Development and evaluation of a 3D printed endoscopic ampullectomy training model (with video).

BACKGROUND

Endoscopic ampullectomy is a technically challenging, high-risk procedure with limited training opportunities. Although simulation models can assist with endoscopic skill acquisition, an ampullectomy model does not currently exist.

OBJECTIVE

To develop a training model that can be used to improve technical skills, knowledge, and confidence in performing endoscopic ampullectomy.

DESIGN

Experimental study.

SETTING

Tertiary hospital innovation laboratory.

SUBJECTS: Twenty-one endoscopists attending an endoscopic resection workshop.

INTERVENTIONS: A prototype for endoscopic ampullectomy was created by computer-aided design and 3-dimensional printing of an ampullary mount and base to which a chicken heart was attached and inserted into a silicone stomach-duodenum model. Study participants performed an ampullectomy and evaluated the prototype with a pre- and postampullectomy questionnaire by using a scale of 1 to 5 (very low to very high).

MAIN OUTCOME MEASUREMENTS: Evaluation of core procedural steps, technical and visual realism, and proceduralist technical knowledge and confidence.

RESULTS

Sixteen endoscopists participated in the study. All core procedural steps were completed by 14 participants. The mean overall technical and visual realism scores were 3.1 (standard deviation [SD], 0.9) and 3.2 (SD, 0.9), respectively. Ten participants (10/15, 66.7%) thought that their technical knowledge had improved, and 11 thought that it would increase further with additional sessions (11/15, 73.3%). Mean confidence score before and after using the model was 2.2 (SD, 1.2) and 2.9 (SD, 1.1), respectively (P=.132).

LIMITATIONS: Pilot study, lack of follow-up of participants' endoscopic practice after model experience.

CONCLUSION

Although further studies are necessary for validation, this novel prototype appears useful for endoscopic ampullectomy training.