Office for Technology Commercialization

Percutaneous Nephrolithotomy Training without Radiation

Technology #20150045

C-Arm Trainer Mimics Fixed X-ray Image Intensifiers

An innovative new C-arm trainer (CAT) benefits surgeons, technicians and others undergoing percutaneous renal access training. The training device includes a mini C-arm used in conjunction with a silicon flank simulation model, an anatomically accurate cast of the upper urinary tract with an overlay simulating adjacent ribs. The CAT features two mounted video cameras connected to a computer that displays a real-time, simulated fluoroscopic image on a computer screen, just as a surgeon would project an X-ray image of an actual kidney. By mimicking the effects of fixed X-ray image intensifiers, the CAT provides radiationless and fluoroscopy-free procedural skills training in percutaneous nephrolithotomy.

Replicates C-arm X-ray Functions

Existing training models, like virtual reality simulators and physical fluoro-assisted biologic and synthetic model training systems, face several disadvantages. They can be expensive, impractical and may require actual fluoroscopy, which exposes both patients and trainees to unnecessary radiation. Fixed X-ray image intensifiers turn X-rays into visible light images, allowing doctors to view their movements on a TV monitor, but these machines are very expensive for training purposes, so students must often practice on actual patients. The new C-arm training system effectively replicates the functions of a C-arm X-ray system for percutaneous renal access without any exposing the learner to unnecessary radiation. In addition, the customized table and anatomic models can be 3D printed at a fraction of the cost of other training models, thus providing trainees nearly unlimited access to inexpensive practice models, allowing them plenty of repeated, deliberate practice to reach proficiency.

Percutaneous Nephrolithotomy Skills Are Critical

Urologists often perform percutaneous nephrolithotomy and other kidney procedures that require percutaneous access. Achieving proper renal access is very challenging and most often requires using a C-Arm, a real-time fluoroscopic guidance machine that involves placing a long needle through the abdominal wall into the kidney. Training for this procedure is complicated and can be lengthy as a surgeon learns to direct a needle to a target based on a real-time, two-dimensional, gray-scale image.


  • Effective training for percutaneous access of the kidney
  • Accurate silicon flank models replace human subjects
  • Fluoroless C-arm trainer eliminates radiation exposure
  • 3D printing reduces costs
  • Allows adequate training time to master the procedure

Phase of Development Prototype