A novel modular approach for the design of physical simulators for colonoscopy

Over the past decade, a great interest has grown in the employment of simulators for the acquisition, maintenance, and assessment of skills in GI endoscopy. In particular, physical simulators are supposed to be used in the standard colonoscopy setup enabling a true interaction with the medical instrumentation, albeit they often lack visual realism and variability of configurations, besides their limited affordability. The present Master Thesis focuses on investigating colon morphology and biomechanics to envisage an innovative modular silicone-made training platform offering a low-cost, versatile, and customizable alternative to commercial static simulators. Straight and curved molds realizing the different colonic units are designed in SolidWorks and afterward, 3D printed: the adopted modular approach enables the user to fabricate custom straight modules and curved connections by setting the number of colonic units and the angle of flexion, respectively. FEM simulations are performed to address silicone selection and get insights into the insufflation behavior, with the aim of qualitatively mimicking colon biomechanics. A complete colon simulator prototype is fabricated and equipped with assorted sizes and shapes of polyps: its performance is tested by means of cecal intubation and polypectomy within the Kyoto Kagaku phantom and within a custom-made abdominal simulator embedded with monoaxial strain gauge sensors. This work shows promising results in view of improving the accessibility, versatility, and anatomical realism of current colonoscopy physical simulators

Physical simulator for colonoscopy: a modular design approach and validation

Simulators for gastrointestinal endoscopy offer the opportunity to train and assess clinicians’ skills in a low-risk and reliable environment. Physical simulators can enable a direct instrument-to-organ interaction not provided by virtual platforms. However, they present scarce visual realism and limited variability of the anatomical conditions. Herein, the authors present an innovative and low-cost methodology for designing and fabricating modular silicone colon simulators. The fabrication pipeline envisages parametric customization and development of 3D-printed molds for silicone pouring to obtain colon segments. The sizing of each colon segment is based on clinical data extracted by CT colonography images. Straight and curved segments are connected through silicone conjuncts to realize a customized and modular monolithic physical simulator. A 130 cm-long colon simulator prototype with assorted magnetically-connected polyps was fabricated and laid on a custom-made sensorized abdominal phantom. Content, face, and construct validity of the designed simulator were assessed by 17 endoscopists. In summary, this work demonstrated promising results for improving accessibility and flexibility of current colonoscopy physical simulators, paving the way for modular and personalized training programs.This work was supported by the ATLAS project. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 813782