo pig model and a silicone-based percutaneous access model. Questionnaires were given at the end of the session.

Results: There was a total 14 responders for each model, with incomplete responses on two surveys. A total of 15% of responders for the pig model and 7% of responders for the silicone model had previous percutaneous access experience. For the pig model, 93% of trainees agreed or strongly agreed that the model was easy to use, and 79% of the silicone model trainees felt the same. After the session, 50% of silicone model trainees and 86% of pig model trainees reported increased confidence in their ability to obtain PCNL access. All the pig model trainees and 71% of the silicone model trainees felt that the simulation activity was worthwhile.

Conclusions: The inexpensive but anatomically realistic ex-vivo pig model using real-world equipment provides trainees with an excellent tool to learn PCNL access.

Author Biographies

Connor M. Forbes, University of British Columbia
Urology Resident, Deparment of Urology
Jonathan Lim, University of British Columbia
Research Student, Department of Urologic Sciences
Justin Chan, University of British Columbia
Research Student, Department of Urologic Sciences
Ryan F. Paterson, University of British Columbia

Assistant Professor, Department of Urologic Sciences

Ben H. Chew, University of British Columbia

Associate Professor, Department of Urologic Sciences

Kymora Scotland, University of British Columbia
Fellow, Department of Urologic Sciences


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How to Cite
Forbes, C. M., Lim, J., Chan, J., Paterson, R. F., Gupta, M., Chew, B. H., & Scotland, K. (2018). Introduction of an ex-vivo pig model for teaching percutaneous nephrolithotomy access techniques. Canadian Urological Association Journal, 13(10), 355-60.
Original Research