Cadaver-Free Neurosurgical Simulation Using a 3-Dimensional Printer and Augmented Reality

BACKGROUND Training to become a neurosurgeon takes time and effort, with the training requirements continuing to increase. As such, more efficient educational tools are needed. OBJECTIVE To evaluate the use of 3-dimensional (3D) printing and augmented reality (AR) systems within neurosurgical training programs. METHODS The skull and its structures were segmented using normal computed tomography and MRI and printed with a 3D printer. Basic procedures (burr-hole trephination and other craniotomies) and advanced procedures of skull base approaches (anterior clinoidectomy, anterior petrosectomy, and mastoidectomy) were practiced with the printed model. Skull base approaches were practiced in an AR system. After the training program, a questionnaire was administered to the trainees about the effectiveness of the program. RESULTS The basic procedure program was conducted four times with 22 trainees. Twenty trainees indicated that the present simulation program was important to their education (average of 4.9/5.0). When asked whether the model was similar to a human skull, the average score was 4.5 of 5 points. The advanced procedure program was conducted five times with 10 trainees. All 10 answered that the simulation program was a useful tool for training on skull base approaches (average of 5/5). All respondents answered that they would be able to perform the skull base approaches in patients after completing the training program (an average of 4.7/5). CONCLUSION The simulation-based training program using 3D-printed anatomy with an AR system was demonstrated to be an important adjunct to training neurosurgery. It provides trainees a realistic environment to improve skills and performance during clinical practice.