Use of a perfused cadaver for training of robotic pancreaticoduodenectomy allows for realistic tissue dissection and management of intra-operative bleeding

Presenter: Britney Harris MD | West Virginia University, Morgantown Background: Minimally invasive pancreaticoduodenectomy (MIPD) has emerged as a promising alternative to open pancreaticoduodenectomy. However, the learning curve associated with mastering this complex operation is significant hurdle for new programs and widespread implementation. Novel training modalities that realistically simulate MIPD are needed provide sufficient without compromising patient safety. Perfused, fresh human cadavers (FHC) have been shown be beneficial in surgical skills training. Herein, we aim evaluate use of perfused FHC model MIPD. Methods: The initial evaluation included performing resection portion robotic on standard operating room setting. cadaver used was fresh, non-embalmed never frozen. Vascular perfusion achieved via cannulation femoral vessels centrifugal pump water-based blood substitute. selectively utilized during procedure enhance vascular anatomy hemorrhage. Two oncology faculty evaluated tissue integrity compared live dissection well ability clearly demonstrate pertinent anatomy, including structures. Additionally, assessed pefused portal vein injury. Results: successfully performed by two faculty. Both found high fidelity regard highly realistic identification particularly Moreover, replicating procedural steps representative technical troubleshooting required both console surgeon bedside assistant. Similarly, intentional injury allowed operative control bleeding repair vessel, closely simulating one hazardous intra-operative complications Conclusion: Overcoming presents challenge surgeons implementing clinical trials evaluating outcomes surgery, evident recent randomized plagued unexpectedly complication rates. Training incorporating virtual reality biotissue drills useful, however these strategies do not experience handling. Perfused offer an innovative approach safe effective close recapitulation necessary safely complete procedure. Further studies development method other procedures.