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用于军事外科医生神经创伤学教育的 3D 打印模型的制造。

The Manufacturing of 3D Printed models for the Neurotraumatological Education of Military Surgeons.

机构信息

Department of Neurosurgery, Hospital of the German Armed Forces, Lange Straße 38, 26655 Westerstede, Germany.

Laboratory for Manufacturing Technology, Helmut Schmidt University/University of the German Armed Forces, Holstenhofweg 85, 22043 Hamburg, Germany.

出版信息

Mil Med. 2020 Dec 30;185(11-12):e2013-e2019. doi: 10.1093/milmed/usaa183.

Abstract

INTRODUCTION

When deployed abroad, military surgeons frequently have to deal with casualties involving head trauma. The emergency treatments, as well as craniotomies, are often performed by non-neurosurgeons qualified with basic neurotraumatological skills. Previous neurotrauma courses for education of non-neurosurgeons in Germany teach surgical emergency skills but do not include the training of skills needed to successfully utilize imaging in surgical planning, which is of importance for the safety and success of the treatment. To overcome these limitations, 3D printed models of neurotrauma cases were fabricated for application in the training of non-neurosurgeons.

MATERIALS AND METHODS

Five models of actual neurotrauma cases from our neurosurgical department were segmented from CT scans and 3D printed using multi-part fused deposition modeling. Model quality was assessed with respect to the representation of pre-defined anatomical landmarks. The models were then fixed to a wooden mount with a central light source and covered by a latex mask for skin simulation. Surgical planning by means of craniometric measurements on the basis of available CT scans of the corresponding patients was then applied to the model.

RESULTS

The 3D printed models precisely represented the cranium, the lesion, and anatomical landmarks, which are taken into consideration during surgical planning. Surface covering with washable latex masks ensured sufficient masking of the now non-noticeable lesion within the semi-translucent skull. Surgical planning was performed using washable marker drawings. When lighted, the otherwise non-visible lesion within the semi-translucent 3D printed craniums became visible and facilitated immediate success control for the course participants.

CONCLUSION

The presented method provided a way to fabricate precise 3D models of neurotrauma cases, which are suitable to teach the application of medical imaging in surgical planning. For further benefit analysis, the application of the presented education tool needs to be investigated within a neurotrauma course.

摘要

简介

当军人外科医生在海外部署时,经常需要处理涉及头部创伤的伤员。紧急治疗以及开颅手术通常由具有基本神经创伤技能的非神经外科医生进行。德国以前的神经创伤课程旨在为非神经外科医生提供教育,教授外科急救技能,但不包括成功运用影像学进行手术规划所需技能的培训,这对于治疗的安全性和成功至关重要。为了克服这些限制,我们为非神经外科医生的培训制作了神经创伤病例的 3D 打印模型。

材料与方法

我们神经外科部门的 5 个实际神经创伤病例从 CT 扫描中分割出来,并使用多部件熔丝制造技术进行 3D 打印。根据预定义的解剖学标志评估模型质量。然后,将模型固定在带有中央光源的木制支架上,并覆盖乳胶面具以模拟皮肤。然后,根据相应患者的可用 CT 扫描,通过颅骨测量进行手术规划。

结果

3D 打印模型精确地代表了颅骨、病变和在手术规划中需要考虑的解剖学标志。可水洗乳胶面具的表面覆盖确保了在半透明颅骨内现在不可见的病变得到充分遮蔽。手术规划使用可水洗标记笔进行。当点亮时,半透明 3D 打印颅骨内原本不可见的病变变得可见,为课程参与者提供了即时的成功控制。

结论

所提出的方法提供了一种制作神经创伤病例精确 3D 模型的方法,适合教授医学成像在手术规划中的应用。为了进行进一步的效益分析,需要在神经创伤课程中应用所提出的教育工具。

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