Gu Hyundam, Lee Suyoung, Kim Sol, Jang Hye-Lim, Choi Da-Woon, Kim Kyu Seok, Shin Yu Ri, Cheung Dae Young, Lee Bo-In, Kim Jin Il, Lee Han Hee
Division of Gastroenterology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
MEDICAL IP, Seoul, Korea.
Clin Endosc. 2024 Nov;57(6):790-797. doi: 10.5946/ce.2024.110. Epub 2024 Sep 23.
BACKGROUND/AIMS: Colonic stenting plays a vital role in the management of acute malignant colonic obstruction. The increasing use of self-expandable metal stents (SEMS) and the diverse challenges posed by colonic obstruction at various locations underscore the importance of effective training for colonic stent placement.
All the components of the simulator were manufactured using silicone molding techniques in conjunction with three-dimensional (3D) printing. 3D images sourced from computed tomography scans and colonoscopy images were converted into a stereolithography format. Acrylonitrile butadiene styrene copolymers have been used in fused deposition modeling to produce moldings.
The simulator replicated the large intestine from the rectum to the cecum, mimicking the texture and shape of the human colon. It enables training for colonoscopy insertion, cecum intubation, loop reduction, and stenting within stenotic areas. Interchangeable stenotic modules for four sites (rectum, sigmoid colon, descending colon, and ascending colon) were easily assembled for training. These modules integrate tumor contours and blood vessel structures with a translucent center, allowing real-time visualization during stenting. Successful and repeatable demonstrations of stent insertion and expansion using the reusable SEMS were consistently achieved.
This innovative simulator offers a secure colonic stenting practice across various locations, potentially enhancing clinical outcomes by improving operator proficiency during actual procedures.
背景/目的:结肠支架置入术在急性恶性结肠梗阻的治疗中起着至关重要的作用。可自膨胀金属支架(SEMS)的使用日益增加,以及结肠不同部位梗阻带来的各种挑战,凸显了结肠支架置入有效培训的重要性。
模拟器的所有组件均采用硅胶成型技术结合三维(3D)打印制造。源自计算机断层扫描和结肠镜检查图像的3D图像被转换为立体光刻格式。丙烯腈-丁二烯-苯乙烯共聚物已用于熔融沉积建模以生产模制品。
该模拟器复制了从直肠到盲肠的大肠,模拟了人类结肠的质地和形状。它能够进行结肠镜插入、盲肠插管、肠袢复位以及狭窄区域内支架置入的培训。用于四个部位(直肠、乙状结肠、降结肠和升结肠)的可互换狭窄模块易于组装用于培训。这些模块将肿瘤轮廓和血管结构与半透明中心整合在一起,允许在支架置入过程中进行实时可视化。使用可重复使用的SEMS始终成功且可重复地演示了支架插入和扩张。
这种创新的模拟器在不同部位提供了安全的结肠支架置入实践,有可能通过提高实际操作中操作者的熟练程度来改善临床结果。