Alshomer Feras, Alhazmi Bushra, Alowais Fahad, Aldekhayel Salah
Plastic and Reconstructive Surgery Section, Surgery Department, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2020 Feb 11;8(2):e2567. doi: 10.1097/GOX.0000000000002567. eCollection 2020 Feb.
Microsurgical anastomosis is a technically demanding skill. The most difficult part of the learning process was in achieving the necessary orientation and dexterity. In this project, we adopted computer-aided design and desktop 3D-printing in the development of an affordable training model with different levels of vessel orientation and angulation.
The training model was designed using CAD software (Rhino3D). The models were then 3D-printed with a thermoplastic polyurethane (TPU 95A) semiflexible filament on a desktop fused deposition modeling, Ultimaker 2 + 3D printer.
The printed training tool was assembled by fitting the ball-and-socket mechanism between two parts having an overall round table top with integrated vascular clamps. Trial with synthetic and nonliving animal blood vessels shows the utility of the clamps in holding the vessels within the working space. By rotating the top part, a multiaxial vessel orientation from 0 to 360 degrees was achieved. The top part was also capable of multiangular orientation of the vessels (±30 degrees) regardless of its axial orientation during vessel anastomosis. For the 3D-printing process, the average printing time was about 3.5 hours with a cost of 1.3$ per material.
The utility of desktop 3D printing represents an affordable modality in microsurgical training. The designed model is capable of providing a trainee with multiaxial and multiangular vessel orientation during the anastomosis process. To our knowledge, the adoption of this technology in the field of microsurgery training has never been investigated before.
显微外科吻合术是一项对技术要求很高的技能。学习过程中最困难的部分在于实现必要的操作方向和灵活性。在本项目中，我们采用计算机辅助设计和桌面3D打印技术，开发了一种价格实惠的训练模型，该模型具有不同水平的血管方向和角度。
使用CAD软件（Rhino3D）设计训练模型。然后在桌面熔融沉积成型Ultimaker 2 + 3D打印机上，用热塑性聚氨酯（TPU 95A）半柔性细丝对模型进行3D打印。
打印出的训练工具通过在两个部件之间安装球窝机构进行组装，整体为带有集成血管夹的圆桌桌面。使用合成血管和非活体动物血管进行试验表明，血管夹在将血管固定在工作空间内很有用。通过旋转顶部部件，可实现从0到360度的多轴血管方向。在血管吻合过程中，无论血管的轴向方向如何，顶部部件还能够实现血管的多角度方向（±30度）。对于3D打印过程，平均打印时间约为3.5小时，每材料成本为1.3美元。
桌面3D打印的实用性代表了显微外科训练中一种经济实惠的方式。所设计的模型能够在吻合过程中为学员提供多轴和多角度的血管方向。据我们所知，此前从未研究过在显微外科训练领域采用这项技术。
