3D-printed tracheoesophageal puncture and prosthesis placement simulator

Objectives: A tracheoesophageal prosthesis (TEP) allows for speech after total laryngectomy. However, TEP placement is technically challenging, requiring a coordinated series of steps. Surgical simulators improve technical skills and reduce operative time. We hypothesize that a reusable 3-dimensional (3D)-printed TEP simulator will facilitate comprehension and rehearsal prior to actual procedures. Methods: The simulator was designed using Fusion360 (Autodesk, San Rafael, CA). Components were 3D -printed in-house using an Ultimaker 2+ (Ultimaker, Netherlands). Squid simulated the common tracheoesophageal wall. A Blom-Singer TEP (InHealth Technologies, Carpinteria, CA) replicated placement. Subjects watched an instructional video and completed pre- and post-simulation surveys. Results: The simulator comprised 3D -printed parts: the esophageal lumen and superficial stoma. Squid was placed between components. Ten trainees participated. Significant differences existed between junior and senior residents with surveys regarding anatomy knowledge(p < 0.05), technical details(p < 0.01), and equipment setup(p < 0.01). Subjects agreed that simulation felt accurate, and rehearsal raised confidence in future procedures. Conclusions: A 3D -printed TEP simulator is feasible for surgical training. Simulation involving multiple steps may accelerate technical skills and improve education. (C) 2017 Elsevier Inc All rights reserved.