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

Laparoscopic Nissen fundoplication (LNF) requires extensive training for surgical proficiency, with significant early learning curve complications. A ...

Zhejiang Chinese Medical University

Magnetic sphincter augmentation (MSA) is a novel surgical technique investigated at many clinical institutes worldwide. In 2012, it received approval for treating Gastroesophageal reflux disease (GERD) because of its superior benefits compared to drug therapies. This study aimed to explore the safety and efficacy of MSA compared with Laparoscopic Nissen fundoplication (LNF) for GERD treatment.

A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD.

A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD. Author's reply.

Three-dimensional (3D) printed surgical models provide an excellent surgical training option to closely mimic real operations to teach medical students who currently rely largely on visual learning aided with simple suturing pads. There is an unmet need to create simple to complex surgical training programs suitable for medical students. A prospective cohort study was conducted on a group of 16 6th year students. They were randomly divided into two groups for suture training on a basic training pad or on unique 3D-printed intestinal anastomosis models. After 4 weeks of open and laparoscopic surgical training, exams were performed on the standardized 3D-printed model at the end of each stage to assess surgical performance including surgical time and scores. Both groups had similar skills before the start of each stage. In stage 1, both groups showed comparable learning performance, but the 3D model group performed better in Exam 1. In stage 2, the 3D model group took more time but showed significant improvements and outperformed the pad group in Exam 2 in both performance scores and time. Post-training questionnaires indicated increased interest in surgery and technical training among students using 3D models. Realistic 3D-printed models benefit surgical training, expected to become integral in teaching operative skills and techniques to medical students.

A randomized cohort study on the use of 3D printed models to enhance surgical training in suturing techniques.

Gastroesophageal reflux disease (GERD) is a prevalent condition often associated with hiatal hernia (HH). While conventional laparoscopic anti-reflux surgery (CLAS) remains the gold standard for refractory GERD, robotic-assisted anti-reflux surgery (RAAS) has emerged as a promising alternative, offering enhanced precision and ergonomics. This study compares perioperative outcomes and mid-term symptom resolution between RAAS and CLAS. A retrospective cohort analysis included 91 patients undergoing primary anti-reflux surgery (RAAS n = 31, CLAS n = 60) between April 2022 and April 2024. Patients had confirmed GERD unresponsive to proton pump inhibitors (PPI), excluding giant HH or prior surgery. Standardized preoperative evaluation and surgical protocols were followed. Perioperative metrics (operative time, complications) and symptomatic outcomes at 12-month follow-up (GERDQ scores, symptom resolution, reoperations, PPI use, endoscopic/ultrasound findings) were compared. Demographic and baseline characteristics were comparable between groups. RAAS had significantly longer total operative time (158.8 vs. 146.4 min, p = 0.02) and docking/setup time (21.2 vs. 11.5 min, p = 0.02), primarily due to the initial dissection phase. Intraoperative complication rates (3.2% vs. 5.0%, p = 0.65), postoperative stay (3.32 vs. 3.75 days, p = 0.40), and 30-day mortality (0% both) were similar. At median follow-up, rates of complete symptom resolution (80.6% vs. 75.0%, p = 0.55), residual symptoms (e.g., dysphagia: 6.5% vs. 15.0%, p = 0.40), postoperative PPI use (16.1% vs. 8.3%, p = 0.43), objective reflux on imaging (7.7% both), and reoperation rates (3.2% vs. 5.0%, p = 0.70) showed no significant differences. RAAS achieves perioperative safety and medium-term symptomatic outcomes comparable to CLAS. While technically feasible, RAAS requires longer operative times initially, with a notable learning curve for docking. No significant clinical superiority of RAAS was demonstrated in this cohort. Further randomized trials evaluating long-term durability and cost-effectiveness are warranted.

Robot-assisted versus conventional laparoscopic antireflux surgery: a retrospective cohort analysis of perioperative and medium-term outcomes.

Correction: Robot-assisted versus conventional laparoscopic antireflux surgery: a retrospective cohort analysis of perioperative and medium-term outcomes.

Article	Year
A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD. Hernia : the journal of hernias and abdominal wall surgery\| PubMed ID: 39400916	2024
A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD. Author's reply. Hernia : the journal of hernias and abdominal wall surgery\| PubMed ID: 39666230	2024
A randomized cohort study on the use of 3D printed models to enhance surgical training in suturing techniques. Scientific reports\| PubMed ID: 39753693	2025
Robot-assisted versus conventional laparoscopic antireflux surgery: a retrospective cohort analysis of perioperative and medium-term outcomes. Journal of robotic surgery\| PubMed ID: 40613965	2025
Correction: Robot-assisted versus conventional laparoscopic antireflux surgery: a retrospective cohort analysis of perioperative and medium-term outcomes. Journal of robotic surgery\| PubMed ID: 40772990	2025

Menghui Zhou

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