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Hands On Skills Training

Hands-On Skills Training - Additional Registration Fee Required

102HO - Interventional Ultrasonography: A New Urology Paradigm for Using Renal Ultrasound to Guide Renal Access and Biopsies

Hands-on Skills Stations

Saturday, May 14, 2022

10:00 AM – 12:00 PM

Course Director(s)

Thomas Chi, MD

University of California, San Francisco
Roger L. Sur, MD

UC San Diego Health
Jaime Landman, MD

Chairman, Department of Urology
University of California, Irvine

Proctor(s)

Gregory E. Tasian, MD

Associate Professor of Urology and Epidemiology
The Children's Hospital of Philadelphia
Joel E. Abbott, DO, BS

Urologist
PM

Patrick W. Mufarrij, MD

Associate Professor of Urology
Johns Hopkins University Brady Department of Urology
Seth Bechis, MD, MS

UC San Diego
Amy Elizabeth Krambeck, MD (she/her/hers)

Professor of Urology
Northwestern Medicine
David T. Tzou, MD

Assistant Professor
Ryan S. Hsi, MD,FACS

Vanderbilt University Medical Center
Thomas Tailly, MD, PHD (he/him/his)

University Hospital Ghent
KC

Kaitlan Cobb, MD

Eastern Virginia Medical School
David Bayne, MD, MPH

UCSF
Roshan M. Patel, MD

University of California, Irvine
MG

Mantu Gupta, MD, FACS (he/him/his)

Professor
Icahn School of Medicine at Mount Sinai
Noah Canvasser, MD (he/him/his)

Associate Professor, Department of Urologic Surgery
UC Davis Medical Center
Fadl Hamouche, MD

Assistant Professor
McGill University
JA

Justin Seungchan Ahn, MD

Assistant Professor
University of California San Francisco

Learning Objectives:

Utilize ultrasound consoles for renal imaging.
Understand the basics of renal ultrasonography for patient in both the supine and prone positions.
Optimize imaging for renal ultrasound.
Gain fundamental skills to adopt ultrasound guided renal access.
Achieve confidence for performing ultrasound guided renal biopsy.

For renal masses and large urinary stones, mastery of renal ultrasound will allow the urologist to take control of the two most critical steps of the management pathway: renal biopsies and renal puncture for access. This hands on course will allow the learner to change the paradigm in which they practice. Our goal is to teach urologists practical skills in renal ultrasound to enable them to perform their own renal biopsies and obtain percutaneous renal access.

Most renal biopsies are performed by non-urologists and with the growing number of small renal masses being diagnosed in the modern era, the need for efficient, patient friendly care pathways for renal biopsy is growing. Currently, patients will see a urologist, schedule a renal biopsy with another provider, return to the urologist to make a care plan, and then proceed with active management. If the urologist is doing the surgery, the ablation, or following the patient, the urologist should perform the biopsy, just as we do for prostate cancer. By shifting urologists to learn and perform office based or outpatient ultrasound renal biopsy, patients will receive stream lined, improved cancer care.

For large renal stones, percutaneous nephrolithotomy (PCNL) is the surgery of choice. Despite more than 30 years of teaching fluoroscopy as the standard for gaining renal access, less than a quarter of urologists obtain their own access for PCNL. We have demonstrated that renal ultrasound for obtaining access is easier to learn and safer for urologists compared to fluoroscopy. The greatest number of renal puncture needles placed around the world are for nephrostomy tubes performed by Interventional radiologists, and they use ultrasound for the most part. If other proceduralists can use ultrasound for access, clearly this is a learnable skill for urologists. It is an easier imaging modality to guide renal access and its adoption will facilitate urologists regaining control of the most critical step of a successful PCNL. The clear rate-limiting step to the utilization of PCNL as a treatment modality, and thus greater adherence to AUA stone guidelines, is the challenge of percutaneous access. Teaching urologists to use renal ultrasound for renal access will improve quality of patient care.

Renal ultrasound and its application for interventional procedures is an achievable, learnable skill for the practicing urologist. The primary barrier to renal ultrasound, as well as ultrasound guided renal access and biopsy adoption is lack of training opportunities. To this end, we are offering a hands-on renal ultrasound renal access and biopsy course. The course will provide step-by-step instruction for not only mastery of renal ultrasonography but also renal ultrasound needle placement for the purposes of renal biopsy and access These are skills that attendees can readily adopt into their practice and provide significant improvements in their patient care with AUA Hands On Course exposure.

Accreditation: The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The American Urological Association designates this live activity for a maximum of 4.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.