Development of a 3D-printed external ventricular drain placement simulator: technical note

Abstract

22abbreviatioNs EVD = external ventricular drain; ICP = intracranial pressure; VR = virtual reality. In this paper, the authors present a physical model developed to simulate accurate external ventricular drain (EVD) placement with realistic haptic and visual feedbacks to serve as a platform for complete procedural training. Insertion of an EVD via ventriculostomy is a common neurosurgical procedure used to monitor intracranial pressures and/or drain CSF. Currently, realistic training tools are scarce and mainly limited to virtual reality simulation systems. The use of 3D printing technology enables the development of realistic anatomical structures and customized design for physical simulators. In this study, the authors used the advantages of 3D printing to directly build the model geometry from stealth head CT scans and build a phantom brain mold based on 3D scans of a plastinated human brain. The resultant simulator provides realistic haptic feedback during a procedure, with visualization of catheter trajectory and fluid drainage. A multiinstitutional survey was also used to prove content validity of the simulator. With minor refinement, this simulator is expected to be a cost-effective tool for training neurosurgical residents in EVD placement.

Development of Simulator System Using Endovascular Evaluator for Catheter Intervention Training

“…In the field of neurosurgery, various simulators for training in bypass surgery and endoscopic surgery have been reported. [8][9][10][11] To make simulation training in neuroendovascular treatment more practical, it is necessary to make the training environment closer to clinical settings. Trainees are required not only to learn the procedure of catheter treatment and the usage of instruments, but also to experience comprehensive simulation including rinsing inside of the catheter, imaging, catheter and wire manipulation, and handling of various other devices.…”

The role of simulation in neurosurgery

“…The physical trainer was designed to perform skinto-skin external ventricular drain placement, allowing participants to practice the entire procedure [117]. The developers described that the trainer provides realistic tactile feedback and enables visualization of the trajectory of the catheter during the simulation.…”

A mechanistic force model for simulating haptics of hand-held bone burring operations

“…The synthetic cortical bone is made using 3D printer ProJet® 160 and hardened with epoxy, by following a composition-recipe to mimic the properties of real human bone. This synthetic bone can better simulate a burring process on the cortical bone compared to the currently available commercial products [19,20].…”