MP23-09 A NOVEL TECHNIQUE FOR SIMULATED SURGICAL PROCEDURES USING 3D PRINTING TECHNOLOGY

摘要

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment II1 Apr 2015MP23-09 A NOVEL TECHNIQUE FOR SIMULATED SURGICAL PROCEDURES USING 3D PRINTING TECHNOLOGY Jonathan Stone, Braden Candela, Vincent Alleluia, Anees Fazili, Michael Richards, Changyong Feng, Sarah Peyre, Jean Joseph, and Ahmed Ghazi Jonathan StoneJonathan Stone More articles by this author , Braden CandelaBraden Candela More articles by this author , Vincent AlleluiaVincent Alleluia More articles by this author , Anees FaziliAnees Fazili More articles by this author , Michael RichardsMichael Richards More articles by this author , Changyong FengChangyong Feng More articles by this author , Sarah PeyreSarah Peyre More articles by this author , Jean JosephJean Joseph More articles by this author , and Ahmed GhaziAhmed Ghazi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1252AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Teaching surgical skills in the operating room has become less than ideal because of the restrictions placed on resident education time, medicolegal concerns, and most importantly from a patient safety perspective. Virtual reality trainers are valuable tools to teach robotic techniques in a non-patient non-animal environment but are limited to basic skills exercises and augmented reality platforms. We introduce a novel method for replicating organs using hydrogels casted in anatomically correct 3D printed molds. This form of simulation was validated for a complete robotic partial nephrectomy (RPN). METHODS Idealized 3D geometries of a left kidney, renal artery/vein, pelvicalyceal system, great vessels, and tumors were created. 3D printed molds of these constructs were injected with a poly-vinyl alcohol hydrogel and tissue specific characteristics were altered by variations in freeze/thaw cycles. Face and content validity was measured using questions related to surgical authenticity and educational value. Construct validity was measured by comparing clinically relevant metrics between 3 experts (> 250 RPN) and novices (< 50 RPN). RESULTS This novel technique produced high fidelity organs with a realistic appearance (Figure 1). All experts agreed or strongly agreed to live procedural authenticity and usefulness of the model as a training tool. Experts showed superior performance in operative time (p=0.003), warm ischemia time (p=0.003) and estimated blood loss (p=0.002, table 1). CONCLUSIONS Simulated inanimate models are inexpensive and safe for surgical training, with realistic properties that enhance the educational experience. This validated novel technique may serve as an excellent supplement to surgical education. Multiple different technical procedures can be created to provide robust physical training within this innocuous environment. Simulated Inanimate Model for Physical Learning Experience (SIMPLE) Variables Expert Mean (N=3) Novice Mean (N=3) p Value Total operative time (min) 50.67 84.33 0.0003 Warm ischemia time (min) 13.33 35.33 0.0003 Estimated blood loss (ml) 143.33 366.7 0.0002 Positive margins (mm) 0.67 6.35 0.63 Pelvicalyceal violation (mm) 1.67 6.43 0.62 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e270 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Stone More articles by this author Braden Candela More articles by this author Vincent Alleluia More articles by this author Anees Fazili More articles by this author Michael Richards More articles by this author Changyong Feng More articles by this author Sarah Peyre More articles by this author Jean Joseph More articles by this author Ahmed Ghazi More articles by this author Expand All Advertisement Advertisement PD