Learning the skills used to master pediatric fluoroscopic exams can be challenging. Hand-eye coordination and specific timing is required while at the same time being mindful of radiation dose and interpreting the images generated in real time. Training on live neonates will often mean less diagnostic exams and increased radiation dose for those exams. An inexpensive reusable simulator model was devised to allow residents practice of upper GI fluoroscopic exams to increase efficiency using ALARA principles and utilizing 3D printing technology off-the-shelf dolls. Generic gastrografin provided a cost effective contrast medium as its concerns in real UGI studies are of no issue on the training models. A 30ml bottle of generic gastrografin can be purchased for less than $20, which would last for several simulated exams. The 3D model was based on a computer generated imagery (CGI) mesh of a stomach which was modified in Blender™ to try to best replicate the full duodenum and effect of the ligament of Treitz. The final iteration of the model was printed in polylactic acid polymer (PLA) in a size that would fit inside the plastic doll, which already contained portions of the necessary tubing. The model was sealed to be watertight. Testing under fluoroscopy showed that the model behaved similar enough to an infant when placed in various positions then filled with an appropriate volume contrast. There are several limitations of this model including the lack of the distractions of a real pediatric patient. Also, the flow of contrast is purely gravity dependent without the effects of sphincters and peristalsis. Overlying skeletal structures and bowel gas are not represented, however these could also be simulated in various ways. Future work on this and similar projects could include expansion into other organ systems such as the colon.
SPR 2018 Annual Meeting & Postgraduate Course