A realistic, durable, and low-cost training model for percutaneous renal access using ballistic gelatin

Objective: The purpose of this study was to design and implement a realistic, durable, and low-cost training model for percutaneous renal access. Material and methods: Ballistic gelatin mixed with radiographic contrast was poured into surgical gloves to create a radio-dense renal collecting system. The collecting system model was then embedded in a pure ballistic gelatin block resting upon a clear acrylic glass base. Finally, the model was covered by a visually opaque polyurethane foam cover with chalk sticks positioned to simulate ribs. Experienced attending urologists and interventional radiologists, urology residents, and medical students used the model to access the upper, middle, and lower renal calyces under fluoroscopic guidance. Outcomes included model durability, realism rated by participants on a visual analogue scale, and cost. Results: The ballistic gelatin model was durable and anatomically realistic. Each model sustained over 200 needle punctures with no significant compromise in structural integrity or any contrast leakage. Attending and resident physicians considered it to provide an accurate simulation of renal access and medical students and residents considered the model to be a practical training modality (residents 8.4/10 vs. medical students 9.4/10). The total cost for one model was $60. Conclusion: The ballistic gelatin collecting system provided a realistic, durable, and low-cost renal access training model. This could allow trainees to develop skills without compromising patient safety.