Multi-institutional Evaluation of Producing and Testing a Novel 3D-Printed Laparoscopic Trainer

Egor Parkhomenko,Renai Yoon,Zhamshid Okhunov,Roshan M Patel,Benjamin Dolan,Kamaljot Kaler,Michael J Schwartz,Paras H Shah,Hannah Bierwiler,Aldrin Joseph Gamboa,Roberto Miano,Stefano Germani,Dario Del Fabbro,Alessio Zordani,Salvatore Micali,Louis R Kavoussi,Ralph V Clayman,Jaime Landman

doi:10.1016/j.urology.2018.06.034

Abstract

ObjectiveTo create, distribute, and evaluate the efficacy of a portable, cost-effective 3D-printed laparoscopic trainer for surgical skills development. MethodsThe UCI Trainer (UCiT) laparoscopic simulator was developed via computer-aided designs (CAD), which were used to 3D-print the UCiT. Once assembled, a tablet computer with a rear-facing camera was attached for video and optics. Four institutions were sent the UCiT CAD files with a 3D-printer and instructions for UCiT assembly. For a comparison of the UCiT to a standard trainer, peg transfer and intracorporeal knot tying skills were accessed. These tasks were scored, and participants were asked to rate their experience with the trainers. Lastly, a questionnaire was given to individuals who 3D-printed and assembled the UCiT. ResultsWe recruited 25 urologists; none had any 3D-printing experience. The cost of printing each trainer was $26.50 USD. Each institution used the Apple iPad for optics. Six of eight participants assembled the UCiT in < 45 minutes, and rated assembly as somewhat easy. On objective scoring, participants performed tasks equally well on the UCiT vs the conventional trainer. On subjective scoring, the conventional trainer provided a significantly better experience vs the UCiT; however, all reported that the UCiT was useful for surgical education. ConclusionThe UCiT is a low cost, portable training tool that is easy to assemble and use. UCiT provided a platform whereby participants performed laparoscopic tasks equal to performing the same tasks on the more expensive, nonportable standard trainer.

Highlights

The demands of surgical training have changed over the past few decades requiring surgical trainees to acquire increasingly greater skills in less time
Incorporating a laparoscopic training curriculum is essential for surgical training, as is the objective assessment of those skills.[1,2]
Eight participants were selected to assemble the UCI Trainer (UCiT) at their respective institution; 6 successfully assembled UCiT independently while 2 participants required additional assistance provided through email and oral instructions from the study investigators

Summary

CONCLUSION

We have developed a low-cost ($26.50 USD) 3D printed alternative to the standard laparoscopic trainer. The UCiT is portable, and once printed it can be assembled in less than 45 minutes. Despite a preference for the standard trainer, the participants in this study performed well on both the UCiT and the traditional laparoscopic trainer and the majority would purchase UCiT as well as recommend UCiT to their colleagues

MATERIALS AND METHODS

RESULTS

DISCUSSION