Abstract
Introduction: An important phase in surgical training is gaining experience in real human anatomical situations. When a cadaver is available it may complement the various artificial practice models. However, it is often necessary to supplement the characteristics of the cadavers with a simulation of a tumor. Our objective was to develop an easy-to-create, realistic artificial tumor-mimic model for peripheral lung tumor resection practice. Methods: In our work we injected barium sulphate enriched silicone suspension into 10 isolated, non-fixed lungs of human cadavers, through the puncture of the visceral pleura. Four lesions–apical, hilar and two peripheral–were created in each of ten specimens. After fixation CT scans were obtained and analyzed. The implanted tumor-mimics were examined after anatomical preparation and slicing. Also performed CT-guided percutaneous puncture was also performed to create the lesions in situ in two lungs of human cadavers. Results: Analyzing the CT data of 10 isolated lungs, out of 40 lesions, 34 were nodular (85.0%) and in the nodular group five were spiculated (12.5%). Satellite lesions were formed in two cases (5.0%). Relevant outflow into vessels or airway occurred in five lesions (12.5%). Reaching the surface of the lung occured in 11 lesions (27.5%). The tumor-mimics were elastic and adhered well to the surrounding tissue. The two lesions, implanted via percutaneous puncture, both were nodular and one also showed lobulated features. Conclusion: Our artificial tumor-mimics were easy to create, varied in shape and size, and with percutaneous implantation the lesions provide a model for teaching every step of a surgical procedure.
Highlights
An important phase in surgical training is gaining experience in real human anatomical situations
Relevant outflow into vessels or airway occurred in five lesions (12.5%)
The collapse of the lung adds difficulty as it significantly changes the anatomy in the intraoperative situation, compared to the anatomy seen in the preoperative diagnostic imaging
Summary
An important phase in surgical training is gaining experience in real human anatomical situations. Artificial models, mimicking different types of tumors were developed by others The use of these tumor-mimics have multiple purposes as they are used for testing imaging modalities, developing ultrasound localization, radiofrequency ablation devices and surgical navigation systems and they can be used in surgical training. 3D printed models [21, 22] of artificial tumor-mimics included their surrounding tissue and the whole organ. Most of these lung related models [5, 8, 9, 13,14,15, 17, 18] that were developed for testing, are suboptimal for surgical training
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