A camera was also placed above the model to allow the trainees to train eye-hand coordination while viewing the image on a monitor in real time. For the puncture, we used a 20-G Chiba needle and a wire with distal double arches these were used to troll a cord, simulating the successful puncture of a bile duct. The skin, ribs, intercostal muscles, and right lower lobe pleura were simulated using foam sponge, plastic tubes, a polystyrene foam panel, and an air pad, respectively. MethodsĪn anatomically based model of the biliary tree was developed using a cord network fixed to a wooden frame. The aim of this study was to present a percutaneous transhepatic biliary puncture simulator that can be used without radiation exposure and that reflects the conventional anatomy of the biliary ducts and its vicinity structures.
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