• Shunji Narumi, Yoshikazu Toyoki, Keinosuke Ishido, Daisuke Kudo, Minoru Umehara, Norihisa Kimura, Takuya Miura, Takahiro Muroya, and Kenichi Hakamada.
• Department of Gastrointestinal Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. shunji@cc.hirosaki-u.ac.jp
• Hepato Gastroenterol. 2012 Oct 1; 59 (119): 2333-4.

AbstractPancreaticoduodenectomy includes choledochojejunostomy and pancreaticojejunostomy, which require hand-sewn anastomoses. Educational simulation models for choledochojejunostomy and pancreaticojejunostomy have not been designed. We introduce a simulation model for choledochojejunostomy and pancreaticojejunostomy created with a skin closure pad and a vascular model. A wound closure pad and a vein model (4 mm diameter) were used as a stump model of the pancreas. Pancreaticojejunostomy was simulated with a stump model of the pancreas and a double layer bowel model; these models were stabilized in an end-to-side fashion on a magnetic board using magnetic clips. In addition, vein (6 or 8 mm diameter) and bowel models were used to simulate choledochojejunostomy. Pancreatic and hepatobiliary surgery are relatively rare, particularly in a community hospital although surgical residents wish to practice these procedures. Our simulator enables surgeons and surgical residents to practice choledocho- and pancreaticojejunostomy through open or laparoscopic approaches.

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