The development and clinical efficacy of simulation training of open duct-to-mucosa pancreaticojejunostomy using pancreas and intestine silicone models.

ABSTRACT

Purpose: As pancreaticojejunostomy (PJ) is a challenging anastomosis, an education program is needed to train young surgeons to perform PJ. This study evaluated the effects of simulation-based training of open PJ using pancreas and intestine silicone models. Methods: Five videos pancreatobiliary clinical fellows who did not perform PJ participated in this study. After watching the master video created by a senior pancreatobiliary surgeon, each trainee performed the PJ using silicone models and recorded them 10 times using a video camera. Of these videos, 5 were randomly duplicated due to the validation of the scoring system. The scoring system developed consisted of 20 scores. Three pancreatobiliary professors scored their performance by watching videos. Results: The mean procedure time of the 5 trainees was 25.4 minutes (range, 23.5-27.3 minutes) in the first video and 15.8 minutes (range, 13.8-19.1 minutes) in the 10th video. The mean score was 12.6 (range, 5-19) and 18.3 (range, 15-20) in the first and 10th videos, respectively. The scores were similar among the duplicated videos for each supervisor. Conclusion: This education system would help pancreatobiliary trainees to overcome learning curves efficiently without ethical issues related to animal models or direct practice to human patients.