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

Abstract

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.

A Novel Dry Simulator Model for Learning Comprehensive Endoscopic Retrograde Cholangiopancreatography/Endoscopic Sphincterotomy Procedures while Minimizing Adverse Bleeding Events (with Video)

“…However, because on-the-job training requires trainees to learn under high-pressure situations, learning through simulator models may be effective in acquiring fundamental knowledge and understanding ERCP/EST techniques and procedures. Several simulator models have been reported for practicing ERCP and EST, including wet laboratory models using explanted porcine [14][15][16][17][18] or chicken [17][18][19] organs that mimic the human duodenum and papilla and dry laboratory models represented by computerized virtual reality [20] or artificially made plastic [21] or silicone [22] models. However, these models have certain limitations.…”

Endoscopic retrograde cholangiopancreatography training using a silicone simulator fabricated using a 3D printing technique

“…Five attempts decreased the insertion time (R=−0.591, P <0.001) and cannulation time (R=−0.424, P =0.002). 1 2…”