Development of a novel 3D-printed and silicone live-wire model for thyroidectomy

We present the development and validation of a novel and innovative low-cost model for thyroidectomy. The purpose is to provide a high-fidelity and inexpensive method to provide repetition to surgeons early on the learning curve.

The model consists of a 3D-printed laryngeal and tracheal framework, with silicone components to replicate the thyroid gland, strap muscles, and skin. A copper wire models the recurrent laryngeal nerve and is circuited with a buzzer to indicate contact with instruments. Thirteen resident trainees successfully completed the simulated thyroidectomy after viewing an instructional video. Face validity of the model was assessed with a 19-item 5-point Likert scale survey. Subject performance was assessed using a checklist of procedure steps.

Participant feedback indicated enthusiasm for realism of the recurrent nerve (4.46 average Likert rating, 5 indicates strong agreement), dissection of the nerve (4.15), use of the buzzer (4.69), and overall satisfaction (4.46). Soft tissue components scored poorly including realism of the skin (3.08), thyroid gland (3.31), and mobilization of the lobe (3.23), identifying aspects to improve. All participants reported increased confidence with thyroid surgery after using the model; this was most pronounced among junior residents (1.5 ± 0.76 versus 3.13 ± 1.13; p = 0.016).

Thyroidectomy requires repetition and volume to gain competence. Use of the simulator early in training will provide confidence and familiarity, to enhance the educational value of subsequent live surgery.