Journal of Surgical Simulation 2017; 4: 35 - 40
Published: 23 August 2017
Ultrasound-guided central line placement: is a gelatine phantom a good and affordable alternative?
Background: Central venous catheter (CVC) insertion is a common procedure. However, it has a complication rate of up to 15%. Ultrasound-guided (USG) central venous catheter insertion (USG-CVC) is recommended to reduce complications. USG punctures require hand–eye coordination. USG puncture training requires an adequate training phantom that mimics the ultrasound characteristics and in addition provides haptic feedback of tissue and veins. However, the commercially available phantoms are expensive. The aim of this proof of concept study was to produce a low-cost, realistic phantom to improve hand–eye coordination. The quality and utility of the phantom were reviewed by several participants experienced in USG punctures. Methods: This study took place in a peripheral teaching hospital and an academic centre. All available participants (n = 20) experienced in USG-CVC insertion were asked to perform a USG puncture on the phantom. In addition, participants reviewed the quality and different properties of the phantom by completing a questionnaire. Results: The age of the participants ranged from 24 to 55 years. Participants were surgical residents and surgeons with an average experience of 10–50 blind CVC procedures and 20–50 USG-CVC procedures. The phantom was rated moderate (mean, 3 out of 5) from a realistic perspective and good (mean, 4 out of 5) from a procedural perspective. Training of hand–eye coordination and the overall rating was good (mean, 4 out of 5). Conclusions: Overall, the phantom was rated good, especially for training of hand–eye coordination. These findings confirm the feasibility of this easy to make, affordable home-made phantom for USG puncture training.
central venous puncture; phantom; home-made; training; ultrasound; gelatine
Video 1. A low cost gelatine phantom for simulating ultrasound guided central line placement: demonstration of use. Available online at https://youtu.be/EnH9rmjelRk