Development and Evaluation of a 3D Printed Endoscopic Ampullectomy Training Model (with Video)

Background: Endoscopic ampullectomy is a technically challenging, high-risk procedure with limited training opportunities. Although simulation models can assist with endoscopic skill acquisition, an ampullectomy model does not currently exist.

Objective: To develop a training model that can be used to improve technical skills, knowledge, and confidence in performing endoscopic ampullectomy.

Design: Experimental study.

Setting: Tertiary hospital innovation laboratory.

Subjects: Twenty-one endoscopists attending an endoscopic resection workshop.

Interventions: A prototype for endoscopic ampullectomy was created by computer-aided design and 3-dimensional printing of an ampullary mount and base to which a chicken heart was attached and inserted into a silicone stomach-duodenum model. Study participants performed an ampullectomy and evaluated the prototype with a pre- and postampullectomy questionnaire by using a scale of 1 to 5 (very low to very high).

Main Outcome Measurements: Evaluation of core procedural steps, technical and visual realism, and proceduralist technical knowledge and confidence.

Results: Sixteen endoscopists participated in the study. All core procedural steps were completed by 14 participants. The mean overall technical and visual realism scores were 3.1 (standard deviation [SD], 0.9) and 3.2 (SD, 0.9), respectively. Ten participants (10/15, 66.7%) thought that their technical knowledge had improved, and 11 thought that it would increase further with additional sessions (11/15, 73.3%). Mean confidence score before and after using the model was 2.2 (SD, 1.2) and 2.9 (SD, 1.1), respectively (P=.132).

Limitations: Pilot study, lack of follow-up of participants' endoscopic practice after model experience.

Conclusion: Although further studies are necessary for validation, this novel prototype appears useful for endoscopic ampullectomy training.