Three-dimensional Printed Surgical Simulator for Kirschner Wire Placement in Hand Fractures

Brichacek, Michal; Diaz-Abele, Julian; Shiga, Sarah; Petropolis, Christian

doi:10.1097/gox.0000000000001706

Cited by 8 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fluoroscopy of the model demonstrated vivid visualization and differentiation of bone and soft tissue. The overall cost of labor and materials was reported at $50 [20]. Wu et al created a model for percutaneous pinning with the additional advantage of providing greater tactile feedback.…”

Section: Resultsmentioning

confidence: 99%

Simulation in Hand Surgery: A Literature Review

et al. 2022

View full text Add to dashboard Cite

Background Due to duty hour regulations, patient safety and inadequate operative time simulation have become a necessary part of surgical education and training in residency. Currently, there is no formal adoption of simulators for the use of surgical education or assessment in hand surgery. This literature review analyzes that the simulation techniques established thus far in hand surgery. Methods A comprehensive literature search was performed on PubMed. Search results were filtered by title and abstract to isolate articles that were relevant to simulation in hand surgery. Articles that were nonspecific to the hand, non-English and cadaveric were excluded. Additional articles were identified through references from the initial search.Results A total of 1192 articles were yielded from the initial query. After the application of the inclusion criteria, this was narrowed down to 28 articles. Another 8 additional articles were excluded as they did not pertain to the hand although the simulators could be adapted for hand surgery. A total of 20 articles were included in this study. Conclusions Surgical simulation is a growing and essential field of surgical education. Simulators in hand surgery are limited and require further research and validation. Like other surgical subspecialties, hand surgery may benefit from the adoption of an official simulation curriculum for the assessment of residents and enhancement of technical skills.

show abstract

Section: Resultsmentioning

confidence: 99%

Simulation in Hand Surgery: A Literature Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…However, a silicone or PlastiDip liquid rubber (Plasti Dip International, Minnesota, USA, www.plastidip.com) coating has not yet provided sufficient results. Using 3D printing, casting moulds according to Brichacek et al [2018] could be created to pour the phantom hand in a layer of flexible silicone improving phantom hands life periods (38).…”

Section: Discussionmentioning

confidence: 99%

Optically tracked and 3D printed haptic phantom hand for surgical training system

Maier¹,

Weiherer²,

Huber³

et al. 2020

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: For surgical fixation of bone fractures of the human hand, so-called Kirschner-wires (K-wires) are drilled through bone fragments. Due to the minimally invasive drilling procedures without a view of risk structures like vessels and nerves, a thorough training of young surgeons is necessary. For the development of a virtual reality (VR) based training system, a three-dimensional (3D) printed phantom hand is required. To ensure an intuitive operation, this phantom hand has to be realistic in both, its position relative to the driller as well as in its haptic features. The softest 3D printing material available on the market, however, is too hard to imitate human soft tissue. Therefore, a support-material (SUP) filled metamaterial is used to soften the raw material. Realistic haptic features are important to palpate protrusions of the bone to determine the drilling starting point and angle. An optical real-time tracking is used to transfer position and rotation to the training system.Methods: A metamaterial already developed in previous work is further improved by use of a new unit cell.Thus, the amount of SUP within the volume can be increased and the tissue is softened further. In addition, the human anatomy is transferred to the entire hand model. A subcutaneous fat layer and penetration of air through pores into the volume simulate shiftability of skin layers. For optical tracking, a rotationally symmetrical marker attached to the phantom hand with corresponding reference marker is developed. In order to ensure trouble-free position transmission, various types of marker point applications are tested.Results: Several cuboid and forearm sample prints lead to a final 30 centimeter long hand model. The whole haptic phantom could be printed faultless within about 17 hours. The metamaterial consisting of the new unit cell results in an increased SUP share of 4.32%. Validated by an expert surgeon study, this allows in combination with a displacement of the uppermost skin layer a good palpability of the bones. Tracking of the hand marker in dodecahedron design works trouble-free in conjunction with a reference marker attached to the worktop of the training system.Conclusions: In this work, an optically tracked and haptically correct phantom hand was developed using dual-material 3D printing, which can be easily integrated into a surgical training system.

show abstract

“…Benefits of surgical simulation include reduced time spent in the operating room teaching basics, maximizing the benefit from actual cases, ensuring adequate case volume, skill transfer from the simulator to the operating room, and improved patient outcomes. 3 , 4 Microsurgical simulation has become increasingly popular among training programs for these reasons.…”

Section: Introductionmentioning

confidence: 99%

A Novel Silicone Simulation Model for Microvascular Anastomosis

Winter

Petropolis

2021

Plast Surg (Oakv)

Self Cite

View full text Add to dashboard Cite

Purpose: Surgical simulation of microvascular anastomosis has become increasingly popular. There are several living and silicone models available. Current silicone models fail to accurately reproduce a vessel’s loose adventitial layer, which may lead to the development of improper microsurgical technique. Our purpose is to create a realistic 3-dimensional microsurgical simulator that incorporates an adventitial vessel layer for higher fidelity manipulation of vessels. Methods: A microvascular anastomosis simulator was manufactured using metal moulds and inorganic materials. Synthetic tubing was created with a metal cylinder, 1.65 mm in diameter, painted with 2 sequential layers of silicon with a shore hardness of 2A. Silicone was allowed to fully cure in-between layers. Vessel adventitia was created with a 100-micron polyester mesh adhered to the silicone vessel exterior. Once dry, the synthetic tube is removed from the metal cylinder is then clipped to reveal the inner lumen. Both Resident and attending physicians evaluated the model with and without the adventitial layer and completed a questionnaire. Results: Grasping and manipulation of the vessel were scored on Average score 4.5 and 3 out of 5, with adventitia and without, respectively ( P = .00906). Usefulness as a teaching tool was scored on average 4.9 and 4.2, with adventitia and without, respectively ( P = .0232). The analysis included: simulation realism, educational utility, and overall satisfaction. Responses in all domains were favourable, suggesting the utility of this model. Conclusion: We created a realistic, high fidelity microvascular anastomosis simulator that is low cost and easily reproducible. Initial feedback is encouraging regarding realism, educational utility, and overall usefulness. Further validation is required to assess its effectiveness in resident education and skill transfer to the operating room.

show abstract

Three-dimensional Printed Surgical Simulator for Kirschner Wire Placement in Hand Fractures

Abstract: Supplemental Digital Content is available in the text.

Cited by 8 publications

References 11 publications

Simulation in Hand Surgery: A Literature Review

Simulation in Hand Surgery: A Literature Review

Optically tracked and 3D printed haptic phantom hand for surgical training system

A Novel Silicone Simulation Model for Microvascular Anastomosis

Contact Info

Product

Resources

About