Development of a training model to simulate laparoscopic distal pancreatectomy

Kenichi Oshiro, MD¹, Kazuhiro Endo, MD², Naoya Kasahara, MD, PhD², Atsushi Miki, MD, PhD², Masaru Koizumi, MD, PhD², Hideki Sasanuma, MD, PhD², Yasunaru Sakuma, MD, PhD², Hisanaga Horie, MD, PhD², Yoshinori Hosoya, MD, PhD², Joji Kitayama, MD, PhD², Alan K Lefor, MD, MPH, PhD, FACS², Naohiro Sata, MD, PhD². ¹Kouseikai Nishikata Hospital, ²Jichi Medical University, Department of Surgery

INTRODUCTION: Appropriate education is necessary to promote advanced laparoscopic surgical techniques. Each existing method has associated benefits and difficulties. The aim of this study is to develop a training model allowing simulation of the scenario for laparoscopic distal pancreatectomy using standard surgical instruments.

METHODS

Planning: A standard surgical scenario for laparoscopic distal pancreatectomy was developed. The scenario was broken down into multiple processes and each process divided into multiple steps. We established tasks to be achieved for each step, and defined the related anatomical structures, instruments to be used, factors determining the level of difficulty, and possible complications.

Design: Structures that could be visualized by imaging studies such as computed tomography or magnetic resonance imaging were directly extracted. The intestinal tract was designed based on anatomical knowledge, and imaging data used to establish its position. Fine structures and membranes such as the visceral peritoneum were designed based on advice from an experienced clinician and images from actual procedures.

Prototyping and evaluation: The model is made of polyvinyl chloride, which conducts electricity making it possible to use electro-surgical devices. Each component was produced individually. The parts were assembled after evaluating shape, texture, operability and device processes.

RESULTS: We created a training model for simulating laparoscopic distal pancreatectomy (Figure). The model includes the pancreas, spleen, stomach, duodenum, transverse colon, portal vein, splenic vein, superior mesenteric vein, celiac artery, splenic artery, common hepatic artery, left gastric artery and greater omentum. The procedure can be simulated in its entirety. The model utilizes standard surgical devices (e.g. various kind of energy devices, automatic suturing, etc.).

CONCLUSIONS: We developed a training model that allows re-creation of operative scenarios using standard surgical instrumentation. The model is anticipated to contribute to patient safety by shortening the learning curve.

Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79767

Program Number: P318

Presentation Session: Poster (Non CME)

Presentation Type: Poster