New ex-vivo porcine model for endoscopic ultrasound-guided training in transmural puncture and drainage of pancreatic cysts and fluid collections (with videos).

Abstract

Background and Objectives:Endoscopic transmural puncture cysts and drainage pancreatic fluid collections are an important part of endoscopic ultrasound practices, but can be technically difficult to master, particularly with regards to placing stents. We developed an ex-vivo model that is inexpensive and can be used for cyst puncture and fluid collection drainage.Methods:Over the last 5 years, we have perfected the creation of this ex-vivo model. The model is easy and inexpensive to create and multiple aspirations and device placements and removals into a single cavity with decompression. The model allows the use of cautery devices and placement of expandable metal stents. Additionally, the contents in the model can be altered to appear as walled-off necrotic collections endosonographically.Results:The model can be created for <300 US dollars. It has been used at multiple international conferences for teaching purposes and can withstand up to 10 puncture and drainages without having to replace the “cyst.” The cyst can easily be exchanged for other prepared cysts. Preliminary surveys obtained from users show ratings that are realistic.Conclusions:A new ex-vivo model can be easily and economically created, is realistic and can be used multiple times during the single training session.