By: Amy Wiggins

A simulator which looks like part of a baby’s chest is being trialled to teach surgeons how to do a tricky neonatal surgery where the trachea and esophagus are stitched together. Photo / Supplied

New Zealand surgeons are developing a tiny, life-like simulator so they can train to do a tricky piece of keyhole surgery on newborns.

Christchurch consultant paediatric surgeon Dr Jonathan Wells is part of the team developing a 3-D printed neonatal simulator to help train surgeons.

It is being developed specifically to allow surgeons to practice a less invasive procedure to repair two relatively rare conditions discovered at birth which prevent babies from feeding – the tracheoesophageal fistula and oesophageal atresia.

The conditions, which normally occur together, involve an abnormal connection between the upper part of the oesophagus and the trachea (windpipe) or the upper part of the oesophagus failing to connect with the lower oesophagus and stomach.

About one in 4000-5000 babies are affected by the conditions.

Wells said the surgery traditionally involved a large incision in the chest to allow them to stitch the ends of the trachea and oesophagus together properly but keyhole surgery would reduce the scarring and recovery time.

The problem, he said, was how surgeons could develop the skills and practice doing such a rare operation correctly without any risk.

“It’s a challenging operation. Doing it minimally invasive is just pushing the boundaries,” he said.

A new simulator is being trialled to teach surgeons how to do a tricky keyhole neonatal surgery. Photo / Supplied

The most difficult part was the stitching so the simulator, which is in the shape of a baby’s ribcage, had to realistically mimic the tissue in order to be useful, he said.

In the past dead animal tissue had been used for simulators but thanks to 3-D printing, a combination of silicon compounds had been used to make it very realistic – as well as being quick, reasonably cheap and easy to produce.

Wells had wanted to develop the model for years and was confident that, with the help of medical physicist Nicholas Cook and the 3-D printing department at Christchurch Hospital, they now had a useful, workable simulator.

Much of the model could be reused and only an insert under the skin and ribcage would have to be replaced each time, he said.

A simulator is being trialled to teach surgeons how to do a tricky neonatal surgery where the trachea and esophagus are stitched together. The model shows the tubes under a rib cage. Photo/ Supplied

But the next step before it could begin to be used was testing it properly.

“We’ve got to prove that it’s effective,” he said.

He asked surgeons to have a go and provide feedback at the Paediatric Society of New Zealand’s Annual Scientific Meeting this week but it would be properly put through its paces over summer.

Source: NZ Herald

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