Orecchia Luca, Manfrin Diego, Germani Stefano, Del Fabbro Dario, Asimakopoulos Anastasios D, Finazzi Agrò Enrico, Miano Roberto
Urology Unit, Policlinico Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy.
Medics3D S.r.L, Moncalieri, Italy.
3D Print Med. 2021 Jun 7;7(1):15. doi: 10.1186/s41205-021-00105-9.
Training in retrograde intrarenal surgery for the treatment of renal stone disease is a challenging task due to the unique complexity of the procedure. This study introduces a series of 3D printed models of upper urinary tract and stones designed to improve the training process.
Six different models of upper urinary tract were algorithmically isolated, digitally optimized and 3D printed from real-life cases. Soft and hard stones in different sizes were produced from 3D printed moulds. The models were fitted onto a commercially available part-task trainer and tested for retrograde intrarenal surgery.
Each step of the procedure was simulated with extraordinary resemblance to real-life cases. The unique anatomical intricacy of each model and type of stones allowed us to reproduce surgeries of increasing difficulty. As the case-load required to achieve proficiency in retrograde intrarenal surgery is high, benchtop simulation could be integrated in training programs to reach good outcomes and low complication rates faster. Our models match incredible anatomical resemblance with low production cost and high reusability. Validation studies and objective skills assessment during simulations would allow comparison with other available benchtop trainers and the design of stepwise training programs.
3D printing is gaining a significant importance in surgical training. Our 3D printed models of the upper urinary tract might represent a risk-free training option to hasten the achievement of proficiency in endourology.
由于逆行性肾内手术治疗肾结石疾病的过程具有独特的复杂性,因此该手术的培训是一项具有挑战性的任务。本研究介绍了一系列用于改善培训过程的上尿路及结石的3D打印模型。
从实际病例中通过算法分离出六种不同的上尿路模型,进行数字优化并3D打印。用3D打印模具制作不同尺寸的软硬结石。将这些模型安装到市售的部分任务训练器上,并进行逆行性肾内手术测试。
该手术的每个步骤都能被模拟得与实际病例极为相似。每个模型独特的解剖复杂性以及结石类型使我们能够重现难度不断增加的手术。由于要熟练掌握逆行性肾内手术所需的病例量很大,因此可以将台式模拟纳入培训计划,以更快地取得良好效果并降低并发症发生率。我们的模型具有令人难以置信的解剖相似性,生产成本低且可重复使用性高。模拟过程中的验证研究和客观技能评估将有助于与其他现有的台式训练器进行比较,并设计逐步的培训计划。
3D打印在外科手术培训中越来越重要。我们的上尿路3D打印模型可能代表一种无风险的培训选择,以加速在腔内泌尿外科领域达到熟练水平。