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Kidney Week

Abstract: FR-PO064

Simulation of Ultrasound-Guided Renal Biopsy Using a Novel Custom-Made Training Model

Session Information

  • Educational Research
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 1000 Educational Research

Authors

  • Kim, Ji Hwan, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Jang, Jinha, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Kim, In Soo, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • An, Jung Nam, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Kim, Jwa-kyung, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Kim, Sung Gyun, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Lee, Hyungseok, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
Background

Kidney biopsy is a critical procedure in nephrology fellowship training, necessitating extensive simulation to prevent biopsy-related complications. There's a need to practice optimizing ultrasound imaging and guiding the biopsy needle to target points in real-time images. We introduce a novel, cost-effective renal biopsy training model.

Methods

We developed a model using Konjac jelly and soft-boiled chicken or duck eggs to simulate ultrasound-guided renal biopsy. The soft-boiled eggs' yolk and egg white were distinctly depicted in grayscale images due to their differences in echogenicity, resembling the renal sinus and corticomedullary area of the kidney's lower pole (Figure 1A). Trainees were instructed to sample the egg white selectively. The biopsied yolk and egg white samples were easily distinguishable with the naked eye (Figure 1B), allowing trainees to verify if the sample was successfully obtained from the target with immediate feedback. The materials were readily available, and the model was easy to construct and reproduce. Trainees were able to simulate the operation of biopsy devices, optimize ultrasound imaging, and guide the biopsy needle in real time.

Results

Nephrology fellows underwent the simulation training using the model before performing kidney biopsies on patients. After implementing this curriculum, a total of 186 kidney biopsies were performed from March 3, 2022, to May 20, 2023. Biopsies were conducted with a 16-gauge needle under ultrasound guidance. There were no failed procedures. Complications included three minor hematomas that resolved with bed rest and one arteriovenous fistula that was treated with coil embolization. In pre- and post-training surveys, trainees' confidence levels in performing renal biopsies significantly improved.

Conclusion

This novel model may assist nephrology fellows in familiarizing themselves with biopsy procedures and enhancing their skills before commencing renal biopsies in a clinical setting.

Figure 1.
A. A duck egg embedded in Konjac jelly (white arrow: the egg white, yellow arrow: the yolk, black arrow: biopsy needle).
B. the yolk (left) and egg white (right)