Laparoscopic Pancreatoduodenctomy Surgical Training: An Anatomical and Clinical Realistic Simulation Learning Model

Background The learning curve in surgical training to perform laparoscopic pancreatoduodenectomy, tends to be long. The surgeon needs to develop advanced laparoscopic skills to accomplish a safe resection and a complex anastomosis like pancreatojejunostomy and hepaticojejunostomy. The low prevalence of pancreatic disease and the risks of leakage and post‐operative pancreatitis during the attempt to perform an adequate anastomosis are some of the major problems related to this surgical learning curve. Objective To describe a pancreatoduodenectomy realistic simulation learning model based on anatomical and clinical knowledge of pancreatic and biliary tract morphology, capable to develop and improve surgical skills. Material and Methods Using the “EVA Laparoscopica II geração”(Prodelphus Comercio e Industria Importação & Exportação de Simuladores e Equipamentos Médicos Ltda. – www.prodelphus.com.br ) (figure 1) as model to simulate an abdominal cavity, we built a resected pancreatic remnant, the liver and choledochal duct, a segment of jejunal loop, located and fixed on the correct abdominal topography similar to the previous recognition of anatomical videolaparoscopy landmarks showed in human anatomy laboratory (figure 2,3). This prosthetic simulator permit to the trainee, the practice of pancreatojejunostomy and hepaticojejunostomy using different technics and surgical material, mimicking the real procedure (figure 4,5,6). This realistic simulation learning model allows the surgeon to improve his surgical skills and permit the instructor to evaluate and teach in real time the position of trocars, tricks of running or separate sutures, knots, drainage and the quality of the anastomosis that are perform using an external catheter infusion system with colored ink In the teaching process, progressive levels of surgical skills can be scored (figure 7,8). Results The presented model above had its first test with a group of ten (10) surgeons in a hands‐on laparoscopic pancreatic surgery course last october 2017. The students had different levels of graduation from senior residents with basic laparoscopic training to post graduated and fellows with mild to advanced experience in laparoscopic pancreatic surgery. Conlusion This anatomical and clinical realistic simulation learning model permits the development and improvement of surgical skills necessary for surgeons to shorten the laparoscopic pancreatoduodenectomy learning curve. Support or Funding Information there is no support or funding This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .