V11-11 A 3-D PRINTED SYNTHETIC VAS DEFERENS FOR MICROSURGERY PRACTICE AND TRAINING

Abstract

You have accessJournal of UrologyCME1 Apr 2023V11-11 A 3-D PRINTED SYNTHETIC VAS DEFERENS FOR MICROSURGERY PRACTICE AND TRAINING Parth Joshi, Brian Gillette, and Richard Schoor Parth JoshiParth Joshi More articles by this author , Brian GilletteBrian Gillette More articles by this author , and Richard SchoorRichard Schoor More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Microsurgery is difficult to perform and to teach. While other models for microsurgical practice exist, such as rubber tubing, dog neuter specimens, bull reproductive tracts, and human cadaver specimens, these are either not realistic enough to be useful as practice tools or are expensive or are not readily available. We believe that practicing microsurgery improves performance in real world conditions. As such, in order to become better microsurgeons ourselves and for our patients and to improve the quality of microsurgical training for our residents, we developed a synthetic vas deferens that has the physical characteristics of native human vas deferens. This video demonstrates the results of that endeavor. METHODS: We determined the physical characteristics of native human vas deferens in terms of inner lumen diameter, outer diameter, flexibility, axial rigidity, and tactile similarity using previously published anatomic studies, ultrastructural and imaging research and professional knowledge. We then used to a 3-D printer to create a cylindrical tube that had similar characteristics to native vas deferens and then tested it by performing anastomoses on the model using 7-0, 8-0, and 9-0 suture. After a process of trial and error, we eventually developed a working prototype that met our specifications. RESULTS: The synthetic 3-D printed vas deferens models had similar inner luminal diameter and outer diameter to native human vas deferens. The synthetic vas deferens had a similar tactile feel and physical characteristics as native vas. Surgical placement of 7-0, 8-0, and 9-0 nylon suture into the wall of the synthetic vas deferens and its lumen mimicked closely the experience of operating on native vas deferens. While tying good quality square knots was straightforward using 7-0 and 8-0 nylon suture, the synthetic vas deferens was too springy for the 9-0 suture and often resulted in either air-knots or suture breakage. However, by using excellent microsurgical techniques, it was possible to perform a quality modified one layer anastomosis using our 3-D printed synthetic vas deferens. The experience of practice with our model system simulated the experience of doing an actual anastomosis on a human. Aside for research and development costs, the cost for each synthetic vas specimen is less than $1.00 and the specimens have an unlimited shelf-life. CONCLUSIONS: The time to learn microsurgery or to practice it is not when the patient is on the operating table. We have developed a excellent, inexpensive, and readily available simulation vas deferens that is useful for both the experienced microsurgeon and the trainee or novice. Our research team is continually refining the synthetic vas deferens so that it becomes more lifelike and better accommodates 9-0 sutures and even everted 10-0 inner layer suture placement. Our goal is to share this technology with other training programs and standardize microsurgical education nationally and internationally. Source of Funding: Internal funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1002 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Parth Joshi More articles by this author Brian Gillette More articles by this author Richard Schoor More articles by this author Expand All Advertisement PDF downloadLoading ...