Practice of peritoneal dialysis access education using the new hybrid simulator in Japan.

Abstract To promote the increase in patients undergoing peritoneal dialysis (PD) in Japan, the Japanese Society for Dialysis Access started offering workshops on peritoneal access (PA) preparation procedures for doctors with less experience. Since the transfer of technology used in surgical procedures is difficult in small communities such as individual hospitals, a specialist group such as a society should take the initiative and fulfill this responsibility. Here we used a hybrid simulator developed by Terumo Medical Pranex that uses the abdominal wall of an edible pig (a lump from the peritoneum to skin) and a mannequin. Since the structure of the porcine abdominal wall is similar to that of humans, the PA procedure can be simulated in this actual procedure. With three-dimensional reproduction of the Douglas pouch and other features of the pelvis using human computed tomography images, we created a system in which even drainage is possible if the catheter is well placed. Using this simulator, students were able to experience the PA access preparation procedure 2-4 times and easily observed the catheter position after insertion by peeling the abdominal wall from the mannequin. In the future, by leveraging the advantages of the hybrid simulator, we aim to promote the training of medical staff interested in PD health care and increase the number of patients able to benefit from the many advantages of PD.