Development and validation of a novel 3D-printed simulation model for open oesophageal atresia and tracheo-oesophageal fistula repair

Abstract

Background The role of simulation training in paediatric surgery is expanding as more simulation devices are designed and validated. We aimed to conduct a training needs assessment of UK paediatric surgical trainees to prioritise procedures for simulation, and to validate a novel 3D-printed simulation model for oesophageal atresia and tracheo-oesophageal fistula (OA-TOF) repair. Methods A questionnaire was sent to UK trainee paediatric surgeons surveying the availability and utility of simulation. The operation ranked as most useful to simulate was OA-TOF repair. 3D-printing techniques were used to build an OA-TOF model. Content, face and construct validity was assessed by 40 paediatric surgeons of varying experience. Results Thirty-four paediatric surgeons completed the survey; 79% had access to surgical simulation at least monthly, and 47% had access to paediatric-specific resources. Perceived utility of simulation was 4.1/5. Validation of open OA-TOF repair was conducted by 40 surgeons. Participants rated the model as useful 4.9/5. Anatomical realism was scored 4.2/5 and surgical realism 3.9/5. The model was able to discriminate between experienced and inexperienced surgeons. Conclusion UK paediatric surgeons voted OA-TOF repair as the most useful procedure to simulate. In response we have developed and validated an affordable 3D-printed simulation model for open OA-TOF repair.

The “chicken-leg anastomosis”: Low-cost tissue-realistic simulation model for esophageal atresia training in pediatric surgery

“…Indeed, the haptic component of the chicken skin was unanimously well appraised, consistently with previous studies on similar models ( 11 ). We believe that this constitutes a significant advantage to the synthetic models currently available ( 1 , 5 , 22 ), although the realism of a multilayered tissue is still missing.…”

“…Training in pediatric surgery notably faces the challenge of acquiring experience in rare diseases, complex procedures and small operating fields ( 1 ). In the last decade changes to the health system have disrupted the traditional paradigm of surgical training, where the resident gradually acquires autonomy in the operating room, further hampering the quality of pediatric surgical training ( 2 ).…”

“…Simulation training has been proven effective in enhancing surgical skills, reducing the learning time to achieve competency and overall improving patient care (4). As such, interest in this field is currently rising in pediatric surgery training programs (1,(5)(6)(7). Ultra-realistic high-end surgical training units are evolving, but are often cost intensive and limited to wealthy clinical institutions.…”

Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons

“…Of all neonatal surgical pathologies, esophageal atresia constitutes the paradigm: its high technical complexity, the potential sequelae of surgical iatrogenesis, and the need for a fast and e cient procedure due to the respiratory and hemodynamic lability of the patients justify the need for prior targeted training before performing the procedure in humans. There are few precedents for neonatal thoracic and esophageal atresia models for surgical training [9][10][11][12][13][14][15]. Under this premise, we conceptualized, developed, and validated the present model of type III esophageal atresia (esophageal atresia with distal tracheoesophageal stula).…”

Development of a 3D-printed neonatal congenital diaphragmatic hernia model and standardisation of intra-operative measurement

“…Three-dimensional (3D) printed models are used to simulate whole or parts of paediatric surgical procedures. These include pyloromyotomy, congenital heart disease and oesophageal atresia repair [ 8 ]. To our knowledge, there have been no previous reports of a 3D-printed model of CDH.…”