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Training on a 3D-Printed Simulation Model Improves Accuracy in External Ventricular Drain Placement.

Michael Kosterhon1, Merih Ö Turgut1, Matthias Gielisch2

  • 1Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, Mainz , Germany.

Operative Neurosurgery (Hagerstown, Md.)
|February 18, 2025
PubMed
Summary

A 3D-printed training model significantly improved external ventricular drain (EVD) placement accuracy and surgeon confidence. Regular training with this model is recommended for neurosurgeons to maintain high clinical performance.

Keywords:
3D-printingAccuracyEVDExternal ventricular drainSimulationTraining

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Area of Science:

  • Neurosurgery
  • Medical Education
  • Biomedical Engineering

Background:

  • External ventricular drain (EVD) placement is a critical neurosurgical procedure.
  • Manual EVD placement relies on variable anatomical landmarks, impacting accuracy.
  • A 3D-printed training model offers a novel approach to enhance EVD placement skills.

Purpose of the Study:

  • To evaluate the efficacy of a 3D-printed EVD training model.
  • To assess the impact of standardized training on EVD placement accuracy.
  • To measure changes in neurosurgeons' confidence levels post-training.

Main Methods:

  • Three-dimensional (3D)-printed head models with varying ventricle sizes were created from patient CT scans.
  • Twenty-five neurosurgeons underwent a three-round training protocol (pre-training, training with neuronavigation, post-training).
  • EVD placement accuracy was measured using an optical navigation system; confidence was assessed via questionnaires.

Main Results:

  • Intraventricular EVD placement accuracy increased from 55.3% pre-training to 84.0% post-training (P < .001).
  • Distances to ideal entry and target points significantly improved post-training (P < .001).
  • Confidence in EVD placement and puncture direction significantly increased, with experienced surgeons showing similar success rates to less experienced ones after training.

Conclusions:

  • A standardized training protocol utilizing a 3D-printed model significantly enhances neurosurgical EVD placement accuracy and confidence.
  • Regular training is crucial for maintaining high clinical performance in EVD placement.
  • Standardized procedures and neuronavigation are recommended for complex cases.