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A study of simulation training in laparoscopic bilioenteric anastomosis on a 3D-printed dry lab model

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Abstract

Background

There are few studies on simulation training in laparoscopic bilioenteric anastomosis. There is also a lack of mature and reliable training models for bilioenteric anastomosis. In this study, we aimed to assess a feasible training model for bilioenteric anastomosis. Surgeons can improve their surgical ability by performing laparoscopic bilioenteric anastomosis on this model through repeated training.

Method

The original articles related to simulation training in surgical anastomosis were identified from January 2000 to November 2021 in the Clarivate Analytics Web of Science Core Collection database. We conducted a bibliometric analysis based on the country of these publications and the type of anastomosis. A 3D-printed bilioenteric anastomosis model was applied in this study. Baseline data of 15 surgeons (5 surgeons of Attendings, 5 surgeons of Fellows, and 5 surgeons of Residents) were collected. The bilioenteric anastomosis data, including the operation time and operation score, were recorded and analyzed. A study of the learning curve was also performed for further assessment.

Result

Surgeons at different levels of experience exhibited different levels of performance in conducting laparoscopic bilioenteric anastomosis on this model. Experienced surgeons completed their first training session in a shorter time and obtained a higher surgical score. In turn, repeated training significantly shortened the time of laparoscopic bilioenteric anastomosis for each trainer and improved the surgical score. Surgeons with different levels of experience needed different numbers of cases to reach the stable period of the learning curve. Experienced surgeons were able to reach a proficient level through fewer training cases.

Conclusion

A suitable biliary-enteric anastomosis model can help surgeons conduct simulation training and provide experience and skill accumulation for future real operations. Our training model performed well in this study and can effectively accomplish this goal.

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Acknowledgements

The authors thank all the surgeons who participated in the current trial. The authors also appreciate all the colleagues at Sir Run-Run Shaw Hospital who contributed to this research.

Funding

This article is supported by the Education Reform Project of Zhejiang University School of Medicine (jgyb20202027).

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Authors and Affiliations

  1. Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medical College, Zhejiang University, No. 3 East Qing Chun Road, Hangzhou, 310016, China

    Jiliang Shen, Mingyu Chen, Renan Jin & Jin Yang

  2. Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China

    Zhifei Wang

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  1. Jiliang Shen
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Correspondence to Zhifei Wang or Jin Yang.

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Drs. Jiliang Shen, Mingyu Chen, Renan Jin, Zhifei Wang, and Jin Yang have no conflicts of interest or financial ties to disclose.

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Supplementary Information

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464_2022_9465_MOESM1_ESM.jpg

Supplementary file1 (JPG 1331 KB)—(a) 3D model of the liver: the yellow tube is the bile duct, the red tube is the hepatic artery, the small green tube is the portal vein, and the big green tube is the inferior cava vein; (b) the pink intestinal 3D model; (c) preparation to perform bilioenteric anastomosis; (d) a hole was cut in the intestine to anastomose the bile duct; (e, f) the first suture entered laterally from the nine o’clock orientation of the bile duct into its lumen and came from the inside of the intestine to its outside; (g) three knots were tied on the outside of the bile duct and intestine; (h) the needle was sewn from the lateral side of the intestine back to the medial side for continuous suture of the posterior wall; (i) continuous suture of the posterior wall was performed from the nine o’clock orientation to the three o’clock orientation of the bile duct; (j) the needle was sewn from the medial side of the intestine back to the lateral side for continuous suture of the anterior wall; (k) continuous suture of the anterior wall was performed from the three o’clock orientation to the nine o’clock orientation of the bile duct; (l) three knots were tied on the position of the first knot

464_2022_9465_MOESM2_ESM.jpg

Supplementary file2 (JPG 1536 KB)—(a) Holistic view of a bilioenteric anastomosis completed on the model; (b) the main structure could be removed from the liver model; (c–f) the suture quality of each side, including the front, reverse, left and right sides, was evaluated by two surgical experts; (g) a 5-item Likert scale was used to evaluate the quality of each side, including five aspects: overall visual evaluation, suture margin, suture spacing, suture tearing, and suture leakage

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Shen, J., Chen, M., Jin, R. et al. A study of simulation training in laparoscopic bilioenteric anastomosis on a 3D-printed dry lab model. Surg Endosc 37, 337–346 (2023). https://doi.org/10.1007/s00464-022-09465-7

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  • DOI: https://doi.org/10.1007/s00464-022-09465-7

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