Neurosurgical Endoscopic Training via a Realistic 3-Dimensional Model With Pathology

Waran, Vicknes; Narayanan, Vairavan; Karuppiah, Ravindran; Thambynayagam, Hari Chandran; Muthusamy, Karthikeyan; Rahman, Zainal Ariff Abdul; Kirollos, Ramez

doi:10.1097/sih.0000000000000060

Cited by 62 publications

(48 citation statements)

References 15 publications

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“…Institutions are already using them to educate trainees on treatment of complex bony fractures(53), critical care and surgical treatment of congenital heart disease(6), and neurosurgical procedures (54). The utility of realistic anatomic models has the potential to make a big impact in the field of neurosurgery.…”

Section: Physician Training and Educationmentioning

confidence: 99%

See 1 more Smart Citation

Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications

Marro

Bandukwala

Mak

2016

Current Problems in Diagnostic Radiology

320

234

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Section: Physician Training and Educationmentioning

confidence: 99%

“…Using 3D printing techniques, models with pathology can be created using actual patient's imaging data. These models provide a safe and realistic environment for teaching neuroendoscopic procedures (54).…”

Section: Physician Training and Educationmentioning

confidence: 99%

Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications

Marro

Bandukwala

Mak

2016

Current Problems in Diagnostic Radiology

320

234

View full text Add to dashboard Cite

“…Subsequent improvement in the surgeon’s competence may lead to enhanced clinical outcomes and a reduced risk of complications. Investigators from various surgical disciplines have demonstrated the utility of 3D printing in training, such as neurosurgery (72–77, 141, 142), cardiothoracic surgery (54, 78–80, 143–145), urology (81, 146), and general surgery (29) However, one of the major limitations currently is the ability to print in materials that closely mimic the biomechanical properties and modulus of real human tissue as well as possessing realistic colors. As more materials enter the scope of 3D printing, future 3D-printed biomodels will be able to more closely reproduce true anatomy (50, 72, 74, 79).…”

Section: D Printing In Plastic and Reconstructive Surgerymentioning

confidence: 99%

Emerging Applications of Bedside 3D Printing in Plastic Surgery

et al. 2015

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Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.

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“…11, 49 We believe that further advances in this technology will provide a means to print highly accurate components of the surgical trainer in an automated fashion, thus reducing cost as well as the time and effort required to assemble the models. 9,48,50 We estimate that the cost of the lifelike ETV training model and simulator will be less than that of a cadaveric specimen.…”

Section: 1419mentioning

confidence: 99%

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

Weinstock

Rehder

Prabhu

et al. 2017

Journal of Neurosurgery: Pediatrics

105

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OBJECTIVERecent advances in optics and miniaturization have enabled the development of a growing number of minimally invasive procedures, yet innovative training methods for the use of these techniques remain lacking. Conventional teaching models, including cadavers and physical trainers as well as virtual reality platforms, are often expensive and ineffective. Newly developed 3D printing technologies can recreate patient-specific anatomy, but the stiffness of the materials limits fidelity to real-life surgical situations. Hollywood special effects techniques can create ultrarealistic features, including lifelike tactile properties, to enhance accuracy and effectiveness of the surgical models. The authors created a highly realistic model of a pediatric patient with hydrocephalus via a unique combination of 3D printing and special effects techniques and validated the use of this model in training neurosurgery fellows and residents to perform endoscopic third ventriculostomy (ETV), an effective minimally invasive method increasingly used in treating hydrocephalus.METHODSA full-scale reproduction of the head of a 14-year-old adolescent patient with hydrocephalus, including external physical details and internal neuroanatomy, was developed via a unique collaboration of neurosurgeons, simulation engineers, and a group of special effects experts. The model contains “plug-and-play” replaceable components for repetitive practice. The appearance of the training model (face validity) and the reproducibility of the ETV training procedure (content validity) were assessed by neurosurgery fellows and residents of different experience levels based on a 14-item Likert-like questionnaire. The usefulness of the training model for evaluating the performance of the trainees at different levels of experience (construct validity) was measured by blinded observers using the Objective Structured Assessment of Technical Skills (OSATS) scale for the performance of ETV.RESULTSA combination of 3D printing technology and casting processes led to the creation of realistic surgical models that include high-fidelity reproductions of the anatomical features of hydrocephalus and allow for the performance of ETV for training purposes. The models reproduced the pulsations of the basilar artery, ventricles, and cerebrospinal fluid (CSF), thus simulating the experience of performing ETV on an actual patient. The results of the 14-item questionnaire showed limited variability among participants' scores, and the neurosurgery fellows and residents gave the models consistently high ratings for face and content validity. The mean score for the content validity questions (4.88) was higher than the mean score for face validity (4.69) (p = 0.03). On construct validity scores, the blinded observers rated performance of fellows significantly higher than that of residents, indicating that the model provided a means to distinguish between novice and expert surgical skills.CONCLUSIONSA plug-and-play lifelike ETV training model was developed through a combination of 3D printing and special effects techniques, providing both anatomical and haptic accuracy. Such simulators offer opportunities to accelerate the development of expertise with respect to new and novel procedures as well as iterate new surgical approaches and innovations, thus allowing novice neurosurgeons to gain valuable experience in surgical techniques without exposing patients to risk of harm.

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Neurosurgical Endoscopic Training via a Realistic 3-Dimensional Model With Pathology

Cited by 62 publications

References 15 publications

Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications

Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications

Emerging Applications of Bedside 3D Printing in Plastic Surgery

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

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