From Memorial University of Newfoundland, St. John's, Nfld. (Oxford, Walsh, Bungay, Quigley); and the University of Ottawa Institute of Technology, Oshawa, Ont. (Dubrowski)
From Memorial University of Newfoundland, St. John's, Nfld. (Oxford, Walsh, Bungay, Quigley); and the University of Ottawa Institute of Technology, Oshawa, Ont. (Dubrowski).
Can J Surg. 2021 Oct;64(5):E484-E490. doi: 10.1503/cjs.018719.
It is critical that junior residents be given opportunities to practise bowel anastomosis before performing the procedure in patients. Three-dimensional (3D) printing is an affordable way to provide realistic, reusable intestinal simulators. The aim of this study was to test the face and content validity of a 3D-printed simulator for bowel anastomosis.
The bowel anastomosis simulator was designed and assembled with the use of desktop 3D printers and silicone solutions. The production cost ranges from $2.67 to $131, depending on which aspects of the model one prefers to include. We incorporated input from a general surgeon regarding design modifications to improve the realism of the model. Nine experts in general surgery (6 staff surgeons and 3 senior residents) were asked to perform an anastomosis with the model and then complete 2 surveys regarding face and content validity. Items were rated on a 5-point Likert scale ranging from 1 ("strongly disagree") to 5 ("strongly agree").
The overall average score for product quality was 3.58, indicating good face validity. The average score for realism (e.g., flexibility and texture of the model) was 3.77. The simulator was rated as being useful for training, with an overall average score of 3.98. In general, the participants agreed that the simulator would be a valuable addition to current simulation-based medical education (average score 4.11). They commented that the model would be improved by adding extra layers to simulate mucosa.
Experts found the 3D-printed bowel anastomosis simulator to be an appropriate tool for the education of surgical residents, based on the model's texture, appearance and ability to undergo an anastomosis. This model provides an affordable way for surgical residents to learn bowel anastomosis. Future research will focus on proving educational efficacy, effectiveness and transfer that can be adapted for laparoscopic anastomosis training, hand-sewing and stapling procedures.
让住院医师有机会在患者身上进行肠吻合术之前进行练习至关重要。三维（3D）打印是提供逼真、可重复使用的肠道模拟器的一种经济实惠的方法。本研究旨在测试用于肠吻合术的 3D 打印模拟器的表面有效性和内容有效性。
使用桌面 3D 打印机和硅树脂溶液设计并组装肠吻合模拟器。生产成本从 2.67 美元到 131 美元不等，具体取决于模型的哪一部分。我们根据一般外科医生的意见进行了设计修改，以提高模型的真实性。9 名普通外科专家（6 名主治外科医生和 3 名高级住院医师）被要求使用模型进行吻合术，然后完成 2 项关于表面有效性和内容有效性的调查。项目的评分范围为 1（“强烈不同意”）至 5（“强烈同意”）。
产品质量的总平均得分为 3.58，表明具有良好的表面有效性。模型的逼真度（例如模型的柔韧性和质地）的平均得分为 3.77。该模拟器被评为用于培训非常有用，总平均得分为 3.98。总体而言，参与者一致认为模拟器将成为当前基于模拟的医学教育的有价值的补充（平均得分为 4.11）。他们评论说，通过添加额外的层来模拟黏膜，可以改进模型。
根据模型的质地、外观和进行吻合术的能力，专家认为 3D 打印肠吻合模拟器是外科住院医师教育的合适工具。该模型为外科住院医师学习肠吻合术提供了一种经济实惠的方法。未来的研究将集中在证明教育效果、有效性和可适应腹腔镜吻合术训练、手工缝合和吻合器程序的转移。
