Development and Validation of a Neurosurgical Phantom for Simulating External Ventricular Drain Placement

Area of Science:

• Neurosurgery
• Medical Simulation
• Biomedical Engineering

Background:

• External ventricular drain (EVD) placement is a critical neurosurgical procedure.
• Effective training for EVD placement is essential for patient safety and surgical proficiency.
• Existing simulation methods may lack patient-specificity, cost-effectiveness, or anatomical realism.

Purpose of the Study:

• To develop and validate a cost-effective, customizable patient-specific phantom for simulating external ventricular drain (EVD) placement.
• To assess the phantom's utility as a training tool for neurosurgical procedures.
• To evaluate the anatomical and mechanical realism of the developed phantom.

Main Methods:

• Image segmentation of patient MRI data was used to create patient-specific models.
• 3-D printing and molding techniques were employed to fabricate the phantom, including a realistic skin layer, 3-D printed skull, agarose gel brain, and ventricular cavity.
• Fifteen neurosurgical trainees performed 30 EVD placements on the phantom.
• User experience questionnaires and mechanical testing (catheter insertion forces) were used for validation.

Main Results:

• The phantom successfully facilitated EVD placements with a 76.7% optimal placement rate, comparable to clinical practice.
• User feedback indicated high anatomical accuracy and value in enhancing surgical skills.
• Mechanical testing confirmed that catheter insertion forces closely mimicked those of real brain tissue.
• Areas for improvement included enhancing the realism of the skin layer.

Conclusions:

• The developed patient-specific phantom is a realistic, low-cost, and adaptable tool for EVD simulation training and research.
• The phantom demonstrates comparable mechanical properties to actual brain tissue.
• Future iterations will focus on improving skin realism and incorporating additional anatomical features for enhanced fidelity.