Wang Zixi, Saija Carlo, Raison Nicholas, Aydin Abdullatif, Xu Zhouyang, Zuo Katie, Rhode Kawal, Pontiki Antonia
Department of Surgical & Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
MRC Centre for Transplantation, Guy's Hospital, King's College London, London, UK.
3D Print Med. 2025 Jan 3;11(1):1. doi: 10.1186/s41205-024-00248-5.
Penile implant surgery is the standard surgical treatment for end-stage erectile dysfunction. However, the growing complexity of modern high-tech penile prostheses has increased the demand for more practical training opportunities. The most advanced contemporary training methods involve simulation training using cadavers, with costs exceeding $5,000 per cadaver, inclusive of biohazard fees. This study introduces an innovative and cost-efficient male urogenital simulator designed to enhance penile implant surgery training.
Utilizing image segmentation of patient pre-operative computed tomography (CT) scans, combined with three-dimensional (3D) printing and silicone molding techniques, we developed a high-fidelity simulator replicating the anatomical structures of the male urogenital system. The simulator incorporates an innovative double-layer structural design encompassing the corpus spongiosum and glans, corpora cavernosa, testes, epididymides, and pelvic bones. Additionally, it utilizes a two-stage skin manufacturing process tailored for different skin regions. The simulator was produced at a low material cost of £10, with an average production time of 3 h. To evaluate its training efficacy, we conducted a penile implant surgery training session involving 15 urology trainees and surgeons ranging from specialty training levels ST3 to ST6. The session began with a demonstration of penile implant surgery and error detection. Trainees, averaging three per simulator, practiced corporotomy, dilation, measurement, penile prosthesis, and scrotal pump placement under expert guidance. Participants' feedback was collected using a Likert scale questionnaire, assessing learning, satisfaction, and anatomical accuracy.
Quantitative analysis of the questionnaire responses indicated highly positive feedback from the participants. Satisfaction rates surpassed 96% in learning effectiveness, over 89% in overall satisfaction, and 86% in anatomical accuracy demonstration. The simulator was favourably reviewed by both urology trainees and experienced surgeons, highlighting its utility as a practical training tool. Its low production cost and high precision make it a viable alternative to current training models.
The development of this cost-efficient, anatomically accurate urogenital simulator through advanced imaging and additive manufacturing techniques represents a significant advancement in penile implant surgical training. This state-of-the-art simulator not only provides a realistic and practical training experience but also underscores the potential for 3D printing technologies to revolutionize medical education and training.
阴茎植入手术是终末期勃起功能障碍的标准外科治疗方法。然而，现代高科技阴茎假体日益复杂，这增加了对更实用培训机会的需求。当代最先进的培训方法包括使用尸体进行模拟训练，每具尸体的成本超过5000美元，包括生物危害处理费用。本研究介绍了一种创新且经济高效的男性泌尿生殖模拟器，旨在加强阴茎植入手术培训。
利用患者术前计算机断层扫描（CT）图像分割，结合三维（3D）打印和硅胶成型技术，我们开发了一种高保真模拟器，复制男性泌尿生殖系统的解剖结构。该模拟器采用创新的双层结构设计包括海绵体和龟头、阴茎海绵体、睾丸、附睾和骨盆骨。此外，它针对不同皮肤区域采用两阶段皮肤制造工艺。该模拟器以10英镑的低材料成本生产，平均生产时间为3小时。为评估其培训效果，我们对15名从专科培训水平ST3到ST6的泌尿外科实习生和外科医生进行了阴茎植入手术培训课程。课程开始时进行了阴茎植入手术演示和错误检测。平均每个模拟器有三名学员，在专家指导下练习阴茎白膜切开术、扩张、测量、阴茎假体植入和阴囊泵放置。使用李克特量表问卷收集参与者的反馈，评估学习、满意度和解剖准确性。
对问卷回复的定量分析表明参与者反馈非常积极。学习效果满意度超过96%，总体满意度超过89%，解剖准确性演示满意度为86%。该模拟器受到泌尿外科实习生和经验丰富的外科医生的好评，突出了其作为实用培训工具的效用。其低生产成本和高精度使其成为当前培训模型的可行替代方案。
通过先进成像和增材制造技术开发的这种经济高效、解剖结构准确的泌尿生殖模拟器代表了阴茎植入手术培训的重大进步。这种先进的模拟器不仅提供了逼真且实用的培训体验，还突出了3D打印技术在彻底改变医学教育和培训方面的潜力。
