Kong Xiangxue, Nie Lanying, Zhang Huijian, Wang Zhanglin, Ye Qiang, Tang Lei, Huang Wenhua, Li Jianyi
Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China.
Department of Traumatic Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, China.
World J Surg. 2016 Aug;40(8):1969-76. doi: 10.1007/s00268-016-3541-y.
It is a difficult and frustrating task for young surgeons and medical students to understand the anatomy of hepatic segments. We tried to develop an optimal 3D printing model of hepatic segments as a teaching aid to improve the teaching of hepatic segments.
A fresh human cadaveric liver without hepatic disease was CT scanned. After 3D reconstruction, three types of 3D computer models of hepatic structures were designed and 3D printed as models of hepatic segments without parenchyma (type 1) and with transparent parenchyma (type 2), and hepatic ducts with segmental partitions (type 3). These models were evaluated by six experts using a five-point Likert scale. Ninety two medical freshmen were randomized into four groups to learn hepatic segments with the aid of the three types of models and traditional anatomic atlas (TAA). Their results of two quizzes were compared to evaluate the teaching effects of the four methods.
Three types of models were successful produced which displayed the structures of hepatic segments. By experts' evaluation, type 3 model was better than type 1 and 2 models in anatomical condition, type 2 and 3 models were better than type 1 model in tactility, and type 3 model was better than type 1 model in overall satisfaction (P < 0.05). The first quiz revealed that type 1 model was better than type 2 model and TAA, while type 3 model was better than type 2 and TAA in teaching effects (P < 0.05). The second quiz found that type 1 model was better than TAA, while type 3 model was better than type 2 model and TAA regarding teaching effects (P < 0.05). Only TAA group had significant declines between two quizzes (P < 0.05).
The model with segmental partitions proves to be optimal, because it can best improve anatomical teaching about hepatic segments.
对于年轻外科医生和医学生来说，理解肝段的解剖结构是一项困难且令人沮丧的任务。我们试图开发一种最佳的肝段三维打印模型作为教学辅助工具，以改进肝段的教学。
对一个无肝脏疾病的新鲜人类尸体肝脏进行CT扫描。三维重建后，设计了三种类型的肝脏结构三维计算机模型，并三维打印成无实质的肝段模型（1型）、有透明实质的肝段模型（2型）以及带有节段分隔的肝管模型（3型）。六位专家使用五点李克特量表对这些模型进行评估。92名医科新生被随机分为四组，借助这三种模型和传统解剖图谱（TAA）学习肝段。比较他们两次测验的结果，以评估这四种方法的教学效果。
成功制作出三种类型的模型，展示了肝段的结构。经专家评估，3型模型在解剖条件方面优于1型和2型模型，2型和3型模型在触感方面优于1型模型，3型模型在总体满意度方面优于1型模型（P<0.05）。第一次测验显示，1型模型在教学效果方面优于2型模型和TAA，而3型模型优于2型模型和TAA（P<0.05）。第二次测验发现，1型模型优于TAA，而3型模型在教学效果方面优于2型模型和TAA（P<0.05）。只有TAA组在两次测验之间有显著下降（P<0.05）。
带有节段分隔的模型被证明是最佳的，因为它能最好地改进肝段的解剖教学。
