Abstract

BackgroundERCP 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.MethodsAll 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 module-type.ResultsERCP 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.ConclusionsWe made a specialized ERCP training silicon model with 3D printing technique. This model is durable, relatively cheap and easy to make, and thus allows the users to perform various specialized ERCP techniques, which increases its chances of being a good ERCP training model.

Highlights

  • Endoscopic retrograde cholangiopancreatography (ERCP) training models are very different in terms of anatomical differences, ethical issues, storage problems, realistic tactile sensation, durability and portability

  • We made a specialized ERCP training silicon model with 3D printing technique. This model is durable, relatively cheap and easy to make, and allows the users to perform various specialized ERCP techniques, which increases its chances of being a good ERCP training model

  • Endoscopic retrograde cholangiopancreatography (ERCP) is an attractive procedure for endoscopists because it provides a variety of treatment options and clinically dramatic results [1]

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Summary

Introduction

ERCP training models are very different in terms of anatomical differences, ethical issues, storage problems, realistic tactile sensation, durability and portability. 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. It is necessary to proceed very sophisticatedly and carefully because it can induce serious adverse events even during the basic procedures. Both patients and endoscopists are usually under great pressure when ERCP is being conducted. To minimize this burden, endoscopists should perform all techniques of ERCP in a highly skilled and well-educated state to prevent all procedural-related adverse events. Under the mentorship program, both trainees and mentors are forced to undertake ERCP education with great burdens and limitations

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