OP13.09: Development of a Non‐animal Task Trainer for in Utero Stenting

The pig model described for in utero stent training is cumbersome and in our experience learners and teachers can be uncomfortable using animal tissue. The goal of this project was to develop an easy, yet realistic non-animal training model for in utero stenting and to compare the time required to setup, perform and reload the synthetic and pig models. A prospective observational study performed at the Mayo Clinic in February and March 2015. The Ziploc task trainer was constructed using two Ziploc freezer bags (Dow, Indianapolis, IN) filled with ultrasound gel and sealed. The bags were stacked horizontally in a transparent plastic container with ultrasound gel applied between the bags. The pig model was constructed using the method described by Nitsche et al. Maternal fetal medicine specialists and trainees were timed at constructing and using the task trainers. The average times required to load, deploy the stent on the Ziploc task trainer and reload it were 2.3 minutes (2.20–2.35), 1.0 minutes (0.70–1.93) and 0.1 minutes (0.08–0.10) respectively. For the pig model, they were 6.0 minutes (5.00–7.06), 3.7 minutes (3.63–3.75) and 3.3 minutes (3.00–3.70). According to these results, the Ziploc model can be used 3.8 times in the time required to use the pig model. Common problems encountered using the pig model were failure to create an adequate thoracic space and leaking from the pig uterine model, whereas there were no reported problems with the Ziploc task trainer. In utero stenting is a multi-step procedure. Although the pig model enables us to simulate a very realistic model with ultrasound visualisation, the Ziploc model allows the trainee to first master stent deployment with direct visualisation of the apparatus to better understand the technique. Moreover, the Ziploc bag task trainer is inexpensive (1$ per model), efficient, can be reutilised more than 30 times and replicates the sensation of piercing through the uterine cavity during a clinical scenario.