Improved ex vivo training model for percutaneous renal surgery.

Percutaneous endourological procedures require an advanced level of skills. To facilitate the training of the proper technique, some years ago we developed a porcine ex vivo model for training percutaneous endourological procedures. When dilating the percutaneous tract silicone and gelatine were frequently damaged thus inhibiting proper working with the endoscopes. To circumvent these problems we improved our ex vivo model in order to be as close to the clinical situation as possible. The kidney with the ureter was dissected off the retroperitoneal organ package of the freshly slaughtered pigs. The kidneys were put into bags cut into parts of the thoracic/abdominal wall of these pigs. The renal pelvis can be filled with saline to simulate hydronephrosis; stones can be implanted for PCNL. Our new model allows for even better training of all percutaneous endourological procedures (e.g. percutaneous nephrostomy, PCNL, endopyelotomy). Especially puncturing is extremely close to the situation in humans as the porcine thoracic/abdominal wall in principal has the same anatomy as the human one. The new model has been already used with great success in hands-on courses. Concerning "tissue feeling", the anatomic relations and the great variety of procedures that can be trained, it is superior to non-biological models. Nevertheless, it is easily available and inexpensive.