Universität zu Köln

Lichtenstein, Juergen Thomas, Zeller, Alexander Nicolai, Lemound, Juliana, Lichtenstein, Thorsten Enno, Rana, Majeed, Gellrich, Nils-Claudius and Wagner, Maximilian Eberhard (2017). 3D-Printed Simulation Device for Orbital Surgery. J. Surg. Educ., 74 (1). S. 2 - 9. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-7452

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Abstract

OBJECTIVES: Orbital surgery is a challenging procedure because of its complex anatomy. Training could especially benefit from dedicated study models. The currently available devices lack sufficient anatomical representation and realistic soft tissue properties. Hence, we developed a 3D-printed simulation device for orbital surgery with tactual (haptic) correct simulation of all relevant anatomical structures. DESIGN, SETTING, AND PARTICIPANTS: Based on computed tomography scans collected from patients treated in a third referral center, the hard and soft tissue were segmented and virtually processed to generate a 3D-model of the orbit. Hard tissue was then physically realized by 3D printing. The soft tissue was manufactured by a composite silicone model of the nucleus and the surrounding tissue over a negative mold model also generated by 3D-printing. The final model was evaluated by a group of 5 trainees in oral and maxillofacial surgery (1) and a group of 5 consultants (2). All participants were asked to reconstruct an isolated orbital floor defect with a titanium implant. A stereotactic navigation system was available to all participants. Their experience was evaluated for haptic realism, correct representation of surgical approach, general handling of model, insertion of implant into the orbit, placement and fixation of implant, and usability of navigated control. The items were evaluated via nonparametric statistics (1 [poor]-5 [good]). RESULTS: Group 1 gave an average mark of 4.0 (+/- 0.9) versus 4.6 (+/- 0.6) by group 2. The haptics were rated as 3.6 (+/- 1.1) [1] and 4.2 (+/- 0.8) [2]. The surgical approach was graded 3.7 (+/- 1.2) [1] and 4.0 (+/- 1.0) [2]. Handling of the models was rated 3.5 (+/- 1.1) [1] and 4 (+/- 0.7) [2]. The insertion of the implants was marked as 3.7 (+/- 0.8) [1] and 4.2 (+/- 0.8) [2]. Fixation of the implants was also perceived to be,realistic with 3.6 (+/- 0.9) [1] and 4.2 (+/- 0.45) [2]. Lastly, surgical navigation was rated 3.8 (+/- 0.8) [1] and 4.6 (+/- 0.56) [2]. CONCLUSION: In this project, all relevant hard and soft tissue characteristics of orbital anatomy could be realized. Moreover, it was possible to demonstrate that the entire workflow of an orbital procedure may be simulated. Hence, using this model training expenses may be reduced and patient security could be enhanced. ((C) 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lichtenstein, Juergen Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeller, Alexander Nicolai UNSPECIFIED UNSPECIFIED UNSPECIFIED Lemound, Juliana UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtenstein, Thorsten Enno UNSPECIFIED UNSPECIFIED UNSPECIFIED Rana, Majeed UNSPECIFIED UNSPECIFIED UNSPECIFIED Gellrich, Nils-Claudius UNSPECIFIED UNSPECIFIED UNSPECIFIED Wagner, Maximilian Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-247865
DOI:	10.1016/j.jsurg.2016.07.005
Journal or Publication Title:	J. Surg. Educ.
Volume:	74
Number:	1
Page Range:	S. 2 - 9
Date:	2017
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-7452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPUTER-ASSISTED SURGERY; FRACTURES; RECONSTRUCTION; MANAGEMENT; DEFECTS; ANATOMY; FLOOR Multiple languages Education, Scientific Disciplines; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24786