Efficacy of a Three-Dimensional-Printed Training Simulator for Endoscopic Biopsy in the Stomach

Lee, Sunpyo; Ahn, Ji Yong; Han, Minkyu; Lee, Gin Hyug; Na, Hee Kyong; Jung, Kee Wook; Lee, Jeong Hoon; Kim, Do Hoon; Choi, Kee Don; Song, Ho June; Jung, Hwoon Yong

doi:10.5009/gnl17126

Cited by 21 publications

(18 citation statements)

References 19 publications

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“…In order to make the experience of being placed around the duodenal ampulla and the feeling of using various ERCP accessories as realistic as possible, 3D modeling data were obtained from human CT images, as per previous reported studies [13][14][15]. One of important steps in this process was to make the stomach and duodenum.…”

Section: Discussionmentioning

confidence: 99%

“…However, products made by 3D printing technique are relatively hard and not suitable for the endoscopic training model. In recent years, the 3D printing technique has been used to create a platform or mold, in which silicone is then poured or inserted to create the desired soft model, such as endoscopic biopsy model and percutaneous endoscopic gastrostomy model [13,14]. If the ERCP training model could be made as a soft silicone model, it would have numerous advantages over the models presented so far, including the possibility of practicing various techniques with it, and its ability to withstand repeated use.…”

Section: Introductionmentioning

confidence: 99%

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Production of ERCP training model using a 3D printing technique (with video)

Kwon

Shin²,

Hong³

et al. 2020

BMC Gastroenterol

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Background: ERCP training models are very different in terms of anatomical differences, ethical issues, storage problems, realistic tactile sensation, durability and portability. There is no easy way to select an optimized model for ERCP training. If the ERCP training model could be made as a soft silicone model using 3D printing technique, it would have numerous advantages over the models presented so far. The purpose of this study was to develop an optimized ERCP training model using a 3D printing technique and to try to find ways for implementing various practical techniques. Methods: All organ parts of this model were fabricated using silicone molding techniques with 3D printing. Especially, various anatomy of the ampulla of Vater and common bile duct (CBD) were creatively designed for different diagnostic and therapeutic procedures. In order to manufacture each of the designed organ parts with silicone, a negative part had to be newly designed to produce the molder. The negative molders were 3D printed and then injection molding was applied to obtain organ parts in silicone material. The eight different types of ampulla and CBD were repeatedly utilized and replaced to the main system as a moduletype. Results: ERCP training silicone model using 3D technique was semi-permanently used to repeat various ERCP procedures. All ERCP procedures using this model could be observed by real-time fluoroscopic examination as well as endoscopic examination simultaneously. Using different ampulla and CBD modules, basic biliary cannulation, difficult cannulation, stone extraction, mechanical lithotripsy, metal stent insertion, plastic stent insertion, and balloon dilation were successfully and repeatedly achieved. Endoscopic sphincterotomy was also performed on a specialized ampulla using a Vienna sausage. After repeat procedures and trainings, all parts of organs including the ampulla and CBD modules were not markedly damaged or deformed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Production of ERCP training model using a 3D printing technique (with video)

Kwon

Shin²,

Hong³

et al. 2020

BMC Gastroenterol

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“…3D-printed materials can be used to train various procedures, such as in orthopedics, spinal surgery, neurosurgery, and cardiac surgery 16,17. Recently, a simulator for endoscopic training and biopsy was developed and evaluated in our center 18,19. Because this first stomach biopsy simulator was made from a rectangular plastic box, it provides a different feeling compared with the actual stomach.…”

Section: Discussionmentioning

confidence: 99%

A Newly Designed 3-Dimensional Printer-Based Gastric Hemostasis Simulator with Two Modules for Endoscopic Trainees (with Video)

2019

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Background/Aims We used 3-dimensional (3D) printing technology to create a new hemostasis simulator for the stomach and investigated its efficacy and realism in endoscopic hemostasis training. Methods A new stomach hemostasis simulator, with two hemostasis modules for hemoclipping and injection, was constructed using a 3D printer. Twenty-one endoscopists, including 11 first-year fellows (beginner group) and 10 faculty members (expert group), tested the performance of the simulator. We recorded and reviewed five training sessions and evaluated the simulator with questionnaires using a 7-point Likert scale. Results The mean evaluation score of the expert group was 6.3±0.5 for the hemoclipping module and 6.0±0.6 for the injection module. The expert group strongly agreed that endoscopic handling in the simulator was realistic and reasonable for hemostasis training. The mean procedure time for hemoclipping was 72.7±7.1 seconds for the beginner group and 19.7±1.2 seconds for the expert group. The mean procedure time for injection was 92.1±9.8 seconds for the beginner group and 36.3±2 seconds for the expert group. The procedure time of beginner group became shorter with repetition and was significantly lower by the fifth trial. Conclusions A new 3D-printed hemostasis simulator is capable of hemostasis training and can very effectively train beginners before they perform the procedure in patients with gastrointestinal bleeding.

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“…An upper gastrointestinal tract (UGIT) model was developed using a 3D printer, with the same method as described in our previous report on an endoscopic biopsy simulator. 9 The first step was UGIT molding (Fig. 1a) creation.…”

Section: Methodsmentioning

confidence: 99%

The efficacy of a novel percutaneous endoscopic gastrostomy simulator using three‐dimensional printing technologies

Ahn

Lee

et al. 2018

J of Gastro and Hepatol

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Background and Aim We developed a novel training simulator for percutaneous endoscopic gastrostomy (PEG) and determined its efficacy and realism in PEG insertion training. Methods The gastrostomy simulator was made using three‐dimensional printing and silicone molding technology. The simulator is of two types: pull type and introducer type. We enrolled 20 participants, comprising 10 beginners with no experience of PEG insertion and 10 PEG‐experienced endoscopists. Each participant underwent two training sessions for the two simulator types. We recorded the simulation time, self‐evaluation, and difficulty score based on a 5‐score scale for PEG insertion among the participants. Subsequently, simulator performance was assessed via a questionnaire based on a 7‐point Likert scale. Results The mean time to completion of PEG simulation decreased from 11.9 (5.2) to 9.0 (4.0) min for the pull type and from 13.8 (7.0) to 12.0 (5.8) min for the introducer type in the beginner group. The mean self‐evaluation scores of beginners increased from 2.2 (1.1) to 3.1 (0.7) (pull type) and from 2.2 (1.2) to 3.3 (0.8) (introducer type). The mean procedure difficulty scores of beginners decreased from 3.4 (1.1) to 2.7 (0.9) (pull type) and from 4.4 (0.5) to 3.0 (0.8) (introducer type). The improvement of skill score was 6.3 (1.2) for the beginner group. The general realism score of the simulator for handling was judged to be 6.0 (0.9) by the experienced group. Conclusions The three‐dimensional‐printed simulator for PEG insertion can be useful for training of beginner endoscopists and shows good efficacy and realism.

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Efficacy of a Three-Dimensional-Printed Training Simulator for Endoscopic Biopsy in the Stomach

Cited by 21 publications

References 19 publications

Production of ERCP training model using a 3D printing technique (with video)

Production of ERCP training model using a 3D printing technique (with video)

A Newly Designed 3-Dimensional Printer-Based Gastric Hemostasis Simulator with Two Modules for Endoscopic Trainees (with Video)

The efficacy of a novel percutaneous endoscopic gastrostomy simulator using three‐dimensional printing technologies

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