Gondalia Dharmik, Parakh Mohit, Mokhale Kunal, Kumar Vineet, Bindu Ameya, Mantri Mayur, Mathews Saumya, Jaiswal Dushyant, Bhavke Akshay, Kant Shankhdhar Vinay
Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Mumbai, India.
Maxillofac Plast Reconstr Surg. 2025 Aug 20;47(1):21. doi: 10.1186/s40902-025-00476-7.
Reconstructive surgery following head and neck cancer resection is inherently complex and technically demanding. Procedures such as osteotomy and flap inset involve a steep learning curve, yet opportunities for hands-on training are increasingly limited. Physical simulation using cost-effective, anatomically realistic models offers a promising solution. This study aimed to evaluate the educational value of 3D-printed training models and custom-made fibula models in enhancing surgical skills, supported by structured assessments and feedback.
A hands-on workshop was conducted for 30 plastic surgery residents utilizing in-house 3D-printed models, created via fused deposition modeling (FDM), and acrylic-based fibula models. Participants performed simulated osteotomies and flap insets. Their performance was assessed using the 4-point Zwisch scale by two independent, blinded consultants. Additionally, a 6-item questionnaire was administered to capture self-reported improvements in anatomical understanding, surgical technique, and procedural planning. Pre- and post-training questionnaire scores were compared using Wilcoxon signed-rank test.
Post-training, the average questionnaire scores significantly improved from 12.03 ± 2.20 to 20.30 ± 1.56 (p < 0.01). The greatest improvement was noted in the participants' comprehension of surgical planning. Zwisch scale evaluations demonstrated a clear progression toward greater technical independence. Participants also expressed high satisfaction with the anatomical realism, durability, and affordability of the training models.
Low-cost 3D-printed training models and custom-made fibula models represent an effective and reproducible training tool for developing technical skills in head and neck reconstructive surgery. Their ease of fabrication, affordability, and anatomical accuracy make them particularly valuable in resource-limited settings. These models offer significant educational utility and warrant integration into structured surgical training curriculum.
头颈癌切除术后的重建手术本质上很复杂，技术要求高。诸如截骨术和皮瓣植入等手术涉及陡峭的学习曲线，但实践培训的机会越来越有限。使用经济高效、解剖结构逼真的模型进行物理模拟提供了一个有前景的解决方案。本研究旨在通过结构化评估和反馈，评估3D打印训练模型和定制腓骨模型在提高手术技能方面的教育价值。
为30名整形外科住院医师举办了一个实践工作坊，使用通过熔融沉积建模（FDM）制作的内部3D打印模型和丙烯酸基腓骨模型。参与者进行模拟截骨术和皮瓣植入。由两名独立的、不知情的顾问使用4分Zwisch量表对他们的表现进行评估。此外，还发放了一份6项问卷，以获取自我报告的在解剖理解、手术技术和手术规划方面的改进情况。使用Wilcoxon符号秩检验比较训练前后问卷得分。
训练后，问卷平均得分从12.03±2.20显著提高到20.30±1.56（p<0.01）。参与者在手术规划理解方面的改善最为显著。Zwisch量表评估表明在技术独立性方面有明显进步。参与者还对训练模型的解剖逼真度、耐用性和可承受性表示高度满意。
低成本的3D打印训练模型和定制腓骨模型是发展头颈重建手术技术技能的有效且可重复的训练工具。它们易于制作、价格实惠且解剖结构准确，在资源有限的环境中尤其有价值。这些模型具有显著的教育用途，值得纳入结构化的外科培训课程。
