Neurosurgical Endoscopic Training For Third Ventriculostomy Using A Self-Made Low-Cost 3-Dimensional Printed Model

Abstract

Objective: Simulation-based techniques using three-dimensional models are gaining popularity in neurosurgical training. The majority of pre-existing models are expensive so we felt a need to develop a low-budget, real-life model using 3D printing technology to train in endoscopic third ventriculostomy (ETV). Methods: The brain model is made using a 3D-printed resin mold from patient-specific MRI data.The mold is filled with silicone Ecoflex™ 00-10 and mixed with Silc Pig® pigment additives to replicate the color and consistency of brain tissue. The dura mater is made from quick-drying silicone paste admixed with gray dye. The blood vessels are made from a silicone 3D-printed mold based on MRA. Liquid with Paprika oleoresin (E160c) dye is used to simulate blood and is pumped through the vessels to simulate pulsatile motion. Results: Seven residents and eight senior neurosurgeons were recruited to test our model. The participants reported that the size and anatomy of the elements were very similar to real structures. The model was helpful for training neuroendoscopic 3D perception and navigation. Conclusions: We developed an ETV training model using 3D printing technology that provides anatomical precision and a realistic simulation. We hope our model can provide an indispensable tool for young neurosurgeons to gain operative experience without exposing patients to risk.