A novel dry model for practicable sphincterotomy and precut needle knife sphincterotomy.

Akio Katanuma,Tomoaki Matsumori,Ryosuke Tonozuka,Kei Yane,Akiko Tomonari,Ryo Takaki,Katsushige Gon,Kazuaki Matsumoto,Junko Umeda,Toshifumi Kin,Shuntaro Mukai,Takao Itoi

doi:10.1155/2014/908693

Abstract

Aim. We aimed to develop a simulation dry model for endoscopic sphincterotomy (ES) and needle knife precut sphincterotomy (NKP) and to evaluate its usefulness as a training simulator. Materials and Methods. An endoscopic retrograde cholangiopancreatography trainer was used as a duodenum, bile duct, and papilla simulator. A simulated papilla was created with a piece of rolled uncured ham, and ES and NKP were performed. Hands-on training was carried out using this model, and success and failure of the procedures were evaluated. A questionnaire survey was conducted among the participants to assess the performance and usefulness of the dry model for ES and NKP training. Results. Twenty-two endoscopists participated in the hands-on training using this dry model. ES was successful in 33 out of 34 attempts (97%) whereas NKP was successful in all 7 attempts (100%). Based on the results of the questionnaire survey, the median score for realism was 7 (range: 2–9) for ES and 8 for NKP on a scale of 1 to 10. Conclusions. The dry model using an uncured ham provides a condition closely similar to actual clinical practice and is useful as a training model for ES and NKP.

Highlights

Endoscopic sphincterotomy (ES) is one of the most frequently performed procedures by endoscopic retrograde cholangiopancreatography (ERCP) endoscopists
We developed a dry model for ES and Needle knife precut sphincterotomy (NKP) training
How confident are you that this dry model training would be successful in improving your ES skills? (Please circle a number, where 1 = not confident; 10 = confident): 1 2 3 4 5 6 7 8 9 10 Q4

Summary

Introduction

Endoscopic sphincterotomy (ES) is one of the most frequently performed procedures by endoscopic retrograde cholangiopancreatography (ERCP) endoscopists. Needle knife precut sphincterotomy (NKP) is performed as an alternative method when cannulation of the bile duct by conventional methods is difficult [3, 4]. The lack of sufficient training and experience may increase procedural failures and complications. To resolve such problems, various simulators have been developed, including computer simulators [11], ex vivo porcine organs with the Erlangen EndoTrainer [12], and an anesthetized pig model [13]. Computer simulators are applicable to various endoscopic procedures, the models are expensive and difficult to apply for routine use. Computer simulators provide little realism of cutting. Models using anesthetized pigs provide the realism of cutting, equipment for animal experiments is necessary as well as various preparations (e.g., anesthesia induction). Each training model has its own features and no optimal model has been developed to date

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