Validation of a Simulation Model for Laparoscopic Myomectomy Developed with 3D-Printed Molds

Abstract

PURPOSE: To develop a model that can be used by Ob-Gyn residents when performing simulation for laparoscopic myomectomy. BACKGROUND: Laparoscopic myomectomy (LM) is a challenging procedure encountered by Ob-Gyn residents during residency training. Limited commercial simulation products exist but are cost-prohibitive for consistent use. METHODS: Uterine and fibroid molds were generated using Pixelogic® Z-brush design software and printed from a 3D printer using polylactic acid filament. Smooth-On® Dragon Skin silicone of varying densities was used for the uterus and fibroids. The model consisted of a uterine body with four fundal subserosal fibroids – two placed anteriorly and two placed posteriorly—fallopian tubes, and round ligaments. Residents evaluated the model and its effectiveness in simulating LM upon simulation completion. RESULTS: Five uterine models with four fibroids each were constructed for a total cost of $318 (printed molds, silicone, and pigment); replacement models cost $30 (silicone and pigment only). The model functioned well within the trainer box using surgical instruments and suture; however, the base of the fibroid adhered to the myometrium making excision of the entire specimen difficult. All residents (N=13) used the model. Residents felt the model was realistic (4/5), helps develop skills needed for LM (4.5/5), and will increase resident competency in laparoscopy (4.8/5). DISCUSSION: Our model provides a realistic simulation of LM at low cost. One model can be used by up to four residents. We can repair previously used models with silicone allowing them to be reused. We have updated the model to decrease fibroid adherence to the myometrium and facilitate complete excision.

The Use of Additive Manufacturing Techniques in the Development of Polymeric Molds: A Review

“…Three-dimensional-printed molds from PLA were used to fabricate replicas of uterine and fibroid elements, and a realistic model with silicone material uterus and fibroids was used to help resistant simulated laparoscopic myomectomy at low cost. Previously used molds can be repaired with silicone and reused by other residents [ 151 ]. Also, breast reconstructive surgery benefits from the use of 3D-printed molds.…”