Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting
Background: To develop a bleeding simulator for transurethral resection of bladder tumors (TURBT) and evaluate its use as a training tool. Methods: Anatomical models of the human bladder and relevant structures were created with poly-vinyl alcohol hydrogels using 3D printed molds. Mucosal, muscular,...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Urology Video Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089722000809 |
| _version_ | 1811160185269387264 |
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| author | Ahmed Ghazi Nathan Schuler Lauren Shepard Guan Wu Hani Rashid Edward Messing |
| author_facet | Ahmed Ghazi Nathan Schuler Lauren Shepard Guan Wu Hani Rashid Edward Messing |
| author_sort | Ahmed Ghazi |
| collection | DOAJ |
| description | Background: To develop a bleeding simulator for transurethral resection of bladder tumors (TURBT) and evaluate its use as a training tool. Methods: Anatomical models of the human bladder and relevant structures were created with poly-vinyl alcohol hydrogels using 3D printed molds. Mucosal, muscular, and perivesical fat layers were created in bladder model that contained 3 tumors of varying size, location and depth of invasion. Participants (n=14) who performed the TURBT simulation were designated as expert or novice based on prior caseload (> 50 TURBT cases). Using surveys, ratings of realism and usefulness of the model as a training tool were calculated. Ability to differentiate between levels of experience was demonstrated by comparison of procedural metrics (operative time, tumor margins, missed tumors, and perforations) between the groups. Results: The model was determined to have good realism and educational effectiveness, both with average scores of 4/5. The simulator was able to differentiate between the skills of novice and expert in several operative metrics including total resection time (p = 0.005), vascular tumor perforation rate (p = 0.01), and anterior tumor missed rate (p = 0.03). Non-statistically significant differences were seen in complete tumor resection, adequate muscle sampling, and complication rate. Conclusion: This perfused 3D printed hydrogel TURBT simulator demonstrated adequate realism education effectiveness and ability to differentiate between skill levels. Incorporating full procedural simulation may have the potential to enhance training, encourage maintenance of procedural skills, and provide a method for technical assessment. |
| first_indexed | 2024-04-10T05:53:20Z |
| format | Article |
| id | doaj.art-d6c2f9c3295243f6a751ad4fce0f0c75 |
| institution | Directory Open Access Journal |
| issn | 2590-0897 |
| language | English |
| last_indexed | 2024-04-10T05:53:20Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj.art-d6c2f9c3295243f6a751ad4fce0f0c752023-03-04T04:23:49ZengElsevierUrology Video Journal2590-08972023-03-0117100206Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel castingAhmed Ghazi0Nathan Schuler1Lauren Shepard2Guan Wu3Hani Rashid4Edward Messing5Simulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA; Department of Urology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA; Corresponding author at: Simulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.Simulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA; Department of Urology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USASimulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA; Department of Urology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USASimulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USASimulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USASimulation Innovation Lab, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USABackground: To develop a bleeding simulator for transurethral resection of bladder tumors (TURBT) and evaluate its use as a training tool. Methods: Anatomical models of the human bladder and relevant structures were created with poly-vinyl alcohol hydrogels using 3D printed molds. Mucosal, muscular, and perivesical fat layers were created in bladder model that contained 3 tumors of varying size, location and depth of invasion. Participants (n=14) who performed the TURBT simulation were designated as expert or novice based on prior caseload (> 50 TURBT cases). Using surveys, ratings of realism and usefulness of the model as a training tool were calculated. Ability to differentiate between levels of experience was demonstrated by comparison of procedural metrics (operative time, tumor margins, missed tumors, and perforations) between the groups. Results: The model was determined to have good realism and educational effectiveness, both with average scores of 4/5. The simulator was able to differentiate between the skills of novice and expert in several operative metrics including total resection time (p = 0.005), vascular tumor perforation rate (p = 0.01), and anterior tumor missed rate (p = 0.03). Non-statistically significant differences were seen in complete tumor resection, adequate muscle sampling, and complication rate. Conclusion: This perfused 3D printed hydrogel TURBT simulator demonstrated adequate realism education effectiveness and ability to differentiate between skill levels. Incorporating full procedural simulation may have the potential to enhance training, encourage maintenance of procedural skills, and provide a method for technical assessment.http://www.sciencedirect.com/science/article/pii/S2590089722000809TURBT3D printingSimulationSurgical trainingBladder tumor |
| spellingShingle | Ahmed Ghazi Nathan Schuler Lauren Shepard Guan Wu Hani Rashid Edward Messing Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting Urology Video Journal TURBT 3D printing Simulation Surgical training Bladder tumor |
| title | Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting |
| title_full | Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting |
| title_fullStr | Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting |
| title_full_unstemmed | Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting |
| title_short | Design of a non-biohazardous perfused simulation model for transurethral resection of bladder tumor (TURBT) using 3D printing and hydrogel casting |
| title_sort | design of a non biohazardous perfused simulation model for transurethral resection of bladder tumor turbt using 3d printing and hydrogel casting |
| topic | TURBT 3D printing Simulation Surgical training Bladder tumor |
| url | http://www.sciencedirect.com/science/article/pii/S2590089722000809 |
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