Producing 3D printed high‐fidelity retroperitoneal models from in vivo patient data: The Oxford Method

Abstract

Classical methods of cadaveric dissection and/or prosection have not changed in over 400 years (Azer and Eizenberg, 2007) and remain the undisputed gold standard for the teaching of anatomy to undergraduate and postgraduate students (Korf et al., 2008; Balta et al., 2017). In recent times, issues have been raised regarding cost and access to bodies (Estai and Bunt, 2016) particularly with the new and added pressure of COVID-19. Recent technological advances have only added to the pressure placed on medical schools to transition away from the use of cadavers (Howe et al., 2004; Ghazanfar et al., 2018). Despite this, it is still widely accepted that cadaveric methods should be maintained and recent advances used as adjuncts rather than replacements to cadaveric learning (Memon, 2018). It is well recognised that students learn best when multiple pedagogical approaches are used to complement one another (Estai and Bunt, 2016). Examples of such adjuncts are numerous and can largely be split into non-digital and digital. Plastinated specimens from Gunther von Hagens (von Hagens, 1979) and plastic models represent the bulk of the former, whilst three-dimensional imaging techniques including virtual (VR) and augmented reality (AR) represent examples

3D printing as a pedagogical tool for teaching normal human anatomy: a systematic review

“…Printers ranged in price from 302 USD to 65,000 USD. The cost per model, when specified, ranged from 1.25 USD to 2800 USD; these extremes corresponded to a bone specimen [ 47 ] and a high-fidelity retroperitoneal model [ 48 ]. Table 2 summarizes the model design data for each included study.…”

“…The main advantages reported by the authors using 3DPAM as a pedagogical tool for teaching normal human anatomy were the visual and haptic characteristics, including authenticity [ 55 , 67 ], precision [ 44 , 50 , 72 , 85 ], variability of consistencies [ 34 , 45 , 48 , 64 ], colours and transparency [ 28 , 45 ], solidness [ 24 , 56 , 73 ], effectiveness for education [ 16 , 32 , 35 , 39 , 52 , 57 , 63 , 69 , 79 ], cost [ 27 , 41 , 44 , 45 , 48 , 51 , 60 , 64 , 80 , 81 , 83 ], reproducibility [ 80 ], possibility of improvement or personalization [ 28 , 30 , 36 , 45 , 48 , 51 , 53 , 59 , 61 , 67 , 80 ], possibility of manipulation by the students [ 30 , 49 ], time savings for teaching [ 61 , 80 ], ease of storage [ 61 ], possibility of integrating functional anatomy or creating a specific design [ 51 , 53 , 67 ], rapid design for bone models [ 81 ], possibility of co-creation and taking the model home [ 49 , 60 , 71 ], improvement in mental rotation ability [ 23 …”

“…The main drawbacks were related to design: stiffness [ 80 ], consistency [ 28 , 62 ], lack of detail or transparency [ 28 , 30 , 34 , 45 , 48 , 62 , 64 , 81 ], overly bright colours [ 45 ], and fragility [ 71 ]. Other drawbacks were the loss of information [ 30 , 76 ], long time needed for image segmentation [ 36 , 52 , 57 , 58 , 74 ], printing time [ 57 , 63 , 66 , 67 ], lack of anatomical variability [ 25 ] and the high cost [ 48 ].…”

“…According to Tripodi and colleagues, bone parts could be printed for 1.25 USD each [ 47 ]. Eleven studies concluded that 3D printing costs less than plastinated or commercial models [ 24 , 27 , 41 , 44 , 45 , 48 , 51 , 60 , 63 , 80 , 81 , 83 ]. Furthermore, these commercial models are intended for patient information and do not have sufficient detail to be used for teaching anatomy [ 80 ].…”

A Method for Producing 3D Printed Models of the Mediastinum

“…This technique also represents a practical method of emulating cadaver-based learning without presenting serious logistical or ethical concerns. We have previously described how models of the hepatobiliary system [9] and retroperitoneum [10] can be generated from CT and MRI images. In this paper we describe the generation of a model of the mediastinum and its contents.…”