Dr. Zhifei Wang
Dr. Zhifei Wang
Zhejiang People’s Provincial Hospital, China
Title: 3D Printed Dry Lab Training Models to Simulate Robotic Assisted Pancreatojejunostomy
Background: The learning of robotic pancreaticojejunostomy (PJ) could not be otherwise accomplished by conventional training methods, making the cases within the learning curve at a risk.
Methods: A series of dry lab models were developed to facilitate surgeon training for robotic PJ, including the anastomosis of a transected silicon pancreatic stent which is commercially available(model 1), a rough model(model 2) simulating PJ, and an advanced 3D printed model (model 3)more vividly simulating PJ. Three surgeons (A, B, C) with similar specialty backgrounds and levels of expertise with laparoscopic and open surgery were enrolled in the training program with difference exposure for trainings with the 3 models. Which means all sugerons (A, B, C) participate in the first round of training on basic technical tasks, and surgeons (A, B) participate in the second round on model 1, with only surgeon A in the third round on model 2.Their proficiency of performance based on the models was evaluated by counting the number of cases attempted before a qualified anastomosis and was tested on model 3.
Results: There was no significant difference among the three surgeons in the first round of training on the basic technique tasks. The result of the second round between surgeon A and B is similar, which was confirmed by comparisons on the practicing cases to complete a consecutive 3 times of qualified anastomosis on model 1(8 and 9), and the time for completing a satisfactory anastomosis of pancreatic stent was similar (31 to 33min). Surgeon A practised with Model 2 for a total of 6 hours, completing approximately 10 cases. In Model 3, the times of attempts in training before a consecutively 3 times of satisfactory anastomosis were achieved were counted and compared, for surgeon A, 6 cases, 20 for B and 25 for C. For each surgeon with the same task, the operation time decreased significantly with the training. Similarly, the security of the anastomosis improved. The coordination of the three robotic arms and the smoothness of the procedure improved. 
Conclusions: The specifically designed series of dry lab training models are rated favorably for both anatomic realism and potential as a training tool for advancing the robotic pancreatojejunostomy through quality improvement exercise in dry lab.