Ann Hepatobiliary Pancreat Surg.  2023 Nov;27(4):428-432. 10.14701/ahbps.23-040.

Low-cost model for pancreatojejunostomy simulation in minimally invasive pancreatoduodenectomy

• Tan HJ
• Chiow AKH
• Lee LS
• Liao S
• Feng Y
• Thiruchelvam N

• KMID: 2548510
• DOI: http://doi.org/10.14701/ahbps.23-040

Abstract

Minimally invasive pancreatoduodenectomy (MIS PD) is a well reported technique with several advantages over conventional open pancreatoduodenectomy. In comparison to distal pancreatectomy, the adoption of MIS PD has been slow due to the technical challenges involved, particularly in the reconstruction phase of the pancreatojejunostomy (PJ) anastomosis. Hence, we introduce a lowcost model for PJ anastomosis simulation in MIS PD. We fashioned a model of a cut pancreas and limb of jejunum using economical and easily accessible materials comprising felt fabric and the modelling compound, Play-Doh. Surgeons can practice MIS PJ suturing using this model to help mount their individual learning curve for PJ creation. Our video demonstrates that this model can be utilized in simulation practice mimicking steps during live surgery. Our model is a cost-effective and easily replicable tool for surgeons looking to simulate MIS PJ creation in preparation for MIS PD.

Keyword

Pancreatojejunostomy; Model; Simulation; Pancreaticoduodenectomy

Figure

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  Fig. 1 Felt paper (green) is cut to a 8 cm × 10 cm rectangle, and rolled about the long axis into a cylinder to mimic the shape of the small bowel.

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  Fig. 2 Felt paper (yellow) is cut into an ellipse of 1.5 cm width and 3.5 cm length.

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  Fig. 3 The elliptic felt is sutured onto the cylinder end in continuous fashion.

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  Fig. 4 The elliptic cylinder is filled with Play-Doh to mimic the remnant pancreas after pancreatoduodenectomy.

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  Fig. 5 Model of small bowel and remnant pancreas for pancreaticojejunostomy creation.

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  Fig. 6 Model after the completion of pancreatojejunostomy.

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