Use of 3-Dimensional Printing Technology and Silicone Modeling in Surgical Simulation: Development and Face Validation in Pediatric Laparoscopic Pyeloplasty
Use of 3-Dimensional Printing Technology and Silicone Modeling in Surgical Simulation: Development and Face Validation in Pediatric Laparoscopic Pyeloplasty
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DOI：
10.1016/j.jsurg.2014.03.001
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发表时间：
2014-09-01
影响因子：
2.9
通讯作者：
Farhat, Walid A.
中科院分区：
文献类型：
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作者：
Cheung, Coding L.;Looi, Thomas;Farhat, Walid A.
目的：与成人类似手术相比，小儿腹腔镜手术具有独特的培训挑战，因为其尺寸更小，使用的缝线更细，组织可能更脆弱，需要更高的手术灵活性。我们描述了一种儿科肾盂成形术模拟器的开发和面部验证，该模拟器使用一种低成本的腹腔镜干实验室模型，该模型是通过三维（3D）打印和硅胶建模开发的。机关（肾脏，肾盂和输尿管）在3步过程中创建，其中模具用3D建模软件创建，用Spectrum Z510 3D打印机打印，并使用龙皮30硅橡胶浇铸。将模型固定在腹腔镜箱训练器中。在加拿大泌尿协会会议上进行了一项试点研究。共有24名儿科泌尿外科研究员和3名经验丰富的教员在微创手术培训课程中评估了我们的技能模块。参与者有60分钟的时间使用腹腔镜工具和5-0薇乔缝线进行右侧肾盂成形术。表面有效性证明了5点李克特scale.Participants和结果：干实验室模型包括一个肾脏，一个可更换的扩张肾盂和输尿管梗阻肾盂输尿管交界处，并与腹腔镜手术模式切割练习的基础上刻上一个覆盖腹膜。在加拿大泌尿外科协会的初步验证期间，参与者对总体印象的评分（共5分）为4.75 +/- 0.29，对真实性的评分为4.50 +/- 0.41，对处理的评分为4.38 +/- 0.48。在微创手术课程中，24名研究员中的22名和所有教职员工完成了评分。14名参与者将可用性评为4或5（总体而言，新手为3.6 +/- 1.22，专家为3.7 +/- 0.58），表明他们将在自己的培训和教学中使用该模型。在美学上，该模型被评为3.5 +/- 0.74（新手）和3.3 +/- 0.58（专家）。结论：我们开发了一个小儿肾盂成形术模拟器应用低成本的可重复使用的腹腔镜培训和技能获取模型。该模型的可用性、真实性和感觉都很好，它可以在常见的模式下成像，并且它显示出作为教育工具的前景。(C)2014年外科手术项目主任协会。爱思唯尔公司出版All rights reserved.
OBJECTIVES: Pediatric laparoscopy poses unique training challenges owing to smaller workspaces, finer sutures used, and potentially more delicate tissues that require increased surgical dexterity when compared with adult analogs. We describe the development and face validation of a pediatric pyeloplasty simulator using a low-cost laparoscopic dry-laboratory model developed with 3-dimensional (3D) printing and silicone modeling.DESIGN AND SETTING: The organs (the kidney, renal pelvis, and ureter) were created in a 3-step process where molds were created with 3D modeling software, printed with a Spectrum Z510 3D printer, and cast with Dragon Skin 30 silicone rubber. The model was secured in a laparoscopy box trainer. A pilot study was conducted at a Canadian Urological Association meeting. A total of 24 pediatric urology fellows and 3 experienced faculty members then assessed our skills module during a minimally invasive surgery training course. Participants had 60 minutes to perform a right-side pyeloplasty using laparoscopic tools and 5-0 VICRYL suture. Face validity was demonstrated on a 5-point Likert scale.PARTICIPANTS AND RESULTS: The dry-laboratory model consists of a kidney, a replaceable dilated renal pelvis and ureter with an obstructed ureteropelvic junction, and an overlying peritoneum with an inscribed fundamentals of laparoscopic surgery pattern-cutting exercise. During initial validation at the Canadian Urological Association, participants rated (out of 5) 4.75 +/- 0.29 for overall impression, 4.50 +/- 0.41 for realism, and 4.38 +/- 0.48 for handling. During the minimally invasive surgery course, 22 of 24 fellows and all the faculty members completed the scoring. Usability was rated 4 or 5 by 14 participants (overall, 3.6 +/- 1.22 by novices and 3.7 +/- 0.58 by experts), indicating that they would use the model in their own training and teaching. Esthetically, the model was rated 3.5 +/- 0.74 (novices) and 3.3 +/- 0.58 (experts).CONCLUSIONS: We developed a pediatric pyeloplasty simulator by applying a low-cost reusable model for laparoscopic training and skills acquisition. The model's usability, realism, and feel are good, it can be imaged under common modalities, and it shows promise as an educational tool. (C) 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.