106HO - Interventional Ultrasonography: A New Urology Paradigm Using Renal Ultrasound to Guide Percutaneous Access and Biopsies

For renal masses and large/obstructive 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 to facilitate percutaneous nephrolithotomy and nephrostomy tube placement.

SCIENTIFIC PROGRAM

7:00 – 7:10 a.m. Welcome and introduction with pre-test

7:10 – 7:30 a.m. “Knobology”: How to use ultrasound machine
Karen Stern MD

7:30 – 7:50 a.m. Visualizing organs with ultrasonography
Justin Ahn MD

7:50 – 8:20 a.m. Renal access and tube placement with ultrasonography
Tom Chi MD

8:20 – 8:50 a.m. Renal biopsy technique
Jaime Landman MD

8:50 – 9:10 a.m. Q&A with Post-test
Tom Chi MD

9:10 am – 11:00 am Hands-on Skills Stations

Hands On Agenda: (100 min)
Hands on Skill Stations (maximum 4 attendees/station (3 stations of each skill, 4 skill sets, 12 stations total) and rotate every 25 min)

Rotation #1 Knobology: How to Use the Ultrasound Machine & Visualize
Organs in Human Patient Volunteers

• Skills Assessed
1. Select the appropriate probe and settings to optimize renal imaging
2. Locate and orient the kidney appropriately on the screen in prone and supine positions and from different intercostal spaces
3. Identify renal anatomy (cortex, hilar fat, collecting system) & adjacent organs (bowel, spleen/liver, pleura)
4. Image the bladder in longitudinal and transverse views and measure bladder volume

Rotation #2 Obtain Access Using Free Hand & Needle Guide Technique in Ex Vivo Porcine Kidney Model

Skills Assessed
1. Identify renal calyx target
2. Obtain needle access using needle guide and free hand technique in both longitudinal and transverse image orientation
3. Exchange needle for wire access

Rotation #3 Perform Tract Dilation & Nephrostomy Tube Placement In Pre- Accessed 3D Printed Kidney Model & Suprapubic Tube Model

• Skills Assessed
1. Perform serial coaxial tract dilation
2. Perform balloon dilation of tract
3. Appropriately deploy drainage tube

Rotation #4 Perform Renal Biopsy and Cyst Aspiration in High Fidelity Renal Mass Gelatin Model

• Skills Assessed
1. Identify a target lesion or cyst
2. Align the needle guide with area of interest
3. Perform a targeted renal biopsy and cyst aspiration

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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 4.0 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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