Tag: 3D printing

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

Operative Neurosurgery 29:418–427, 2025

Training neurosurgeons on a 3D-printed simulation model with a standardized protocol significantly improved external ventricular drain (EVD) placement accuracy, reduced variability, and increased confidence, benefitting both junior and experienced practitioners. Regular simulation-based training is recommended to maintain high clinical performance and standardize EVD procedures.

• 3D-printed head models were developed for training neurosurgical residents in external ventricular drain (EVD) placement.

• Training included pre-training, standardized protocol with neuronavigation, and post-training rounds.

• EVD placement accuracy improved significantly after training, with optimal placement rates rising from 55% to 84%.

• Distances to ideal entry and target points, as well as procedure times, were significantly reduced post-training.

• Experience alone did not predict accuracy; even senior neurosurgeons improved, and post-training results were similar across experience levels.

• Right-handed participants achieved better outcomes using their right hand for both sides; left-sided EVDs were more often misplaced.

• Participants’ confidence in EVD placement and direction increased after training.

• Regular, standardized simulation training is recommended for all neurosurgeons, regardless of experience, to maintain high clinical performance.

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Seven bypasses simulation set: description and validity assessment of novel models for microneurosurgical training

J Neurosurg 138:732–739, 2023

Microsurgical training remains indispensable to master cerebrovascular bypass procedures, but simulation models for training that accurately replicate microanastomosis in narrow, deep-operating corridors are lacking. Seven simulation bypass scenarios were developed that included head models in various surgical positions with premade approaches, simulating the restrictions of the surgical corridors and hand positions for microvascular bypass training. This study describes these models and assesses their validity.

METHODS Simulation models were created using 3D printing of the skull with a designed craniotomy. Brain and external soft tissues were cast using a silicone molding technique from the clay-sculptured prototypes. The 7 simulation scenarios included: 1) temporal craniotomy for a superficial temporal artery (STA)–middle cerebral artery (MCA) bypass using the M4 branch of the MCA; 2) pterional craniotomy and transsylvian approach for STA-M2 bypass; 3) bifrontal craniotomy and interhemispheric approach for side-to-side bypass using the A3 branches of the anterior cerebral artery; 4) far lateral craniotomy and transcerebellomedullary approach for a posterior inferior cerebellar artery (PICA)–PICA bypass or 5) PICA reanastomosis; 6) orbitozygomatic craniotomy and transsylvian-subtemporal approach for a posterior cerebral artery bypass; and 7) extended retrosigmoid craniotomy and transcerebellopontine approach for an occipital artery–anterior inferior cerebellar artery bypass. Experienced neurosurgeons evaluated each model by practicing the aforementioned bypasses on the models. Face and content validities were assessed using the bypass participant survey.

RESULTS A workflow for model production was developed, and these models were used during microsurgical courses at 2 neurosurgical institutions. Each model is accompanied by a corresponding prototypical case and surgical video, creating a simulation scenario. Seven experienced cerebrovascular neurosurgeons practiced microvascular anastomoses on each of the models and completed surveys. They reported that actual anastomosis within a specific approach was well replicated by the models, and difficulty was comparable to that for real surgery, which confirms the face validity of the models. All experts stated that practice using these models may improve bypass technique, instrument handling, and surgical technique when applied to patients, confirming the content validity of the models.

CONCLUSIONS The 7 bypasses simulation set includes novel models that effectively simulate surgical scenarios of a bypass within distinct deep anatomical corridors, as well as hand and operator positions. These models use artificial materials, are reusable, and can be implemented for personal training and during microsurgical courses.

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Patient-specific 3-dimensionally printed models for neurosurgical planning and education

Neurosurg Focus 47 (6):E12, 2019

Advances in 3-dimensional (3D) printing technology permit the rapid creation of detailed anatomical models. Integration of this technology into neurosurgical practice is still in its nascence, however. One potential application is to create models depicting neurosurgical pathology. The goal of this study was to assess the clinical value of patientspecific 3D printed models for neurosurgical planning and education.

METHODS The authors created life-sized, patient-specific models for 4 preoperative cases. Three of the cases involved adults (2 patients with petroclival meningioma and 1 with trigeminal neuralgia) and the remaining case involved a pediatric patient with craniopharyngioma. Models were derived from routine clinical imaging sequences and manufactured using commercially available software and hardware.

RESULTS Life-sized, 3D printed models depicting bony, vascular, and neural pathology relevant to each case were successfully manufactured. A variety of commercially available software and hardware were used to create and print each model from radiological sequences. The models for the adult cases were printed in separate pieces, which had to be painted by hand, and could be disassembled for detailed study, while the model for the pediatric case was printed as a single piece in separate-colored resins and could not be disassembled for study. Two of the models were used for patient education, and all were used for presurgical planning by the surgeon.

CONCLUSIONS Patient-specific 3D printed models are useful to neurosurgical practice. They may be used as a visualization aid for surgeons and patients, or for education of trainees.

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