3D-Printed Simulation Device for Orbital Surgery

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• 作者：Juergen Thomas Lichtenstein ; MD ; DDS^* ; ^&dagger ; ; ^{juergen.lichtenstein@gmx.de} ; Alexander Nicolai Zeller ; MD^* ; Juliana Lemound ; MD ; DDS^* ; Thorsten Enno Lichtenstein ; MD^&Dagger ; ; Majeed Rana ; MD ; DDS^* ; Nils-Claudius Gellrich ; MD ; DDS^* ; Maximilian Eberhard Wagner ; MD ; DDS^* ; ^§ ;
• 关键词：orbit ; simulation training ; computer-aided design ; three-dimensional printing ; computer-assisted surgery
• 刊名：Journal of Surgical Education
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：74
• 期：1
• 页码：2-8
• 全文大小：805 K
• 卷排序：74

文摘

Orbital surgery is a challenging procedure because of its complex anatomy. Training could especially benefit from dedicated study models. The currently available devices lack sufficient anatomical representation and realistic soft tissue properties. Hence, we developed a 3D-printed simulation device for orbital surgery with tactual (haptic) correct simulation of all relevant anatomical structures.Design, Setting, and ParticipantsBased on computed tomography scans collected from patients treated in a third referral center, the hard and soft tissue were segmented and virtually processed to generate a 3D-model of the orbit. Hard tissue was then physically realized by 3D-printing. The soft tissue was manufactured by a composite silicone model of the nucleus and the surrounding tissue over a negative mold model also generated by 3D-printing.The final model was evaluated by a group of 5 trainees in oral and maxillofacial surgery (1) and a group of 5 consultants (2). All participants were asked to reconstruct an isolated orbital floor defect with a titanium implant. A stereotactic navigation system was available to all participants. Their experience was evaluated for haptic realism, correct representation of surgical approach, general handling of model, insertion of implant into the orbit, placement and fixation of implant, and usability of navigated control. The items were evaluated via nonparametric statistics (1 [poor]-5 [good]).ResultsGroup 1 gave an average mark of 4.0 (±0.9) versus 4.6 (±0.6) by group 2. The haptics were rated as 3.6 (±1.1) [1] and 4.2 (±0.8) [2]. The surgical approach was graded 3.7 (±1.2) [1] and 4.0 (±1.0) [2]. Handling of the models was rated 3.5 (±1.1) [1] and 4 (±0.7) [2]. The insertion of the implants was marked as 3.7 (±0.8) [1] and 4.2 (±0.8) [2]. Fixation of the implants was also perceived to be realistic with 3.6 (±0.9) [1] and 4.2 (±0.45) [2]. Lastly, surgical navigation was rated 3.8 (±0.8) [1] and 4.6 (±0.56) [2].ConclusionIn this project, all relevant hard and soft tissue characteristics of orbital anatomy could be realized. Moreover, it was possible to demonstrate that the entire workflow of an orbital procedure may be simulated. Hence, using this model training expenses may be reduced and patient security could be enhanced.