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- W2016750892 abstract "No AccessJournal of UrologyInvestigative Urology1 Oct 2008A Novel Technique for Creating Solid Renal Pseudotumors and Renal Vein-Inferior Vena Caval Pseudothrombus in a Porcine and Cadaveric Modelis companion ofPrognostic Role of Histological Necrosis for Nonmetastatic Clear Cell Renal Cell Carcinoma: Correlation With Pathological Features and Molecular MarkersRenal Cell Carcinoma in Young and Old Patients—Is There a Difference?Retroperitoneal Laparoscopic Partial Nephrectomy: Surgical Experience and Outcomes Daniel Eun, Akshay Bhandari, Ronald Boris, Katy Lyall, Mahendra Bhandari, Mani Menon, and Craig G. Rogers Daniel EunDaniel Eun More articles by this author , Akshay BhandariAkshay Bhandari More articles by this author , Ronald BorisRonald Boris More articles by this author , Katy LyallKaty Lyall Financial interest and/or other relationship with Intuitive Surgical. More articles by this author , Mahendra BhandariMahendra Bhandari More articles by this author , Mani MenonMani Menon More articles by this author , and Craig G. RogersCraig G. Rogers More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.06.005AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We developed a simple means to replicate kidney tumors in an animal and cadaver model that could be used to create pseudotumors of different sizes and locations for use in surgical training. Materials and Methods: Various substances were injected ex vivo into the parenchyma of porcine kidneys to identify an optimal pseudotumor model. Renal pseudotumors were created percutaneously and endoscopically using 8 live pigs and a human cadaver model. A renal vein pseudothrombus porcine model was also created by injecting pseudothrombus material into the renal vein after renal hilar clamping. Procedures performed on pseudotumors included robotic partial nephrectomy, percutaneous biopsy and robotic nephrectomy with renal vein thrombectomy. All specimens were analyzed after resection. Results: The most ideal pseudotumor models were created from a mixture of gelatin, Metamucil® and methylene blue (metagel) or from Kromopan® hydrocolloid. We created 33 tumors 0.5 to 3.5 cm in size (mean 2.8). All tumors were a solid palpable mass on gross examination and ultrasonography revealed clearly visible hyperechoic lesions in 30 of 33. A renal vein tumor pseudothrombus model was successfully created in 3 pigs. We successfully performed robotic excision of pseudotumors, including partial nephrectomy for 16 and radical nephrectomy with renal vein thrombectomy for 3. Percutaneous needle core biopsy under ultrasound guidance was also successfully performed. Conclusions: We describe what is to our knowledge a novel technique of creating solid renal tumors and tumor thrombi that can be used for training in minimally invasive kidney surgery. References 1 : Development of exophytic tumor model for laparoscopic partial nephrectomy: technique and initial experience. Urology2005; 65: 872. Google Scholar 2 : Development of a perfused ex vivo tumor-mimic model for the training of laparoscopic radiofrequency ablation. Surg Endosc2007; 21: 1745. Google Scholar 3 : Development of an in vivo tumor-mimic model for learning radiofrequency ablation. J Gastrointest Surg2000; 4: 620. Google Scholar 4 : Experimental evaluation of accuracy of radiofrequency ablation using conventional ultrasound or a third-dimension navigation tool. Langenbecks Arch Surg2002; 387: 303. Google Scholar 5 : Training for renal ablative technique using an agarose-based renal tumour-mimic model. BJU Int2006; 97: 179. Google Scholar 6 : Development of a renal tumor mimic model for learning minimally invasive nephron sparing surgical techniques. J Urol2004; 172: 382. Link, Google Scholar 7 : Concurrent upper and lower urinary tract robotic surgery: strategies for success. BJU Int2007; 100: 1121. Google Scholar 8 : Laparoscopic radical nephrectomy for cancer with level I renal vein involvement. J Urol2003; 169: 487. Link, Google Scholar 9 : Pure laparoscopic radical nephrectomy with level II vena caval thrombectomy. Urology2006; 68: 1112. Google Scholar 10 : Laparoscopic radical nephrectomy for renal carcinoma with known level I renal vein tumor thrombus. Urology2007; 69: 662. Google Scholar Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsRelated articlesJournal of Urology15 Aug 2008Prognostic Role of Histological Necrosis for Nonmetastatic Clear Cell Renal Cell Carcinoma: Correlation With Pathological Features and Molecular MarkersJournal of Urology15 Aug 2008Renal Cell Carcinoma in Young and Old Patients—Is There a Difference?Journal of Urology15 Aug 2008Retroperitoneal Laparoscopic Partial Nephrectomy: Surgical Experience and Outcomes Volume 180Issue 4October 2008Page: 1510-1514 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsminimally invasivesurgical proceduresmedicalkidney neoplasmseducationanimalkidneydisease modelsAcknowledgmentsDr. Ji-Hyung Choi, Everett, Washington provided Kromopan hydrocolloid. Phuong Ly, Aloka Inc., Tokyo, Japan, provided assistance.Metrics Author Information Daniel Eun More articles by this author Akshay Bhandari More articles by this author Ronald Boris More articles by this author Katy Lyall Financial interest and/or other relationship with Intuitive Surgical. More articles by this author Mahendra Bhandari More articles by this author Mani Menon More articles by this author Craig G. Rogers More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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