107HO - Percutaneous Renal Access Tips and Techniques

This is a hands-on, intensive course in gaining access for PCNL. It is geared for the practicing urologist who wants to gain comfort with performing standard and mini percutaneous stone removal, obtaining your own access using fluoroscopy, ultrasound and combined retrograde/antegrade techniques using training models. The course will include 60 minutes of didactic lectures, 120 minutes of hands-on experience and 30 minutes of interactive discussion of difficult cases directly with our passionate and experienced faculty.

SCIENTIFIC PROGRAM

2:00 – 2:05 p.m. Welcome/Course Format
Robert Sweet, MD, FACS

2:05 – 2:15 p.m. Fundamentals of Fluoroscopy/ Radiation Safety
D. Duane Baldwin, MD

2:15 – 2:25 p.m. Case Selection (STONE Morphometry) Selection of Access Site
Benjamin Canales, MD

2:25 – 2:35 p.m. Positioning (Supine/Prone/Split-leg Prone) and mini-PCNL Instrumentation and Indications
Nicole Miller, MD

2:35 - 2:45 p.m. Fluoroscopic Access and Combined Antegrade Retrograde PCNL
Robert Sweet, MD, FACS

2:45-2:55 p.m. Ultrasound-guided Percutaneous Access
Thomas Chi, MD

2:55-3:05 p.m. Exit Strategies and Preventing Complications for PCNL
Zeph Okeke, MD

3:05-5:05 p.m. Surgical Skills Lab – 4 rotations of 30 minutes each (120 minutes)

5:05-5:35 p.m. Difficult PCNL cases panel/townhall

Surgical Skills Stations: 4 rotations of 30 minutes each (120 minutes), 4 Topics, 12 Stations
1. Percutaneous Access Under Fluoroscopy (Lab stations 1-3)

Skills Trained
1. Identification of anterior vs. posterior calyces
2. Effectively communicate with Radiology Techs.
3. Perform triangulation of target (parallax)
4. Obtain posterolateral needle access of lower pole, interpolar, and upper pole calyces
5. Demonstrate the Bull’s Eye technique and Drift Down Technique
6. Avoid infundibular puncture

2. Percutaneous Access Under Ultrasound

Skills Trained:
1. Knobology
2. Identification of the kidney and collecting system
3. Identification of stone phantom within collecting system
4. Demonstrate proper use of needle guide
5. Visualize needle on ultrasound
6. Obtain needle access
7. Visualize wire advancement into collecting system

3. Mini PCNL

Skills Trained:
1. Utilization and assembly of mini scope/sheath
2. Laser fragmentation of stones with mini scope/sheath
3. Evacuation of stones using mini scope/sheath

4. Endoscopic Guided Access Tricks

Skills Trained:
1. Endoscopic visualization of papillary puncture
2. Effective communication with assistant surgeon
3. Demonstration of lasso technique of through-and-through wire access
4. Demonstration of retrograde “St. Petersburg” through-and-through wire access

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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 3.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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