PS9-02: COMPARISON BETWEEN COMMERCIALLY AVAILABLE SIMULATED BOWEL AND 3D PRINTED SIMULATED BOWEL
Gabrielle Rolland, MD¹, E. Matthew Ritter, MD¹, Peter C Liacouras, PhD², W. Brian Sweeney, MD¹; ¹The Department of Surgery at Uniformed Services University of the Health Sciences & the Walter Reed National Military Medical Center and the National Capital Regional Simulation Consortium, ²3D Medical Applications Center at the Walter Reed National Military Medical Center

Intro: Bowel anastomosis is a critical skill for general surgery residents to learn. One available opportunity for teaching this skill is through the use of simulation. Unfortunately, there can be significant cost associated with using simulation. The purpose of this study is to compare commercially available simulated bowel (CA) to 3D printed simulated bowel (3D) in terms of suitability for teaching bowel anastomosis.

Methods: Seven surgical attendings (1 General Surgeon, 2 Colorectal Surgeons, 1 Surgical Oncologist and 3 Trauma Critical Care Surgeons) performed a side-by-side stapled anastomosis and a running hand-sewn anastomosis on the CA and 3D. The length of simulated bowel, suture, and steps used for each procedure were standardized. The participants were blinded to which simulated bowel was CA and 3D. Afterwards, participants filled out a survey in which they compared the characteristics of the simulation to their experiences with live human tissue. They then graded each bowel on its suitability for teaching both a stapled anastomosis and hand sewn anastomosis as either not suitable, somewhat suitable, or very suitable.

Results: Comparing the simulations’ pliability, ease of cutting with a linear stapler, scissors and scalpel as comparable or not comparable to live tissue, no difference was found between either simulation (p-values 0.577, 0.577, 0.577, and 0.280 respectively). For use of running monofilament suture, participants graded CA and 3D the exact same, but there was a notable difference in regards to the security of lembert placement on the CA vs 3D (85.7% vs. 14.3% respectively; p-value: 0.008). There was no difference between suitability of simulations for each task (Stapled p-value: 0.175 and Hand-sewn p-value: 0.111)

Conclusion: Our preliminary data shows no difference in overall suitability for both stapled and hand-sewn bowel anastomosis teaching between a commercially available bowel ($55/unit) and a 3D printed bowel ($1/unit). One significant difference, 3D tended to tear during lembert placement, was considered a possible strength by 2 participants, as it may help teach the importance of proper tissue handling. This data suggests that there may be a more cost-effective solution for teaching bowel anastomosis to residents.