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Development and evaluation of a 3d printed training model for endoscopic third ventriculostomy in low-income
Pablo González-López1, Cristina Gómez-Revuelta1, Martin Puchol Rizo1
1Department of Neurosurgery, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), Avda. Pintor Baeza Sn, 03010, Alicante, Spain.
Insights
A novel 3D printed hydrocephalus model enhances neurosurgical training for endoscopic third ventriculostomy. This low-cost simulator improves skills acquisition, particularly in low-income countries lacking specialized training resources.
Area of Science:
- Neurosurgery
- Medical Education
- Biomedical Engineering
Background:
- Pediatric hydrocephalus presents a significant neurosurgical challenge, especially in Africa.
- Traditional ventriculoperitoneal shunts have limitations including high costs and potential complications.
- Endoscopic third ventriculostomy (ETV) is an increasingly favored technique, but requires specialized surgical skills and training.
Purpose of the Study:
- To develop and produce a low-cost 3D printed training model for neuroendoscopy.
- To evaluate the efficacy of this model in skill acquisition for ETV procedures.
- To assess the model's usefulness for understanding intraventricular anatomy.
Main Methods:
- A 3D printed neuroendoscopy simulation model was created.
- Medical students and junior neurosurgery residents with no prior ETV experience participated.
- Performance was assessed using metrics like procedure time, fenestration attempts, fenestration diameter, and critical structure contacts.
Main Results:
- A statistically significant improvement in ETV-Training-Scale scores was observed, increasing from 11.6 to 27.5 points (p<0.0001).
- All measured procedural parameters showed significant improvement after training with the model.
- The simulator proved effective in enhancing surgical skills and anatomical understanding.
Conclusions:
- The 3D printed simulator effectively facilitates the acquisition of neuroendoscopic skills for treating hydrocephalus via ETV.
- This low-cost training tool is particularly valuable for neurosurgeons in resource-limited settings.
- The model aids in understanding complex intraventricular anatomical relationships crucial for ETV.
Introduction:
Pediatric hydrocephalus is highly prevalent and therefore a major neurosurgical problem in Africa. In addition to ventriculoperitoneal shunts, which have high cost and potential complications, endoscopic third ventriculostomy is becoming an increasingly popular technique especially in this part of the world. However, performing this procedure requires trained neurosurgeons with an optimal learning curve. For this reason, we have developed a 3D printed training model of hydrocephalus so that neurosurgeons without previous experience with endoscopic techniques can acquire these skills, especially in low-income countries, where specific techniques training as this, are relatively absent.
Research Question:
Our research question was about the possibility to develop and produce a low-cost endoscopic training model and to evaluate the usefulness and the skills acquired after training with it.
Material And Methods:
A neuroendoscopy simulation model was developed. A sample of last year medical students and junior neurosurgery residents without prior experience in neuroendoscopy were involved in the study. The model was evaluated by measuring several parameters, as procedure time, number of fenestration attempts, diameter of the fenestration, and number of contacts with critical structures.
Results:
An improvement of the average score on the ETV-Training-Scale was noticed between the first and last attempt (11.6, compared to 27.5 points; p<0.0001). A statistically significant improvement in all parameters, was observed.
Discussion And Conclusion:
This 3D printed simulator facilitates acquiring surgical skills with the neuroendoscope to treat hydrocephalus by performing an endoscopic third ventriculostomy. Furthermore, it has been shown to be useful to understand the intraventricular anatomical relationships.
