477Four bench models of PCNL are currently described in the literature—three of
them utilize ex vivo porcine renoureteral units. The initial model was described by
Hammond et al. in which the authors placed pebbles within a porcine kidney/ureter,
which was then placed inside a chicken carcass [ 163 ]. Urology residents were then
taught needle access, guidewire placement, tract dilation, retrograde and antegrade
pyelograms, renal access sheath insertion, and rigid and flexible nephroscopy with
the assistance of fluoroscopy. This model has never been validated, but through
anonymous surveys, it is suggested that trainees are satisfied with the model, allow-
ing them to become more comfortable with the technique and equipment of renal
access.
A second bench model, developed by Strohmaier and Giese, also used ex vivo
porcine kidneys and ureters but in a considerably different way [ 164 ]. Calculi are
placed into the cadaveric porcine renoureteral units via opening the collecting sys-
tem and then secured by a watertight closure with a running suture. Then, ureters
can be cannulated with catheters through which saline is instilled to mimic hydro-
nephrosis. The model is then placed upon a rectangular silicone mold, and the entire
setup is covered with liquid silicone, which takes approximately 3 h to solidify and
lasts about 1 week. Trainees can then perform the usual steps to perform nephroli-
thotomy via ultrasound or fluoroscopic guidance into the collecting system. Other
procedures and techniques that can be performed with this model include endopy-
elotomy, incision of calyceal neck stenosis, antegrade stent placement, and inserting
percutaneous drainage catheters.
Fig. 24.13 UroEmerge™ Suprapubic Catheter Model with plastic trainer housing the simulated
full bladder [ 6 ]
24 Simulation in Surgery