Guliev Bakhman, Komyakov Boris, Talyshinskii Ali
Department of Urology, North-Western State Medical University named after I.I.Mechnikov, Saint Petersburg, Russia.
Urology Center with Robot-Assisted Surgery of the Mariinsky Hospital, Saint Petersburg, Russia.
Turk J Urol. 2019 Dec 18;46(3):226-230. doi: 10.5152/tud.2019.19161. Print 2020 May.
The aim of the present study was to determine the effectiveness of the use of the three-dimensional (3D) printed segmented collapsible model of the pelvicalyceal system (PCS) to improve the learning curve of the residents.
3D printed models based on computed tomography (CT) images of 10 patients with a staghorn stone were developed. Used images of patients were obtained from CT scans in Digital Imaging and Communications in Medicine format. The area of interest was extracted and saved in stereolithography format. Further, the bioengineer performed virtual segmentation corresponding to the level of each calyces group that was defined by an experienced urologist. The final stage was the printing of each separated detail. Special questionnaire for evaluating the effectiveness of 3D models during both the examination of PCS anatomy and planning percutaneous nephrolithotomy was invented.
The determination of the anterior and posterior calyces of the upper group was improved by 61% and 69%, the difference in the determination of the calyces of the middle group was 60% and 51%, and the answers regarding the number of the anterior and posterior calyces of the lower group became better by 67% and 74%, respectively (p<0.001). The ability to select the optimal calyx for the primary and the second access became better by 60% and 55%, respectively (p<0.001).
3D printed segmented collapsible model of the PCS is promising for the improvement of the learning curve of residents and enables to optimize their clinical education, as well as compensate for their lack of experience.
本研究的目的是确定使用三维(3D)打印的肾盂肾盏系统(PCS)分段可折叠模型对改善住院医师学习曲线的有效性。
基于10例鹿角形结石患者的计算机断层扫描(CT)图像制作3D打印模型。所使用的患者图像以医学数字成像和通信格式从CT扫描中获取。感兴趣区域被提取并以立体光刻格式保存。此外,生物工程师根据经验丰富的泌尿科医生定义的每个肾盏组水平进行虚拟分割。最后阶段是打印每个分离的细节。发明了用于评估3D模型在PCS解剖检查和经皮肾镜取石术规划过程中的有效性的特殊问卷。
上组前后肾盏的判定分别提高了61%和69%,中组肾盏判定的差异为60%和51%,下组前后肾盏数量的回答分别提高了67%和74%(p<0.001)。选择初次和二次穿刺最佳肾盏的能力分别提高了60%和55%(p<0.001)。
3D打印的PCS分段可折叠模型有望改善住院医师的学习曲线,并能够优化他们的临床教育,以及弥补他们经验的不足。