Abstract
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a complex bariatric surgical procedure that demands advanced technical skills. However, traditional training models (virtual simulators, cadavers, and porcine organs) are Limited by issues concerning realism, cost, and accessibility. Although 3D-printed models offer promising potential solutions, their application in LRYGB training remains underexplored. METHODS: 3D-printed silicone models of stomach and small intestine were fabricated using patient-derived anatomical data. The physical properties of these models (tensile strength, conductivity, and rheology) were compared with those of human and porcine tissues. Face and content validity , as well as technical realism, were evaluated through expert questionnaires. Construct validity was assessed using the Modified Bariatric Objective Structured Assessment of Technical Skills (MBOSATS). Trainees participated in repeated simulation sessions to evaluate their learning curves. RESULTS: The silicone models demonstrated tensile strengths comparable to those of human tissues. Additionally, they exhibited superior aesthetics compared to porcine models (P < 0.05). Experts highly rated the face and content validity of the models, with median scores ranging from 4 to 5 out of 5. MBOSATS scores effectively differentiated between expertise levels (experts: 188.2 ± 1.48 vs. Intermediates: 145.10 ± 11.45 vs. residents: 64.1 ± 4.19, P < 0.001). In terms of training effectiveness, trainees achieved proficiency after 4-5 sessions, and post-training performance of residents on porcine models matched that of intermediates (P > 0.05). The models cost $2,000, significantly less than cadaver or animal alternatives. CONCLUSIONS: The 3D-printed silicone models exhibit realistic mechanical properties, process high validity, and have proven effective in expediting skill acquisition during LRYGB training. They serve as a cost-effective and ethical alternative to traditional training tools, offering particular advantages in resource-constrained settings. TRIAL REGISTRATION: This study was prospectively registered in the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2300078726 on 15 December 2023. The trial protocol was approved prior to the enrollment of the first participant, ensuring adherence to ethical standards and transparency in reporting health care intervention outcomes.