3D打印气管食管穿刺及假体置入模拟器
3D-printed tracheoesophageal puncture and prosthesis placement simulator.
作者信息
Barber Samuel R, Kozin Elliott D, Naunheim Matthew R, Sethi Rosh, Remenschneider Aaron K, Deschler Daniel G
机构信息
Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA, United States; Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, United States.
Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, United States; Department of Otology and Laryngology, Harvard Medical School, United States.
出版信息
Am J Otolaryngol. 2018 Jan-Feb;39(1):37-40. doi: 10.1016/j.amjoto.2017.08.001. Epub 2017 Aug 18.
OBJECTIVES
A tracheoesophageal prosthesis (TEP) allows for speech after total laryngectomy. However, TEP placement is technically challenging, requiring a coordinated series of steps. Surgical simulators improve technical skills and reduce operative time. We hypothesize that a reusable 3-dimensional (3D)-printed TEP simulator will facilitate comprehension and rehearsal prior to actual procedures.
METHODS
The simulator was designed using Fusion360 (Autodesk, San Rafael, CA). Components were 3D-printed in-house using an Ultimaker 2+ (Ultimaker, Netherlands). Squid simulated the common tracheoesophageal wall. A Blom-Singer TEP (InHealth Technologies, Carpinteria, CA) replicated placement. Subjects watched an instructional video and completed pre- and post-simulation surveys.
RESULTS
The simulator comprised 3D-printed parts: the esophageal lumen and superficial stoma. Squid was placed between components. Ten trainees participated. Significant differences existed between junior and senior residents with surveys regarding anatomy knowledge(p<0.05), technical details(p<0.01), and equipment setup(p<0.01). Subjects agreed that simulation felt accurate, and rehearsal raised confidence in future procedures.
CONCLUSIONS
A 3D-printed TEP simulator is feasible for surgical training. Simulation involving multiple steps may accelerate technical skills and improve education.
目的
气管食管假体（TEP）可使全喉切除术后患者恢复发声。然而，TEP植入在技术上具有挑战性，需要一系列协调步骤。手术模拟器可提高技术技能并减少手术时间。我们假设，一种可重复使用的三维（3D）打印TEP模拟器将有助于在实际操作前加深理解和进行预演。
方法
模拟器使用Fusion360（欧特克公司，加利福尼亚州圣拉斐尔）设计。组件在内部使用Ultimaker 2+（Ultimaker公司，荷兰）进行3D打印。鱿鱼模型模拟常见的气管食管壁。使用Blom-Singer TEP（InHealth Technologies公司，加利福尼亚州卡平特里亚）进行植入复制。受试者观看教学视频，并完成模拟前后的调查问卷。
结果
模拟器由3D打印部件组成：食管腔和表面造口。鱿鱼模型置于各部件之间。10名学员参与。初级和高级住院医师在解剖学知识（p<0.05）、技术细节（p<0.01）和设备设置（p<0.01）的调查问卷方面存在显著差异。受试者一致认为模拟感觉准确，预演提高了对未来操作的信心。
结论
3D打印TEP模拟器用于手术训练是可行的。涉及多个步骤的模拟可能会加快技术技能提升并改善教学效果。
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