Abstract
Background
Anastomotic suturing is the Achilles heel of pancreatic surgery. Especially in laparoscopic
and robotically assisted surgery, the pancreatic anastomosis should first be trained
outside the operating room. Realistic training models are therefore needed.
Methods
Models of the pancreas, small bowel, stomach, bile duct, and a realistic training
torso were developed for training of anastomoses in pancreatic surgery. Pancreas models
with soft and hard textures, small and large ducts were incrementally developed and
evaluated. Experienced pancreatic surgeons (n = 44) evaluated haptic realism, rigidity,
fragility of tissues, and realism of suturing and knot tying.
Results
In the iterative development process the pancreas models showed high haptic realism
and highest realism in suturing (4.6 ± 0.7 and 4.9 ± 0.5 on 1–5 Likert scale, soft
pancreas). The small bowel model showed highest haptic realism (4.8 ± 0.4) and optimal
wall thickness (0.1 ± 0.4 on −2 to +2 Likert scale) and suturing behavior (0.1 ± 0.4).
The bile duct models showed optimal wall thickness (0.3 ± 0.8 and 0.4 ± 0.8 on −2
to +2 Likert scale) and optimal tissue fragility (0 ± 0.9 and 0.3 ± 0.7).
Conclusion
The biotissue training models showed high haptic realism and realistic suturing behavior.
They are suitable for realistic training of anastomoses in pancreatic surgery which
may improve patient outcomes.
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Article info
Publication history
Published online: February 08, 2023
Accepted:
February 6,
2023
Received:
August 29,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
