Clin Endosc.  2024 Nov;57(6):790-797. 10.5946/ce.2024.110.

Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea

• Gu H
• Lee S
• Kim S
• Jang HL
• Choi DW
• Kim KS
• Shin YR
• Cheung DY
• Lee BI
• Kim JI
• Lee HH

• KMID: 2561163
• DOI: http://doi.org/10.5946/ce.2024.110

Abstract

Background/Aims
Colonic stenting plays a vital role in the management of acute malignant colonic obstruction. The increasing use of self-expandable metal stents (SEMS) and the diverse challenges posed by colonic obstruction at various locations underscore the importance of effective training for colonic stent placement.
Methods
All the components of the simulator were manufactured using silicone molding techniques in conjunction with three-dimensional (3D) printing. 3D images sourced from computed tomography scans and colonoscopy images were converted into a stereolithography format. Acrylonitrile butadiene styrene copolymers have been used in fused deposition modeling to produce moldings.
Results
The simulator replicated the large intestine from the rectum to the cecum, mimicking the texture and shape of the human colon. It enables training for colonoscopy insertion, cecum intubation, loop reduction, and stenting within stenotic areas. Interchangeable stenotic modules for four sites (rectum, sigmoid colon, descending colon, and ascending colon) were easily assembled for training. These modules integrate tumor contours and blood vessel structures with a translucent center, allowing real-time visualization during stenting. Successful and repeatable demonstrations of stent insertion and expansion using the reusable SEMS were consistently achieved.
Conclusions
This innovative simulator offers a secure colonic stenting practice across various locations, potentially enhancing clinical outcomes by improving operator proficiency during actual procedures.

Keyword

Colonoscopy; Intestinal obstruction; Self expandable metallic stents; Simulation training

Figure

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  Fig. 1. Three-dimensional (3D) modeling and fabrication of a colonic stent simulator. (A) Automated segmentation of the colon from contrast-enhanced computed tomography. (B) 3D images of an artificial whole colon and its individual segments generated using modeling software. (C) A silicone-based colon model and malignant stenotic module were produced through 3D printing. (D) All colon parts were assembled in the body case. (E) Intraluminal view of 3D-printed model.

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  Fig. 2. Reusable self-expandable metal stent using a funnel-shaped reconstruction device.

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  Fig. 3. Interchangeable colonic stenotic modules. (A) Ascending colon stenosis. (B) Descending colon stenosis. (C) Sigmoid colon stenosis. (D) Rectum stenosis.

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  Fig. 4. Details of the colonic stenotic module. (A) The internal form of stenosis incorporates tumor contour and surface blood vessel structure, making it appear realistic. (B) The center of the stenosis module is made of a translucent material, allowing for visual observation during stent insertion.

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  Fig. 5. Stent insertion procedures using our colonic stent simulator.

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