Chen Pin-Chuan, Lin Jang-Chun, Chiang Chung-Hsuan, Chen Yi-Chin, Chen Jia-En, Liu Wei-Hsiu
Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan.
High Speed 3D Printing Research Center, National Taiwan University of Science and Technology, Taipei 106, Taiwan.
Polymers (Basel). 2020 Dec 3;12(12):2901. doi: 10.3390/polym12122901.
Neurosurgeons require considerable expertise and practical experience in dealing with the critical situations commonly encountered during difficult surgeries; however, neurosurgical trainees seldom have the opportunity to develop these skills in the operating room. Therefore, physical simulators are used to give trainees the experience they require. In this study, we created a physical simulator to assist in training neurosurgeons in aneurysm clipping and the handling of emergency situations during surgery. Our combination of additive manufacturing with molding technology, elastic material casting, and ultrasonication-assisted dissolution made it possible to create a simulator that realistically mimics the brain stem, soft brain lobes, cerebral arteries, and a hollow transparent Circle of Willis, in which the thickness of vascular walls can be controlled and aneurysms can be fabricated in locations where they are likely to appear. The proposed fabrication process also made it possible to limit the error in overall vascular wall thickness to just 2-5%, while achieving a Young's Modulus closely matching the characteristics of blood vessels (~5%). One neurosurgical trainee reported that the physical simulator helped to elucidate the overall process of aneurysm clipping and provided a realistic impression of the tactile feelings involved in this delicate operation. The trainee also experienced shock and dismay at the appearance of leakage, which could not immediately be arrested using the clip. Overall, these results demonstrate the efficacy of the proposed physical simulator in preparing trainees for the rigors involved in performing highly delicate neurological surgical operations.
神经外科医生在处理复杂手术中常见的危急情况时需要相当的专业知识和实践经验；然而，神经外科实习生很少有机会在手术室中培养这些技能。因此，使用物理模拟器来给予实习生所需的经验。在本研究中，我们创建了一个物理模拟器，以协助培训神经外科医生进行动脉瘤夹闭以及处理手术中的紧急情况。我们将增材制造与成型技术、弹性材料铸造和超声辅助溶解相结合，得以创建一个能逼真模拟脑干、柔软脑叶、脑动脉以及中空透明的 Willis 环的模拟器，其中血管壁的厚度可以控制，动脉瘤可以在其可能出现的位置制造。所提出的制造工艺还能够将血管壁总厚度的误差限制在仅 2 - 5%，同时实现与血管特性紧密匹配的杨氏模量（约 5%）。一名神经外科实习生报告称，该物理模拟器有助于阐明动脉瘤夹闭的整个过程，并提供了这种精细手术中所涉及触觉感受的逼真印象。该实习生还对出现渗漏感到震惊和沮丧，使用夹子无法立即止住渗漏。总体而言，这些结果证明了所提出的物理模拟器在让实习生为进行高度精细的神经外科手术所涉及的严格要求做好准备方面的有效性。
