Three-Dimensionally–Printed Hand Surgical Simulator for Resident Training

Abstract

Summary: Reduced work hours and funding have fueled an increase in simulation-based training for plastic and orthopedic surgery residency programs. Unfortunately, certain simulation training can fail to enhance surgical skills because of availability, cost, or low fidelity. There is a growing interest among training programs for a cost-effective surgical simulator to improve basic skills and muscle memory of residents. The authors developed a three-dimensionally–printed, malleable, and anatomically accurate hand surgery simulator from a computed tomographic scan of an adult male subject. The bone matrix was specifically designed to provide proprioceptive feedback to hone drilling skills used in fracture repair and arthrodesis. The silicone soft-tissue covering provides excellent malleability to dissect and perform fracture-reducing maneuvers. Three-dimensional printing of “fracture bridges” allows the design of on-demand polyfracture models so the trainee can practice multiple types and locations of repairs as skills progress. To summarize, the authors’ hand simulator is an anatomical, low-cost, multiprocedure tool that can be used to improve the muscle memory and basic surgery skills of residents in training.

WALANT: A Discussion of Indications, Impact, and Educational Requirements

“… 49 High fidelity hand fracture simulation training with three-dimensional (3D) printing has been increasing in recent years with the technology becoming more available and affordable. 50 51 52 Farrell et al describe the 3D printing of a malleable, cost effective, and anatomically accurate hand surgery simulator, with fracture bridges for fixation and silicone soft tissue cover to mimic the process of dissection down to the fracture site. 50 Prsic et al developed a similar model for $40.…”

“… 50 51 52 Farrell et al describe the 3D printing of a malleable, cost effective, and anatomically accurate hand surgery simulator, with fracture bridges for fixation and silicone soft tissue cover to mimic the process of dissection down to the fracture site. 50 Prsic et al developed a similar model for $40. 51 Both of these models were printed using computed tomography scans of patients' hands and present an affordable mechanism for at home/laboratory-based practice for surgeons in training.…”

“… 51 Both of these models were printed using computed tomography scans of patients' hands and present an affordable mechanism for at home/laboratory-based practice for surgeons in training. 50 51 Papavasiliou et al developed a six-step curriculum using a simulated hand for fracture fixation but are yet to demonstrate concurrent validity. 52 All of these models show the importance of simulation in shaping the direction of hand surgery training for the future.…”

Simulation training in hand surgery — where are we now and where should we be?

“…However, the limitations that have been recurring despite multiple modifications to the material throughout the years have been that the “true feel” of a real bone is lacking and that there is little consideration of the soft tissue anatomy surrounding the bone [ 2 ]. The onset of this decade saw significant improvement in simulation models as progress in 3D printing technologies allows the use of materials that are better suited as biomimetics [ 3 , 4 ]. Today, there are a variety of options where simulation has given surgical trainees an option to practice technical skills outside the operating theatre.…”

Commentary: Restructuring residency training in ophthalmology during COVID-19 era: Challenges and opportunities

“…Some specialties have roped in various 3D printed models to improve basic surgical training, accuracy and muscle memory of residents. [ 8 ] They can also learn online from a vast database of surgical videos of different case scenarios. Teachers can discuss important surgical tips through online video-assisted surgical training sessions.…”