Challenges in creating dissectible anatomical 3D prints for surgical teaching

Ratinam, Ratheesraj; Quayle, Michelle R.; Crock, John; Lazarus, Michelle D.; Fogg, Quentin A.; McMenamin, Paul G.

doi:10.1111/joa.12934

Cited by 50 publications

(44 citation statements)

References 128 publications

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“…Whilst a variety of substrates are available in 3D printing [23], the haptic properties are currently limited. In addition, limitations in 3D printing technology complicate the manufacture of hollow flexible models and the replication of soft tissues [24]. The present study overcame these limitations through 3D print-driven moulds which allowed us to cast materials that mimicked real tissues.…”

Section: Discussionmentioning

confidence: 99%

Advanced 3D printed model of middle cerebral artery aneurysms for neurosurgery simulation

et al. 2019

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BackgroundNeurosurgical residents are finding it more difficult to obtain experience as the primary operator in aneurysm surgery. The present study aimed to replicate patient-derived cranial anatomy, pathology and human tissue properties relevant to cerebral aneurysm intervention through 3D printing and 3D print-driven casting techniques. The final simulator was designed to provide accurate simulation of a human head with a middle cerebral artery (MCA) aneurysm.MethodsThis study utilized living human and cadaver-derived medical imaging data including CT angiography and MRI scans. Computer-aided design (CAD) models and pre-existing computational 3D models were also incorporated in the development of the simulator. The design was based on including anatomical components vital to the surgery of MCA aneurysms while focusing on reproducibility, adaptability and functionality of the simulator. Various methods of 3D printing were utilized for the direct development of anatomical replicas and moulds for casting components that optimized the bio-mimicry and mechanical properties of human tissues. Synthetic materials including various types of silicone and ballistics gelatin were cast in these moulds. A novel technique utilizing water-soluble wax and silicone was used to establish hollow patient-derived cerebrovascular models.ResultsA patient-derived 3D aneurysm model was constructed for a MCA aneurysm. Multiple cerebral aneurysm models, patient-derived and CAD, were replicated as hollow high-fidelity models. The final assembled simulator integrated six anatomical components relevant to the treatment of cerebral aneurysms of the Circle of Willis in the left cerebral hemisphere. These included models of the cerebral vasculature, cranial nerves, brain, meninges, skull and skin. The cerebral circulation was modeled through the patient-derived vasculature within the brain model. Linear and volumetric measurements of specific physical modular components were repeated, averaged and compared to the original 3D meshes generated from the medical imaging data. Calculation of the concordance correlation coefficient (ρc: 90.2%–99.0%) and percentage difference (≤0.4%) confirmed the accuracy of the models.ConclusionsA multi-disciplinary approach involving 3D printing and casting techniques was used to successfully construct a multi-component cerebral aneurysm surgery simulator. Further study is planned to demonstrate the educational value of the proposed simulator for neurosurgery residents.

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Section: Discussionmentioning

confidence: 99%

Advanced 3D printed model of middle cerebral artery aneurysms for neurosurgery simulation

et al. 2019

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“…With further cost reductions in 3D printers and printing materials in the near future, personalized 3D printed heart models will become more affordable to patients with CHD. Table 3 shows different types of 3D printers and printing materials that are available in the 3D printing of cardiac models and strengths and weaknesses of these models corresponding to each type of 3D printers [36,46,47,48,49].…”

Section: Summary and Future Research Directionsmentioning

confidence: 99%

Personalized Three-Dimensional Printed Models in Congenital Heart Disease

Sun

Lau

Wong

et al. 2019

JCM

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Patient-specific three-dimensional (3D) printed models have been increasingly used in cardiology and cardiac surgery, in particular, showing great value in the domain of congenital heart disease (CHD). CHD is characterized by complex cardiac anomalies with disease variations between individuals; thus, it is difficult to obtain comprehensive spatial conceptualization of the cardiac structures based on the current imaging visualizations. 3D printed models derived from patient’s cardiac imaging data overcome this limitation by creating personalized 3D heart models, which not only improve spatial visualization, but also assist preoperative planning and simulation of cardiac procedures, serve as a useful tool in medical education and training, and improve doctor–patient communication. This review article provides an overall view of the clinical applications and usefulness of 3D printed models in CHD. Current limitations and future research directions of 3D printed heart models are highlighted.

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“…Finally, it seems valuable to note that the method of fabrication applied by Tenchini to his face artefacts has some unexpected similarities with the method of progressive stratification with biomaterials known as additive layer manufacturing, recently used in 3D reconstruction of facial, skull, and scalp defects (Siemionow, 2015;Simonacci et al 2017), and for a vast array of other medical applications including anatomical-surgical teaching (Ratinam et al 2019).…”

Section: Experimental Studies On the Structure Of Tenchini's Masksmentioning

confidence: 99%

“…), and for a vast array of other medical applications including anatomical‐surgical teaching (Ratinam et al. ).…”

Section: Tenchini's Masks: a Technical Conundrum In Anatomical Ceroplmentioning

confidence: 99%

The masks of Lorenzo Tenchini: their anatomy and surgical/bioengineering clues

et al. 2019

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An academic, anatomist, and Lombrosian psychiatrist active at the University of Parma in Italy at the end of the 19th century, Lorenzo Tenchini produced ceroplastic-like masks that are unique in the anatomical Western context. These were prepared from 1885 to 1893 with the aim of 'cataloguing' the behaviour of prison inmates and psychiatric patients based on their facial surface anatomy. Due to the lack of any reference to the procedure used to prepare the masks, studies were undertaken by our group using X-ray scans, infrared spectroscopy, bioptic sampling, and microscopy analysis of the mask constituents. Results showed that the masks were stratified structures including plaster, cotton gauze/human epidermis, and wax, leading to a fabrication procedure reminiscent of 'additive layer manufacturing'. Differences in the depths of these layers were observed in relation to the facial contours, suggesting an attempt to reproduce, at least partially, the three-dimensional features of the facial soft tissues. We conclude the Tenchini masks are the first historical antecedent of the experimental method for face reconstruction used in the early 2000s to test the feasibility of transferring a complete strip of face and scalp from a deceased donor to a living recipient, in preparation for a complete face transplant. In addition, the layering procedure adopted conceptually mimics that developed only

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Challenges in creating dissectible anatomical 3D prints for surgical teaching

Cited by 50 publications

References 128 publications

Advanced 3D printed model of middle cerebral artery aneurysms for neurosurgery simulation

Advanced 3D printed model of middle cerebral artery aneurysms for neurosurgery simulation

Personalized Three-Dimensional Printed Models in Congenital Heart Disease

The masks of Lorenzo Tenchini: their anatomy and surgical/bioengineering clues

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