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Gastrointest Endosc. 2015 Feb;81(2):440-6. doi: 10.1016/j.gie.2014.09.011. Epub 2014 Dec 2.

Novel ex vivo model for hands-on teaching of and training in EUS-guided biliary drainage: creation of "Mumbai EUS" stereolithography/3D printing bile duct prototype (with videos).

Author information

1
Baldota Institute of Digestive Sciences, Mumbai, India.
2
Tokyo Medical University, Tokyo, Japan.
3
Academic medical Centre, Amsterdam, Netherlands.
4
Valladolid University Medical School, Valladolid, Spain.
5
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
6
Asan Medical Center, Seoul, South Korea.
7
Peking University Medical Center Hospital, Beijing, China.
8
National University Health System, Singapore.

Abstract

BACKGROUND:

EUS-guided biliary drainage (EUS-BD) has emerged as an alternative rescue method in patients with failed ERCP. Opportunities for teaching and training are limited because of a low case volume at most centers.

OBJECTIVE:

To evaluate a stereolithography/3-dimensional (3D) printing bile duct prototype for teaching and training in EUS-BD.

DESIGN:

Prospective observational feasibility study.

SETTING:

Tertiary referral center.

SUBJECTS:

Twenty endosonographers attending an interventional EUS workshop.

INTERVENTION:

A prototype of a dilated biliary system was prepared by computer-aided design and 3D printing. The study participants performed guidewire manipulation and EUS-BD procedures (antegrade procedure and/or choledochoduodenostomy) on the prototype. Participants were scored with the device on a scale of 1 to 5 via a questionnaire. Participants' success rate for various steps of the EUS-BD procedure was noted.

MAIN OUTCOME MEASUREMENTS:

Subjective and objective evaluation of the prototype regarding its overall applicability, quality of radiographic and EUS images, and 4 steps of EUS-BD procedure (needle puncture, guidewire manipulation, tract dilation, stent placement).

RESULTS:

Fifteen participants returned the questionnaire, and 10 completed all 4 steps of EUS-BD. The median score for overall utility was 4, whereas that for EUS and US views was 5. Participants with experience in performing more than 20 EUS-BD procedures scored the prototype significantly lower for stent placement (P = .013) and equivalent for needle puncture, tract dilation, and wire manipulation. The success rate of various steps was 100% for needle puncture and tract dilation, 82.35% for wire manipulation, and 80% for stent placement. The mean overall procedure time was 18 minutes.

LIMITATIONS:

Small number of participants.

CONCLUSION:

The 3D printing bile duct prototype appears suitable for teaching of and training in the various steps of EUS-BD. Further studies are required to elucidate its role.

PMID:
25475900
DOI:
10.1016/j.gie.2014.09.011
[Indexed for MEDLINE]

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