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. 2024 Oct 17:11:1301511.
doi: 10.3389/fmed.2024.1301511. eCollection 2024.

Can high-fidelity 3D models be a good alternative for cadaveric materials in skill assessment for endoscopic sinus surgery? A comparison study in assessment for surgical performance in 3D models and cadavers

Masanobu Suzuki  1 , Ryosuke Watanabe  1 , Akira Nakazono  1 , Yuji Nakamaru  1 , Takayoshi Suzuki  1 , Shogo Kimura  1 , Kotaro Matoba  2 , Manabu Murakami  3 , Dominik Hinder  4 , A J Psaltis  4 , Akihiro Homma  1 , P J Wormald  4
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Can high-fidelity 3D models be a good alternative for cadaveric materials in skill assessment for endoscopic sinus surgery? A comparison study in assessment for surgical performance in 3D models and cadavers

Masanobu Suzuki et al. Front Med (Lausanne). .

Abstract

Introduction: Traditionally formal assessment of surgical skills has not been part of a surgeon's accreditation process. The widely adopted apprentice model of "on-the-job training" does create additional risk for the patients. In the past surgical training has used cadavers, but these are expensive, require dedicated wet-lab facilities and are in increasingly short supply. In many countries religious and cultural practices also preclude cadaveric use. Recent 3D-printed technology allows mass reproduction of high-fidelity 3D models. In this study, we examined the utility of 3D sinus models compared to cadaver dissection for surgical skill assessment for endoscopic sinus surgery (ESS).

Materials and methods: A total of 17 otolaryngologists performed Endoscopic Sinus Surgery (ESS) on 3D printed sinus models and then repeated these procedures on cadavers. Their surgical performance was assessed with the Objective Structured Assessment of Technical Skills (OSATS) score for ESS and time was taken to complete an ESS procedure. Their performance on the 3D models and cadavers was compared.

Results: There were no significant differences in the OSATS score between 3D models and cadavers (50.41 ± 13.31 vs. 48.29 ± 16.01, p = 0.36). There was a strong positive correlation between the score in 3D models and those in cadavers (r = 0.84, p < 0.001). No significant differences were found in time for a mini-ESS (21:29 ± 0:10 vs. 20:33 ± 0:07, p = 0.53). There were positive correlations between 3D models and cadavers in time taken for a mini-ESS (r = 0.55, p = 0.04).

Conclusion: The surgical performance on the 3D models was comparable to that on cadavers. This supports the utility of the 3D models as an inexhaustible alternative for cadavers in ESS surgical skill assessment.

Keywords: 3D printer; cadaver surgery; endoscopic surgery; surgical education; surgical training.

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Conflict of interest statement

PW: consultant for Fusetec and receiving royalties from Fusetec. AP: consultant for Fusetec, Medtronic, ENT technologies, Tissium, and Aerin Medical, shareholder of Chitogel, and speaker’s bureau for Sequiris. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of the simulation surgeries with the 3D-printed sinus models. (A) The setup of the simulation surgeries. (B) The 3D sinus models and its basement. (C) The models were inserted into and hold in the basement which mimics a human face. (D) The 3D models can be mass produced. (E) Endoscopic view of 3D-printed sinuses during the simulation surgeries.
Figure 2
Figure 2
Quality assessment of surgeries done by the same individual surgeons for 3D models and for cadavers. (A) The OSATS score of surgeries done for 3D models and for cadaver. (B) Correlation between the OSATS score in 3D models and in cadaver.
Figure 3
Figure 3
The progress status of surgeries done by the same individual surgeons for 3D models and for cadavers. (A) The progress status of surgeries done for 3D models and for cadavers. (B) Correlation between the status in 3D models and in cadavers.
Figure 4
Figure 4
The time taken for mini-ESS by the same individual surgeons for 3D models and cadavers. (A) The time taken for mini-ESS done on 3D models and for cadavers. (B) Correlation between the time for a mini-ESS in 3D models and in cadavers.
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References

    1. O'Connor T, Papanikolaou V, Keogh I. Safe surgery, the human factors approach. Surgeon. (2010) 8:93–5. doi: 10.1016/j.surge.2009.10.004 - DOI - PubMed
    1. Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, et al. . Mortality after surgery in Europe: a 7 day cohort study. Lancet. (2012) 380:1059–65. doi: 10.1016/s0140-6736(12)61148-9, PMID: - DOI - PMC - PubMed
    1. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. . European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. (2020) 58:1–464. doi: 10.4193/Rhin20.600 - DOI - PubMed
    1. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. (2003) 78:783–8. doi: 10.1097/00001888-200308000-00006 - DOI - PubMed
    1. Bilotta FF, Werner SM, Bergese SD, Rosa G. Impact and implementation of simulation-based training for safety. ScientificWorldJournal. (2013) 2013:652956. doi: 10.1155/2013/652956, PMID: - DOI - PMC - PubMed

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was partially supported by JSPS Grant-in-Aid for Scientific Research JP18H04102, 22K16923, and 22K10599.

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