TY - JOUR
T1 - Development of biotissue training models for anastomotic suturing in pancreatic surgery
AU - Karadza, Emir
AU - Haney, Caelan M.
AU - Limen, Eldridge F.
AU - Müller, Philip C.
AU - Kowalewski, Karl-Friedrich
AU - Sandini, Marta
AU - Wennberg, Erica
AU - Schmidt, Mona W.
AU - Felinska, Eleni A.
AU - Lang, Franziska
AU - Salg, Gabriel
AU - Kenngott, Hannes G.
AU - Rangelova, Elena
AU - Mieog, Sven
AU - Vissers, Frederique
AU - Korrel, Maarten
AU - Zwart, Maurice
AU - Sauvanet, Alain
AU - Loos, Martin
AU - Mehrabi, Arianeb
AU - de Santibanes, Martin
AU - Shrikhande, Shailesh V.
AU - Abu Hilal, Mohammad
AU - Besselink, Marc G.
AU - Müller-Stich, Beat P.
AU - Hackert, Thilo
AU - Nickel, Felix
N1 - Funding Information: This study was funded by Heidelberger Stiftung Chirurgie and Marie-Luise and Normann Stassen Stiftung . Publisher Copyright: © 2023 International Hepato-Pancreato-Biliary Association Inc.
PY - 2023/6
Y1 - 2023/6
N2 - Background: Anastomotic suturing is the Achilles heel of pancreatic surgery. Especially in laparoscopic and robotically assisted surgery, the pancreatic anastomosis should first be trained outside the operating room. Realistic training models are therefore needed. Methods: Models of the pancreas, small bowel, stomach, bile duct, and a realistic training torso were developed for training of anastomoses in pancreatic surgery. Pancreas models with soft and hard textures, small and large ducts were incrementally developed and evaluated. Experienced pancreatic surgeons (n = 44) evaluated haptic realism, rigidity, fragility of tissues, and realism of suturing and knot tying. Results: In the iterative development process the pancreas models showed high haptic realism and highest realism in suturing (4.6 ± 0.7 and 4.9 ± 0.5 on 1–5 Likert scale, soft pancreas). The small bowel model showed highest haptic realism (4.8 ± 0.4) and optimal wall thickness (0.1 ± 0.4 on −2 to +2 Likert scale) and suturing behavior (0.1 ± 0.4). The bile duct models showed optimal wall thickness (0.3 ± 0.8 and 0.4 ± 0.8 on −2 to +2 Likert scale) and optimal tissue fragility (0 ± 0.9 and 0.3 ± 0.7). Conclusion: The biotissue training models showed high haptic realism and realistic suturing behavior. They are suitable for realistic training of anastomoses in pancreatic surgery which may improve patient outcomes.
AB - Background: Anastomotic suturing is the Achilles heel of pancreatic surgery. Especially in laparoscopic and robotically assisted surgery, the pancreatic anastomosis should first be trained outside the operating room. Realistic training models are therefore needed. Methods: Models of the pancreas, small bowel, stomach, bile duct, and a realistic training torso were developed for training of anastomoses in pancreatic surgery. Pancreas models with soft and hard textures, small and large ducts were incrementally developed and evaluated. Experienced pancreatic surgeons (n = 44) evaluated haptic realism, rigidity, fragility of tissues, and realism of suturing and knot tying. Results: In the iterative development process the pancreas models showed high haptic realism and highest realism in suturing (4.6 ± 0.7 and 4.9 ± 0.5 on 1–5 Likert scale, soft pancreas). The small bowel model showed highest haptic realism (4.8 ± 0.4) and optimal wall thickness (0.1 ± 0.4 on −2 to +2 Likert scale) and suturing behavior (0.1 ± 0.4). The bile duct models showed optimal wall thickness (0.3 ± 0.8 and 0.4 ± 0.8 on −2 to +2 Likert scale) and optimal tissue fragility (0 ± 0.9 and 0.3 ± 0.7). Conclusion: The biotissue training models showed high haptic realism and realistic suturing behavior. They are suitable for realistic training of anastomoses in pancreatic surgery which may improve patient outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85150363847&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hpb.2023.02.002
DO - https://doi.org/10.1016/j.hpb.2023.02.002
M3 - Article
C2 - 36828741
SN - 1365-182X
VL - 25
SP - 625
EP - 635
JO - HPB
JF - HPB
IS - 6
ER -