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The complexity of handheld steerable laparoscopic instruments (SLI) may impair the learning curve compared to conventional instruments when first utilized. This study aimed to provide the current state of interest in the use of SLI, the current use of these in daily practice and the type of training which is conducted before using SLI in the operating room (OR) on real patients. An online survey was distributed by European Association of Endoscopic Surgery (EAES) Executive Office to all active members, between January 4th and February 3rd, 2020. The survey consisted of 14 questions regarding the usage and training of steerable laparoscopic instruments. A total of 83 members responded, coming from 33 different countries. Twenty three percent of the respondents using SLI, were using the instruments routinely and of these 21% had not received any formal training in advance of using the instruments in real patients. Of all responding EAES members, 41% considered the instruments to potentially compromise patient safety due to their complexity, learning curve and the inexperience of the surgeons. The respondents reported the three most important aspects of a possible steerable laparoscopic instruments training curriculum to be: hands-on training, safe tissue handling and suturing practice. Finally, a major part of the respondents consider force/pressure feedback data to be of significant importance for implementation of training and assessment of safe laparoscopic and robotic surgery. Training and assessment of skills regarding safe implementation of steerable laparoscopic instruments is lacking. The respondents stressed the need for specific hands-on training during which feedback and assessment of skills should be guaranteed before operating on real patients. [ABSTRACT FROM AUTHOR]

The use of 3D printing is gaining considerable success in many medical fields including surgery. Here, the technology was introduced for increasing the level of anatomical understanding thanks to the inherent characteristics of 3D printed models: these are highly accurate and customized reproductions, being obtained from own radiological imaging of patients, and are solid graspable objects allowing for free manipulation on part of the user. The resulting tactile feedbacks significantly help the comprehension of anatomical details, especially the spatial relations between structures. In this regard, they proved to be more effective than conventional 2D imaging and 3D virtual models. To date, an increasing number of applications have been successfully tested in many surgical disciplines, extending the range of possible uses to pre-operative planning, counselling with patients, education of students and residents, surgical training, intraoperative navigation and others; in recent years, 3D printing was also employed for creating surgical tools and reproducing anatomical parts to be used, respectively, as templates or guides for specific tasks of the surgery and individualized implantable materials in reconstructive procedures. Future expectations concern on one side the reduction of manufacturing costs and time to further increase the accessibility of 3D printing, while on the other the development of novel techniques and materials suitable for 3D printing of biological structures by which recreating the architecture and functionality of real human organs and tissues.