title: Development and evaluation of a 3D printed endoscopic ampullectomy training model (with video).
abstract: 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.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Tertiary hospital innovation laboratory.
  
  
  METHODS
  Twenty-one endoscopists attending an endoscopic resection workshop.
  
  
  METHODS
  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).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Pilot study, lack of follow-up of participants' endoscopic practice after model experience.
  
  
  CONCLUSIONS
  Although further studies are necessary for validation, this novel prototype appears useful for endoscopic ampullectomy training.
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Bronte A
authors.initials: BA
authors.lastname: Holt
authors.affiliation: Florida Hospital Institute for Minimally Invasive Therapy, Orlando, Florida, USA.
authors.forename: Gareth
authors.initials: G
authors.lastname: Hearn
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA; Florida Hospital Institute for Minimally Invasive Therapy, Orlando, Florida, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Hawes
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Tharian
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Varadarajulu
mesh_terms: D014670:Ampulla of Vater / Q000601:surgery*; D000818:Animals; D002645:Chickens; D004724:Endoscopy / Q000193:education* / Q000295:instrumentation / Q000379:methods*; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D017145:Models, Educational; D066330:Printing, Three-Dimensional