Magnetic Spiderman, a New Surgical Training Device: Study of Safety and Educational Value in a Liver Transplantation Surgical Training Program

Introduction Difficulties with liver transplantation (LT)-related surgical techniques are great challenges for young surgeons. Thus, young surgeons need to undergo systematic preclinical training. However, an optimal training system for LT is still lacking. This study aims to evaluate the safety and educational value of the Magnetic Spiderman (MS) during LT-related surgical techniques training, particularly during training for the preparation of the donor's liver and vascular reconstruction. Methods For the donor liver preparation training, the pulling force of the MS was measured using 16 porcine livers. Another 40 porcine livers were divided into two groups: MS group (used MS in the preparation of the liver) (n = 25) and manual group (took manual assistance in the preparation of the liver) (MA group, n = 15). In vascular reconstruction training, 25 pairs of porcine iliac veins were used to practice reconstruction. Five LT experts evaluated the MS for its use in LT-related surgical techniques training. Results During the donor liver preparation training, the number of assistants required in the MS group was significantly less than the number required in the MA group (0 vs. 1.8 +/- 0.1; P < 0.001). However, the number of vasculature leaking points was similar between the two groups (0.2 +/- 0.1 vs. 0.4 +/- 0.2; P = 0.51). In vascular reconstruction training, the trainee alone could complete the vascular reconstruction training, with a reconstruction success rate of 80% (20/25). All five experts considered the MS a viable alternative to assistants, with the ability to facilitate single surgeon training for LT. Four out of five (80%) experts considered MS quite safe for surgery and effective at keeping the surgical field clear. Conclusion MS can reduce the number of assistants to zero in LT-related techniques training without increasing the risk of the operation, thus facilitating training for LT.