3D Printout Models vs. 3D-Rendered Images: Which Is Better for Preoperative Planning?

INTRODUCTION Correct interpretation of a patient's anatomy and changes that occurs secondary to a disease process are crucial in the preoperative process to ensure optimal surgical treatment. In this study, we presented 3 different pancreatic cancer cases to surgical residents in the form of 3D-rendered images and 3D-printed models to investigate which modality resulted in the most appropriate preoperative plan. METHODS We selected 3 cases that would require significantly different preoperative plans based on key features identifiable in the preoperative computed tomography imaging. 3D volume rendering and 3D printing were performed respectively to create 2 different training ways. A total of 30, year 1 surgical residents were randomly divided into 2 groups. Besides traditional 2D computed tomography images, residents in group A (n = 15) reviewed 3D computer models, whereas in group B, residents (n = 15) reviewed 3D-printed models. Both groups subsequently completed an examination, designed in-house, to assess the appropriateness of their preoperative plan and provide a numerical score of the quality of the surgical plan. RESULTS Residents in group B showed significantly higher quality of the surgical plan scores compared with residents in group A (76.4 ± 10.5 vs. 66.5 ± 11.2, p = 0.018). This difference was due in large part to a significant difference in knowledge of key surgical steps (22.1 ± 2.9 vs. 17.4 ± 4.2, p = 0.004) between each group. All participants reported a high level of satisfaction with the exercise. CONCLUSION Results from this study support our hypothesis that 3D-printed models improve the quality of surgical trainee's preoperative plans.

[1]  D.J. van den Heever,et al.  Preoperative Three-Dimensional Model Creation of Magnetic Resonance Brain Images as a Tool to Assist Neurosurgical Planning , 2013, Stereotactic and Functional Neurosurgery.

[2]  Muhammed Ashraf Memon,et al.  Assessing the Surgeon's Technical Skills: Analysis of the Available Tools , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[3]  R. Kneebone,et al.  Surgical experts: born or made? , 2013, International journal of surgery.

[4]  Mario Davidson,et al.  Teaching in the operating room: results of a national survey. , 2012, Journal of surgical education.

[5]  Yong He,et al.  Fabrication of low cost soft tissue prostheses with the desktop 3D printer , 2014, Scientific Reports.

[6]  J. Ross,et al.  The shape of things to come: 3D printing in medicine. , 2014, JAMA.

[7]  Roger L Kneebone,et al.  Practice, rehearsal, and performance: an approach for simulation-based surgical and procedure training. , 2009, JAMA.

[8]  Annabelle L. Fonseca,et al.  Open surgical simulation in residency training: a review of its status and a case for its incorporation. , 2013, Journal of surgical education.

[9]  M. Rand,et al.  Eye-Hand Coordination during Visuomotor Adaptation with Different Rotation Angles , 2014, PloS one.

[10]  H. Aretz,et al.  Climbing the ladder from novice to expert plastic surgeon. , 2012, Plastic and reconstructive surgery.

[11]  David G. Armstrong,et al.  A novel combination of printed 3-dimensional anatomic templates and computer-assisted surgical simulation for virtual preoperative planning in Charcot foot reconstruction. , 2012, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[12]  T. Helling,et al.  The Challenges of Resident Training in Complex Hepatic, Pancreatic, and Biliary Procedures , 2007, Journal of Gastrointestinal Surgery.

[13]  Limin Luo,et al.  Issues in image-guided therapy [A Look at . . .] , 2009, IEEE Engineering in Medicine and Biology Magazine.

[14]  W. Fisher,et al.  Quality metrics in pancreatic surgery. , 2013, The Surgical clinics of North America.

[15]  Frederik L. Giesel,et al.  3D printing based on imaging data: review of medical applications , 2010, International Journal of Computer Assisted Radiology and Surgery.

[16]  P. Boulanger,et al.  Three-Dimensional Eye Tracking in a Surgical Scenario , 2015, Surgical innovation.

[17]  J. Sosna,et al.  Virtual Whipple: preoperative surgical planning with volume-rendered MDCT images to identify arterial variants relevant to the Whipple procedure. , 2007, AJR. American journal of roentgenology.

[18]  A. Ziv,et al.  Status of simulation in health care education: an international survey , 2014, Advances in medical education and practice.

[19]  THE RATIONALE OF RADICAL SURGERY FOR CANCER OF THE PANCREAS AND AMPULLARY REGION. , 1941, Annals of surgery.