A Low-Cost 3D-Printed Tool with Multiaxial/Angular Vessel Orientation for Microvascular Anastomosis Training

Abstract

Background: Microsurgical anastomosis is a technically demanding skill. The most difficult part of the learning process was in achieving the necessary orientation and dexterity. In this project, we adopted computer-aided design and desktop 3D-printing in the development of an affordable training model with different levels of vessel orientation and angulation. Methods: The training model was designed using CAD software (Rhino3D). The models were then 3D-printed with a thermoplastic polyurethane (TPU 95A) semiflexible filament on a desktop fused deposition modeling, Ultimaker 2 + 3D printer. Results: The printed training tool was assembled by fitting the ball-and-socket mechanism between two parts having an overall round table top with integrated vascular clamps. Trial with synthetic and nonliving animal blood vessels shows the utility of the clamps in holding the vessels within the working space. By rotating the top part, a multiaxial vessel orientation from 0 to 360 degrees was achieved. The top part was also capable of multiangular orientation of the vessels (±30 degrees) regardless of its axial orientation during vessel anastomosis. For the 3D-printing process, the average printing time was about 3.5 hours with a cost of 1.3$ per material. Conclusions: The utility of desktop 3D printing represents an affordable modality in microsurgical training. The designed model is capable of providing a trainee with multiaxial and multiangular vessel orientation during the anastomosis process. To our knowledge, the adoption of this technology in the field of microsurgery training has never been investigated before.

Synthetic Simulators for Microsurgery Training: A Systematic Review

“…From the original 612 articles found, 39 met the inclusion criteria. 4,8,9,14–49 According to previous literature, 13 each model was classified depending on the degree of difficulty of the exercises trained with the devices: basic (Supplemental Digital Content 1), intermediate (Supplemental Digital Content 2), or advanced (Supplemental Digital Content 3).…”

Superiority of living animal models in microsurgical training: beyond technical expertise

“…In order to abide by these regulations, researchers and policy creators have begun to recognize and started to turn to alternative educational modalities, such as nonliving models, virtual reality/augmented reality (VR/AR) and three-dimensional tools for microvascular anastomosis training [ 45 ]. Thus, a reduction between 50 and 90% was achieved in the usage of living animal models because of enhanced skills gained through bench models prior to embarking on to the real live tissues of the rat model [ 46 ] without compromising the quality of training [ 47 ].…”

Microsurgical education in Greece: past, present, and future

“…Due to COVID-19, the face and shape of the microsurgical training has shifted towards virtual training worldwide. Ιn order to abide by the new regulations, researchers and policy creators have begun to recognize and started to turn to alternative educational modalities, such as nonliving models, virtual/augmented reality (VR/AR) and three-dimensional tools for microvascular anastomosis training [45]. A myriad of novel synthetic [46] (e.g., silicone) and biological training models have been devised over the years.…”