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. 2014:2014:908693.
doi: 10.1155/2014/908693. Epub 2014 Sep 10.

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

Akio Katanuma  1 , Takao Itoi  2 , Junko Umeda  2 , Ryosuke Tonozuka  2 , Shuntaro Mukai  2 , Kei Yane  1 , Toshifumi Kin  1 , Kazuaki Matsumoto  1 , Tomoaki Matsumori  1 , Katsushige Gon  1 , Ryo Takaki  1 , Akiko Tomonari  1
Affiliations

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

Akio Katanuma et al. Gastroenterol Res Pract. 2014.

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.

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Figures

Figure 1
Figure 1
Endoscopic retrograde cholangiopancreatography trainer (the Chamberlain Group, LLC, Great Barrington, MA, USA).
Figure 2
Figure 2
Creation of the simulated papilla. (a) A piece of rolled uncured ham was inserted into the opening with the tip protruding. (b) For the transmission of current, the model was earthed via a conventional cable connected to the simulated papilla.
Figure 3
Figure 3
(a) Endoscopic observation of the papilla. (b) Insertion of the Autotome into the simulated papilla. (c) Performance of ES while the cutting direction was controlled by manipulating the endoscope and elevator function.
Figure 4
Figure 4
(a) Performance of NKP using an RX knife (Boston Scientific). (b) Performance of NKP while the cutting direction was controlled by the elevator function.
Figure 5
Figure 5
Hands-on training using the dry model. A trainee performed ES with the assistance of an experienced ERCP endoscopist.
See this image and copyright information in PMC

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