Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar;11(1):79-84.
doi: 10.1016/j.aju.2012.12.001. Epub 2013 Jan 15.

The use of a biological model for comparing two techniques of fluoroscopy-guided percutaneous puncture: A randomised cross-over study

Mohamed M Abdallah  1 , Shady M Salem  1 , Mohamed R Badreldin  1 , Ahmed A Gamaleldin  1
Affiliations

The use of a biological model for comparing two techniques of fluoroscopy-guided percutaneous puncture: A randomised cross-over study

Mohamed M Abdallah et al. Arab J Urol. 2013 Mar.

Abstract

Objectives: To develop a new and inexpensive model for training in fluoroscopic puncture into the pelvicalyceal system, and to use this model to compare the learning curve of two fluoroscopic techniques, the 'eye of the needle' (EN) and triangulation techniques.

Materials and methods: For the trial we used a commercial plastic model (a shop-window mannequin) in which a bovine kidney, embedded in sponge with a spatial orientation similar to the human, was inserted into the model. The ureter of the animal kidney was connected to contrast fluid. Ten residents and interns were randomised into two groups; group A started the puncture using the EN technique, each member making five attempts, and then five attempts using the triangulation technique, and group B started with triangulation and then used the EN technique.

Results: There was no statistically significant difference between the techniques for the mean (SD) number of trials to make a correct puncture, at 2.68 (1.00) in the EN technique and 2.86 (1.05) in the triangulation technique, or for the duration of each trial, at 523 (189) s for the EN technique and 578 (175) s for the triangulation technique. The fluoroscopy time was less in the EN technique, at 113.9 (48.9) s than for the triangulation method, at 135.8 (42.4) (P < 0.005).

Conclusions: The model was easy to construct and feasible for training. Both techniques had a similar learning curve, with higher fluoroscopy exposure for the triangulation technique.

Keywords: Biological model; EM, eye of the needle (technique); Eye of the needle; PCNL, percutaneous nephrolithotomy; Percutaneous nephrolithotomy; Radical; Triangulation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) An anteroposterior puncture in the triangulation technique, with the C-arm in position B; (B) a fluoroscopic image showing two syringe tips marking the targeted calyx, with the C-arm in position A and B, with the puncture seen in the horizontal plane.
Figure 2
Figure 2
A fluoroscopic image of the EN technique.
Figure 3
Figure 3
The kidney of a freshly slaughtered cow; the ureter is cannulated with a Nelaton catheter.
Figure 4
Figure 4
(A) The construction of the model; (B) the bovine kidney under fluoroscopy.
None
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Knudsen B.E., Cook A.J., Watterson J.D., Beiko D.T., Nott L., Razvi H. Percutaneous antegrade endopyelotomy: long-term results from one institution. Urology. 2004;63:230–234. - PubMed
    1. Thompson R.H., Krambeck A.E., Lohse C.M., Elliott D.S., Patterson D.E., Blute M.L. Endoscopic management of upper tract transitional cell carcinoma in patients with normal contralateral kidneys. Urology. 2008;71:713–717. - PubMed
    1. El-Nahas A.R., Eraky I., Shokeir A.A. Percutaneous nephrolithotomy for treating staghorn stones: 10 years of experience of a tertiary-care centre. Arab J Urol. 2012;10:324–329. - PMC - PubMed
    1. Morris D.S., Taub D.A., Wei J.T., Dunn R.L., Wolf J.S., Jr., Hollenbeck B.K. Regionalization of percutaneous nephrolithotomy: evidence for the increasing burden of care on tertiary centers. J Urol. 2006;176:242–246. - PubMed
    1. Michel M.S., Trojan L., Rassweiler J.J. Complications in percutaneous nephrolithotomy. Eur Urol. 2007;51:899–906. - PubMed