Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve.

Abstract

Laparoscopic Nissen fundoplication (LNF) requires extensive training for surgical proficiency, with significant early learning curve complications. A structured training protocol utilizing a 3D-printed anatomical model is described and designed to accelerate the acquisition of advanced laparoscopic skills. The protocol entails the production and assembly of models incorporated into an LNF-specific training curriculum focused on critical components involving advanced suturing skills. The model includes anatomically accurate landmarks, all fabricated using specialized silicone materials. A step-by-step training curriculum is presented, focused on mastering the most challenging components of LNF, including crural closure, mesh suturing, and the fundoplication wrap. Representative results from a pilot participant demonstrate a quantifiable learning curve, with total performance scores improving from 21 to 42 and procedural time decreasing from 95 to 34 min across six sessions, systematically approaching the expert benchmark. The overall efficacy of this training paradigm was validated in a comparative study, where the 3D-printed model-trained group demonstrated significantly superior Objective Structured Assessment of Technical Skills (OSATS) scores in the operating room (26.25 ± 1.67 vs. 17.50 ± 2.07) and shorter procedure durations (76.25 ± 2.49 vs. 110.13 ± 3.36 min) compared to a control group, confirming the protocol's positive impact on clinical skills. This validated protocol provides a reproducible method for implementing an effective LNF training program capable of measuring and facilitating progressive skill development.