Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects

Weinstock, Peter; Rehder, Roberta; Prabhu, Sanjay P.; Forbes, Peter; Roussin, Christopher; Cohen, Alan R.

doi:10.3171/2017.1.peds16568

Cited by 105 publications

(80 citation statements)

References 49 publications

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“…Three‐dimensional (3D) printing is a process in which layers of material are successively laid down to generate complex structures, which allows for the creation of relatively inexpensive prototypes . Using imaging data from modalities such as computed tomography (CT) and magnetic resonance imaging (MRI), 3D printing has been used in the medical field to further advancements in prosthetics, undertake perioperative planning of complicated procedures, and facilitate clinical education . Given the complex nature of congenital heart defects (CHD), 3D printing has been increasingly used in this field for anatomic modeling and procedural planning .…”

Section: Introductionmentioning

confidence: 99%

“…1 Using imaging data from modalities such as computed tomography (CT) and magnetic resonance imaging (MRI), 3D printing has been used in the medical field to further advancements in prosthetics, undertake perioperative planning of complicated procedures, and facilitate clinical education. [2][3][4][5][6] Given the complex nature of congenital heart defects (CHD), 3D printing has been increasingly used in this field for anatomic modeling and procedural planning. 7 We have previously reported the utility of 3D printed models in modeling vascular rings and pulmonary slings for resident education.…”

Section: Introductionmentioning

confidence: 99%

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Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects

White

Sedler

Jones

et al. 2018

Congenital Heart Disease

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Incorporation of 3D printed models into lectures about CHD imparts a greater acute level of understanding, both subjective and objective, for pediatric and combined pediatric/emergency medicine residents. There does not seem to be an added benefit for understanding ventricular septal defects, but there is for tetralogy of Fallot, likely due to increased complexity of the lesion and difficulty visualizing spatial relationships in CHD with multiple components.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects

White

Sedler

Jones

et al. 2018

Congenital Heart Disease

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“…30 There is emerging evidence in the literature of the superiority of using a 3D visual field in laparoscopic surgery with its improved depth perception. [31][32][33][34][35][36] Therefore, more complex training models with depth and contours could potentially have an impact on the learning curve and enhance A recent study 37 reported a structured training model with a combination of 3D printing and special effects techniques to allow novices to gain valuable experience in surgical techniques without exposing patients to any risk of harm.…”

Section: Discussionmentioning

confidence: 99%

Face and construct validation study of novel 3D peg transfer models for training and evaluation of laparoscopic skills in two-dimensional and three-dimensional laparoscopic surgery

Morawala¹,

Alaraimi²,

Galloso³

et al. 2019

J Surg Simul

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Background: Fundamentals in Laparoscopic Surgery (FLS) is widely used in practice for skill acquisition and objective assessments. The peg transfer model enables trainees to acquire basic laparoscopic skills. We structured three different three-dimensional (3D) peg transfer models with various heights and depths to replicate 3D laparoscopic anatomy. Before implementing any simulation model in a laparoscopy curriculum, it is important to determine its validity. Aim: To establish face and construct validity of novel 3D peg transfer models in two-dimensional (2D) and 3D visual systems for training and evaluation of laparoscopic skills in novices using the McGill inanimate system. Methods: Three peg transfer 3D models were designed with different peg heights and depths using wooden blocks from the popular game "Jenga". Ten novices, ten intermediates and ten experts were recruited. They performed three repetitions of peg transfer on each model using 3D and 2D visual modalities. Performance time, error and total score were measured. Multiple comparison (post hoc Bonferroni) tests were used to compare the data (mean value of total time, total errors and total score) for each group. All participants completed a six-question post-test questionnaire (face validity) for 2D and 3D viewing modalities. Results: When novices were compared with intermediates and experts using 2D and 3D visual systems, there were statistically significant differences (P50.001) in the total score and performance time for all models with the exception of model 2 in 2D. We were unable to show any significant difference in total score and performance time when intermediates were compared with experts with any of the three models, in either the 2D or the 3D visual modality. All models were highly rated in both visual modalities. Conclusion: Three models were developed for improving laparoscopic surgical skills. Face validity and construct validity were demonstrated by measuring significant differences in improvement of performance time and lower total score when novices were compared with intermediates and experts in both 2D and 3D visual modalities. We recommend using models 1 and 3 for simulation training in both visual modalities, and this could replace the current relatively "flat" 2D models of the FLS training course to shorten the learning curve for acquiring surgical skills.

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“…Current ETV models have been costly when considering the software required to create the simulator and the need for an operating room-grade endoscope with a light source tower. 2,6,20 Such equipment and resources are not available to the average neurosurgical resident and carry the inherent risk of being damaged with high replacement costs. In this paper we present a method for creating an ETV simulator using free open-source software readily available to the public.…”

Section: Discussionmentioning

confidence: 99%

Low-cost endoscopic third ventriculostomy simulator with mimetic endoscope

Garling¹,

Jin²,

Yang³

et al. 2018

Journal of Neurosurgery: Pediatrics

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OBJECTIVEHydrocephalus affects approximately 1 in 500 people in the US, yet ventricular shunting, the gold standard of treatment, has a nearly 85% failure rate. Endoscopic third ventriculostomy (ETV) is an alternative surgical approach for a specific subset of hydrocephalic patients, but can be limited by the inability of neurosurgical residents to practice prior to patient contact. The goal of this study was to create an affordable ETV model and endoscope for resident training.METHODSOpen-source software was used to isolate the skull and brain from the CT and MR images of a 2-year-old boy with hydrocephalus. A 3D printer created the skull and a 3D mold of the brain. A mixture of silicone and silicone tactile mutator was used to cast the brain mold prior to subsequent compression and shearing modulus testing. A mimetic endoscope was then created from basic supplies and a 3D printed frame. A small cohort of neurosurgical residents and attending physicians evaluated the ETV simulator with mimetic endoscope.RESULTSThe authors successfully created a mimetic endoscope and ETV simulator. After compression and shearing modulus testing, a silicone/Slacker ratio between 10:6 and 10:7 was found to be similar to that of human brain parenchyma. Eighty-seven percent of participants strongly agreed that the simulator was useful for resident training, and 93% strongly agreed that the simulator helped them understand how to orient themselves with the endoscope.CONCLUSIONSThe authors created an affordable (US$123, excluding 3D printer), easy-to-use ETV simulator with endoscope. Previous models have required expensive software and costly operative endoscopes that may not be available to most residents. Instead, this attempt takes advantage of open-source software for the manipulation and fabrication of a patient-specific mold. This model can assist with resident development, allowing them to safely practice use of the endoscope in ETV.

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Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects

Cited by 105 publications

References 49 publications

Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects

Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects

Face and construct validation study of novel 3D peg transfer models for training and evaluation of laparoscopic skills in two-dimensional and three-dimensional laparoscopic surgery

Low-cost endoscopic third ventriculostomy simulator with mimetic endoscope

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