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三维打印技术在超声引导下羊膜腔-膀胱分流术治疗早发性胎儿膀胱过度活动症培训模型中的应用进展。

Advancement of 3D printing technology for the development of a training model in US-guided vesicoamniotic shunting for early LUTO therapy.

机构信息

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany.

Department of Medicine III - Oncology, Hematology, Clinical Immunology and Rheumatology, University Hospital Bonn, Bonn, Germany.

出版信息

Acta Obstet Gynecol Scand. 2024 Aug;103(8):1550-1557. doi: 10.1111/aogs.14879. Epub 2024 May 23.

Abstract

INTRODUCTION

Prenatal lower urinary tract obstruction (LUTO) is a rare and challenging condition with potential severe morbidity and mortality. Prenatal shunting methods, specifically vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to manage this condition. However, comprehensive education and training are hindered by the rarity of LUTO. To address this gap, we present a low-cost 3D-printed ultrasound training model for VAS in LUTO fetuses. The aim of the study was to evaluate ultrasound and haptic fidelity of the model.

MATERIAL AND METHODS

Ultrasound images of three LUTO fetuses at 12-14 weeks were utilized to create detailed 3D-printed models. Fusion360TM software generated stereo-lithography files, and the Formlabs Form3® printer, using Flexible 80A resin, produced the models. A simulation box mimicking uterine conditions and fetal anatomy was developed for testing. Ultrasound assessments determined model accuracy, and expert evaluations gauged fidelity for VAS placement.

RESULTS

The 3D-printed model accurately replicated LUTO fetal anatomy, demonstrating structural integrity and realistic sonographic and haptic feedback during 20 punctures. Macroscopic visualization confirmed the model's durability and authenticity.

DISCUSSION

This innovative 3D-printed model addresses the scarcity of LUTO cases and the lack of realistic training tools. Simulation models enhance skills, providing a controlled learning environment that bridges theoretical knowledge and clinical application, potentially improving patient outcomes.

CONCLUSIONS

The 3D-printed training model for VAS in LUTO represents a significant advancement in surgical education, offering realistic anatomical simulation and tactile feedback. Future studies should assess its effectiveness in enhancing surgical skills and impacting patient outcomes in clinical practice.

摘要

简介

产前下尿路梗阻(LUTO)是一种罕见且具有挑战性的疾病,可能导致严重的发病率和死亡率。产前分流方法,特别是膀胱羊膜分流术(VAS)和胎儿膀胱镜检查,旨在治疗这种疾病。然而,由于 LUTO 的罕见性,全面的教育和培训受到阻碍。为了解决这一差距,我们提出了一种用于 LUTO 胎儿 VAS 的低成本 3D 打印超声培训模型。本研究的目的是评估模型的超声和触觉逼真度。

材料和方法

利用 12-14 周的 3 个 LUTO 胎儿的超声图像创建详细的 3D 打印模型。Fusion360TM 软件生成立体光刻文件,Formlabs Form3®打印机使用柔性 80A 树脂制作模型。为了测试,开发了一个模拟子宫环境和胎儿解剖结构的模拟箱。通过超声评估确定模型的准确性,通过专家评估评估 VAS 放置的逼真度。

结果

3D 打印模型准确复制了 LUTO 胎儿的解剖结构,在 20 次穿刺中表现出结构完整性和真实的超声和触觉反馈。宏观可视化证实了模型的耐用性和真实性。

讨论

这种创新的 3D 打印模型解决了 LUTO 病例稀少和缺乏真实培训工具的问题。模拟模型增强了技能,提供了一个可控的学习环境,将理论知识与临床应用联系起来,有可能改善患者的预后。

结论

LUTO 中 VAS 的 3D 打印培训模型代表了手术教育的重大进展,提供了真实的解剖模拟和触觉反馈。未来的研究应评估其在增强手术技能和影响临床实践中患者结局方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bf5/11266640/79db7003355a/AOGS-103-1550-g001.jpg

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