Ultra-Low-Cost Kidney Phantom for Simulating Ultrasound-Guided Percutaneous Nephrostomy Access

The introduction of a do-it-yourself (DIY) kidney phantom represents a significant advancement in the training for percutaneous renal access, a complex yet critical procedure increasingly undertaken by urologists. While ultrasound (US) guidance can reduce reliance on interventional radiologists and fluoroscopy, the high costs of conventional simulation models often pose a barrier to training. This study proposes an innovative, low-cost kidney phantom created from readily available household and hospital items, including surgical gloves, gelatin, psyllium husk, and water. The DIY model was utilized in a hands-on simulation course conducted at the Caribbean Urological Association, where participants were first instructed on needle maneuvering techniques. Using handheld portable ultrasound devices, they practiced identifying targets within the phantom and performing simulated needle placements, with successful entries indicated by water efflux from the needle. The estimated cost for each model was approximately $4, and each could serve up to eight participants before degradation. Among the 14 course participants, predominantly attending physicians, 43% reported comfort with US-guided needle placement before the course, while post-session evaluations indicated that 100% felt more comfortable performing the procedure. Additionally, 71% believed the phantom adequately simulated percutaneous needle placement, and 50% felt it accurately represented renal anatomy. A striking 93% of participants would recommend the course to colleagues. These findings highlight the efficacy of the DIY ultra-low-cost kidney phantom as a valuable tool for enhancing training in ultrasound-guided nephrostomy tube placement, significantly improving participant confidence and skill in this critical area of urological practice.