Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons
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In brief
In brief
Researchers developed and validated a realistic 3D synthetic model for training pediatric surgeons in open repair of type III esophageal atresia with tracheoesophageal fistula. The model demonstrated strong face and content validity, with expert surgeons completing procedures faster and showing superior technical performance compared to trainees, particularly in suture placement and fistula closure verification.
- A 3D synthetic model for type III esophageal atresia repair was validated, showing high face and content validity scores (3.2-3.4/4).
- Expert surgeons completed procedures faster (34 min) than non-experts (38.4 min), with two non-experts unable to finish within 45 minutes.
- Experts demonstrated superior technical skills: 100% achieved equidistant sutures vs 42.9% of non-experts (p=0.02).
- The model effectively discriminates skill levels, particularly in fistula closure verification (66.7% experts vs 11.1% non-experts, p=0.05).
- This cost-effective simulator addresses limited training opportunities in rare neonatal surgical pathology like esophageal atresia.
Written by the GCMD Library team from the article.
Abstract
Background
The technical complexity and limited casuistry of neonatal surgical pathology limit the possibilities of developing the necessary technical competencies by specialists in training. Esophageal atresia constitutes the paradigm of this problem. The use of synthetic 3D models for training is a promising line of research, although the literature is limited.
Methods
We conceptualized, designed, and produced an anatomically realistic model for the open correction of type III oesophageal atresia. We validated it with two groups of participants (experts and non-experts) through face, construct, and content-validity questionnaires.
Results
The model was validated by nine experts and nine non-experts. The mean procedure time for the experts and non-experts groups was 34.0 and 38.4 min, respectively. Two non-experts did not complete the procedure at the designed time (45 min). Regarding the face validity questionnaire, the mean rating of the model was 3.2 out of 4. Regarding the construct validity, we found statistically significant differences between groups for the equidistance between sutures, 100% correct in the expert group vs. 42.9% correct in the non-expert group (p = 0.02), and for the item “Confirms that tracheoesophageal fistula closure is watertight before continuing the procedure”, correctly assessed by 66.7% of the experts vs. by 11.1% of non-experts (p = 0.05). Concerning content validity, the mean score was 3.3 out of 4 for the experts and 3.4 out of 4 for the non-experts.
Conclusions
The present model is a cost-effective, simple-to-produce, and validated option for training open correction of type III esophageal atresia. However, future studies with larger sample sizes and blinded validators are needed before drawing definitive conclusions.