Usability of a Novel 3D Printed Open Inguinal Hernia Repair Simulator

To determine the utility of a novel 3D printed open inguinal hernia repair (IHR) simulator compared to our institution's porcine tissue training model.

We iteratively developed a novel 3D printed inguinal hernia model and then designed a convergent mixed methods study to compare the model with a porcine model. Participants completed a rating form post use of the models and were subsequently interviewed.

We conducted this study at the surgical skills center of a single large urban academic medical center.

Individuals were eligible if they were a senior general surgery resident, defined as postgraduate year (PGY) 3 or higher, or attending surgeon with expertise in open inguinal hernia repair or surgical education. Participants were 6 residents and 7 general surgery faculty; all completed the rating form, and 12 were interviewed.

The 3D printed simulator demonstrated medium (>0.5) to large effect sizes (>0.8) on 10 of 12 evaluative criteria when compared to the porcine model, with the greatest effect seen in pelvic anatomy and the lowest in mechanical properties and operating in small spaces. We identified 4 themes: (1) utility varies between trainees and faculty: trainees prioritized anatomy whereas faculty prioritized both anatomy and tissue fidelity, (2) anticipate less intraop cognitive load: the 3D printed simulator realistically simulated procedure steps and could decrease intraop cognitive load, (3) both models can increase confidence: both models allow residents to practice the repair in a pressure-free environment, allowing them to build confidence, and (4) need novel ways to understand complexity of the anatomy: current methods to understand anatomy are insufficient.

An anatomically accurate 3D printed model may contribute to effective training for IHR. Addition of 3D to a tissue model would allow further development of trainee knowledge and skills.