Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models

Introduction: Full endoscopic spine surgery continues to spread worldwide but has a long learning curve. Conventional endoscopy training uses live pigs or human cadavers, which has disadvantages such as high costs and limited availability. Therefore, this study aimed to develop and evaluate three-di...

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Main Authors: Takahiro Ogawa, Masatoshi Morimoto, Shutaro Fujimoto, Masaru Tominaga, Yasuyuki Omichi, Kosuke Sugiura, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo
Format: Article
Language:English
Published: The Japanese Society for Spine Surgery and Related Research 2024-11-01
Series:Spine Surgery and Related Research
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Online Access:https://www.jstage.jst.go.jp/article/ssrr/8/6/8_2023-0285/_pdf/-char/en
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author Takahiro Ogawa
Masatoshi Morimoto
Shutaro Fujimoto
Masaru Tominaga
Yasuyuki Omichi
Kosuke Sugiura
Fumitake Tezuka
Kazuta Yamashita
Koichi Sairyo
author_facet Takahiro Ogawa
Masatoshi Morimoto
Shutaro Fujimoto
Masaru Tominaga
Yasuyuki Omichi
Kosuke Sugiura
Fumitake Tezuka
Kazuta Yamashita
Koichi Sairyo
author_sort Takahiro Ogawa
collection DOAJ
description Introduction: Full endoscopic spine surgery continues to spread worldwide but has a long learning curve. Conventional endoscopy training uses live pigs or human cadavers, which has disadvantages such as high costs and limited availability. Therefore, this study aimed to develop and evaluate three-dimensional (3D)-printed models for endoscopy training. Methods: Models for 3D printing were generated using raw imaging data from 1.0-mm slices of computed tomography scans, and each part was printed using a different colored material. The combined model was used for training as part of the full endoscopy training kit. Results: This approach offers several advantages. First, it enables the creation of accurate disease models, such as lumbar disc herniation and other abnormalities, which are useful for both surgical training and preoperative simulations. Second, it is useful for learning surgical orientation. During surgical training, the surgical field can be viewed directly through an endoscope or with the naked eye. By using various colors, it becomes easier to recognize the orientation. Third, the amount of drilling resection can be easily confirmed, facilitating feedback. Finally, training for various surgical techniques is possible, including endoscopic holding techniques and using the endoscope's outer sheath to retract nerves. However, this approach also has some disadvantages, such as the lack of bleeding, inability to reproduce tissue hardness, and difficulty in faithfully recreating soft tissue, such as connective tissue, blood vessels, and fat. Therefore, it is difficult to reproduce the hardness of the calcified disc or disc herniation with apophyseal ring fracture. Moreover, 3D-printed models are not suitable for surgical training using the interlaminal approach because it is difficult to perform separation between the ligamentum flavum and dural matter or between the dural matter and intervertebral disc. Conclusions: 3D-printed models are a useful complement to live pigs and human cadavers in surgical training and can reduce the time required to acquire endoscopic skills.
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language English
publishDate 2024-11-01
publisher The Japanese Society for Spine Surgery and Related Research
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series Spine Surgery and Related Research
spelling doaj-art-70bdcaf4927f497e9c30124c6daa53db2024-12-08T23:39:13ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2024-11-018659159910.22603/ssrr.2023-02852023-0285Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed ModelsTakahiro Ogawa0Masatoshi Morimoto1Shutaro Fujimoto2Masaru Tominaga3Yasuyuki Omichi4Kosuke Sugiura5Fumitake Tezuka6Kazuta Yamashita7Koichi Sairyo8Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDivision of Clinical Technology, Dental Technology Section, Dental Laboratories, Tokushima University HospitalDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesDepartment of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health SciencesIntroduction: Full endoscopic spine surgery continues to spread worldwide but has a long learning curve. Conventional endoscopy training uses live pigs or human cadavers, which has disadvantages such as high costs and limited availability. Therefore, this study aimed to develop and evaluate three-dimensional (3D)-printed models for endoscopy training. Methods: Models for 3D printing were generated using raw imaging data from 1.0-mm slices of computed tomography scans, and each part was printed using a different colored material. The combined model was used for training as part of the full endoscopy training kit. Results: This approach offers several advantages. First, it enables the creation of accurate disease models, such as lumbar disc herniation and other abnormalities, which are useful for both surgical training and preoperative simulations. Second, it is useful for learning surgical orientation. During surgical training, the surgical field can be viewed directly through an endoscope or with the naked eye. By using various colors, it becomes easier to recognize the orientation. Third, the amount of drilling resection can be easily confirmed, facilitating feedback. Finally, training for various surgical techniques is possible, including endoscopic holding techniques and using the endoscope's outer sheath to retract nerves. However, this approach also has some disadvantages, such as the lack of bleeding, inability to reproduce tissue hardness, and difficulty in faithfully recreating soft tissue, such as connective tissue, blood vessels, and fat. Therefore, it is difficult to reproduce the hardness of the calcified disc or disc herniation with apophyseal ring fracture. Moreover, 3D-printed models are not suitable for surgical training using the interlaminal approach because it is difficult to perform separation between the ligamentum flavum and dural matter or between the dural matter and intervertebral disc. Conclusions: 3D-printed models are a useful complement to live pigs and human cadavers in surgical training and can reduce the time required to acquire endoscopic skills.https://www.jstage.jst.go.jp/article/ssrr/8/6/8_2023-0285/_pdf/-char/enfull endoscopic spine surgery (fess)lumbar interbody fusionsurgical trainingthree-dimensional (3d)-printed modellive pigshuman cadavers
spellingShingle Takahiro Ogawa
Masatoshi Morimoto
Shutaro Fujimoto
Masaru Tominaga
Yasuyuki Omichi
Kosuke Sugiura
Fumitake Tezuka
Kazuta Yamashita
Koichi Sairyo
Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models
Spine Surgery and Related Research
full endoscopic spine surgery (fess)
lumbar interbody fusion
surgical training
three-dimensional (3d)-printed model
live pigs
human cadavers
title Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models
title_full Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models
title_fullStr Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models
title_full_unstemmed Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models
title_short Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models
title_sort development of new surgical training for full endoscopic surgery using 3d printed models
topic full endoscopic spine surgery (fess)
lumbar interbody fusion
surgical training
three-dimensional (3d)-printed model
live pigs
human cadavers
url https://www.jstage.jst.go.jp/article/ssrr/8/6/8_2023-0285/_pdf/-char/en
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