Chinese-shadows for initial learning of calyx puncture without radiation exposure скачать в хорошем качестве

Chinese-shadows for initial learning of calyx puncture without radiation exposure

Model using Chinese shadows without radiation exposure: a square piece of foam, with a cylinder cut in the middle, is used. A slit is cut in one side. A latex glove is inflated with air, and it is inserted in the slit. Thus, the fingers are horizontal in the middle of the cylinder. The fingers are erect but flexible. The model is put on a retro-projector. The shadows of the fingers and the puncture needle are projected on the screen or the wall. Otherwise, the central cylinder can be covered with a sheet of paper, so the shadows are projected in the paper. The puncture needle is used through the lateral side opposite the slit with the glove. The fingers' tips are used as calyxes; puncture is to push the finger's tip in the middle until it become concave and invaginated. The beam light is perpendicular to the tract, like the angle 0° of the C-arm, so it gives orientation in the frontal plan. To locate the finger's tip in the transversal plan, the needle is aligned with the glove's tip in the frontal plan, then the needle is moved from down to up in the transversal plan, with little thrusting movements, until the finger moves. It is the same technique used in our department for percutaneous renal puncture without moving the C-arm. The glove models are simple to set up, with a preparation time of about a few minutes. They are economical, by using very cheap and widely available material. They can be performed in the operating room, since it is a non-biological model, so there is no risk of biologic contamination, nor any hygiene or sterilization issue. Moreover, the Chinese shadows model can be used in classrooms and workshops without the risks of radiation exposure, and there is no limit of training time. It allows beginners the initial use of the puncture needle and its orientation in the space. However, real puncture is not possible. These models are non-biological models, so there is a limitation in terms of "tissue feeling" and for anatomic relations. In addition, ultrasound-imaging guidance cannot be used.