Development of a Three-dimensional Printed Emergent Burr Hole and Craniotomy Simulator

Abstract

Patients with a traumatic head injury (THI) require immediate surgical intervention, as rapidly expanding intracranial hematomas can be imminently life-threatening, not permitting transfer time to neurosurgical care in a tertiary care center. In rural and remote areas, where neurosurgeons may not be readily available, surgical intervention by Community General Surgeons (CGS) may be required. Currently, the CGS in Newfoundland and Labrador (NL) do not have access to, or have experience training with, an emergent burr hole/craniotomy (EBHC) simulator. One of the barriers is the availability of inexpensive and reliable simulators to practice these skills. Therefore, a low-cost, three-dimensional (3D) printed EBHC simulator was designed and 3D-printed by MUN Med 3D (St John's, NL). The aim of this technical report is to assess the need for such simulator in rural and remote healthcare centers and report on the iterative development of the EBHC simulator. The 3D-printed EBHC simulator developed by MUN Med 3D was utilized during a general surgery workshop at the 26 th Annual Rural and Remote Medicine Conference in St. John’s, NL. A total of six 3D-printed EBHC simulators were provided for the hour and a half workshop. At the end of the workshop, 16 participants were asked to provide feedback on the need for this simulator in their rural or remote environment as well as feedback on the physical attributes. The feedback received from the participants was overall positive, informative, and supported the need for the 3D-printed EBHC simulator.

Prehospital Trauma Care: A Simulation Scenario for Rural-Based Healthcare Providers

“…Three-dimensional (3D) printing of anatomical models is an emerging field in SBME, and it provides a feasible and realistic opportunity to practice procedural skills in safe environments [15]. Several studies suggest that participants using 3D-printed models are generally satisfied with the learning experience [15,16]. 3-D printing has also been utilized successfully in trauma SBME [16].…”

“…Several studies suggest that participants using 3D-printed models are generally satisfied with the learning experience [15,16]. 3-D printing has also been utilized successfully in trauma SBME [16]. In one study, training with these models was successfully used by rural practitioners who were learning to perform emergent burr holes for traumatic head injuries [16].…”

“…3-D printing has also been utilized successfully in trauma SBME [16]. In one study, training with these models was successfully used by rural practitioners who were learning to perform emergent burr holes for traumatic head injuries [16]. Study participants felt that these models were a cost-effective alternative that could potentially fill an identified gap in learning needs for an important HALO procedure, particularly for those healthcare providers located far from large, well-funded neurosurgical programs [16].…”

“…In one study, training with these models was successfully used by rural practitioners who were learning to perform emergent burr holes for traumatic head injuries [16]. Study participants felt that these models were a cost-effective alternative that could potentially fill an identified gap in learning needs for an important HALO procedure, particularly for those healthcare providers located far from large, well-funded neurosurgical programs [16]. Virtual reality (VR) and virtual patients (VP) present another useful way to teach HALO skills, providing realistic, repeated access to situations that are challenging to simulate [17].…”

Hybrid computed tomography and magnetic resonance imaging 3D printed models for neurosurgery planning

“…Moreover, it will be recommended to use this type of hybrid approach in the 3D design of surgical guides for proper identification of spinal cord or other soft tissue structures. Thus, the risk of spinal cord damage will be minimized thanks to the inclusion of information about its relationship with surgical guides and possible target (focal lesion biopsy or external device implantation) (70).…”