Development of a Thoracoscopic Model for Birth Defect Esophageal Atresia and Tracheoesophageal Fistula Using Fresh Sheep Tissues.

Abstract

BACKGROUND: This study aimed to develop an esophageal atresia (EA) model using fresh sheep esophagus, trachea, and lungs to simulate a realistic thoracoscopic surgical environment. METHODS: A thoracoscopic trainer box was used with fresh sheep tissues (esophagus, trachea, and lungs) to create an EA and tracheoesophageal fistula (TEF) model. The distal esophagus was anastomosed to the trachea, and a bicycle pump was integrated to simulate lung function. Additional components, such as a simulated azygos vein and parietal pleura, enhanced the model's realism for surgical training. RESULTS: The developed EA-TEF model was created in six steps, including pleural dissection, azygos vein control, TEF division, and esophageal anastomosis. The procedure used a thoracoscopic trainer box, sheep tissues, and standard instruments. A bicycle pump simulated lung function, and careful techniques were employed for vein ligation and esophageal anastomosis. After the posterior wall was sutured, an 8 Fr feeding tube was inserted. The total cost of the model was $260, with reusable equipment and a $10 recurring cost for sheep tissues. CONCLUSIONS: This study successfully developed a cost-effective and anatomically accurate thoracoscopic model for EA and TEF repair using fresh sheep tissue.