scholarly journals P.012 Spinal durotomy repair simulator for deliberate microsurgical practice: integration into a residency training module

2016 ◽  
Vol 43 (S2) ◽  
pp. S24-S24
Author(s):  
JC Lau ◽  
L Denning ◽  
SP Lownie ◽  
TM Peters ◽  
EC Chen
Keyword(s):  
Residency Training ◽  
Water System ◽  
Cost Effective ◽  
Patient Specific ◽  
Training Module ◽  
Proposed Model ◽  
Spine Model ◽  
3D Printed ◽  
Intravenous Tubing ◽  
Lumbar Spinal

Background: Deliberate practice is one aspect of gaining competency in surgical skills. We have previously integrated a vascular microsurgery module into our residency training curriculum, and have recently described our experience with constructing patient-specific spine models for simulating lumbar spinal durotomy repair. The goal of this project is to develop the necessary infrastructure to facilitate practice on the spine model during residency. Methods: A 3D-printed plastic lumbar spine model was created from a patient computed tomography scan. L2 was manually laminectomized, and paraspinal tissues were simulated using Polyvinyl Chloride (PVC) Plastisol. Harvested bovine pericardium was sewn into tubular form as a dural substitute. The pericardial tubes were tied at either end and attached to intravenous tubing to create a closed loop water system. Results: We are developing a video tutorial describing how to setup and use the model. Residents will be recorded while performing a 1.5 cm durotomy and repair using a surgical microscope available in our training laboratory (Drake-Hunterian Neurovascular Laboratory, London, Ontario, Canada). Residents are asked to grade the realism of the model using a questionnaire. Metrics of quality are to be determined. Conclusions: Our proposed model is a cost-effective, easy-to-prepare lumbar spinal simulator that facilitates microsurgical practice during neurosurgical residency.

scholarly journals 3D Printing of Rapid, Low-Cost and Patient-Specific Models of Brain Vasculature for Use in Preoperative Planning in Clipping of Intracranial Aneurysms

2021 ◽  
Vol 10 (6) ◽  
pp. 1201
Author(s):  
Maciej Błaszczyk ◽  
Redwan Jabbar ◽  
Bartosz Szmyd ◽  
Maciej Radek
Keyword(s):  
3D Visualization ◽  
Low Cost ◽  
Cost Benefit ◽  
Image Data ◽  
Cost Effective ◽  
3D Models ◽  
Urgent Care ◽  
Patient Specific ◽  
Stl File ◽  
3D Printed

We developed a practical and cost-effective method of production of a 3D-printed model of the arterial Circle of Willis of patients treated because of an intracranial aneurysm. We present and explain the steps necessary to produce a 3D model from medical image data, and express the significant value such models have in patient-specific pre-operative planning as well as education. A Digital Imaging and Communications in Medicine (DICOM) viewer is used to create 3D visualization from a patient’s Computed Tomography Angiography (CTA) images. After generating the reconstruction, we manually remove the anatomical components that we wish to exclude from the print by utilizing tools provided with the imaging software. We then export this 3D reconstructions file into a Standard Triangulation Language (STL) file which is then run through a “Slicer” software to generate a G-code file for the printer. After the print is complete, the supports created during the printing process are removed manually. The 3D-printed models we created were of good accuracy and scale. The median production time used for the models described in this manuscript was 4.4 h (range: 3.9–4.5 h). Models were evaluated by neurosurgical teams at local hospital for quality and practicality for use in urgent and non-urgent care. We hope we have provided readers adequate insight into the equipment and software they would require to quickly produce their own accurate and cost-effective 3D models from CT angiography images. It has become quite clear to us that the cost-benefit ratio in the production of such a simplified model is worthwhile.

scholarly journals Towards a deterministic sustainable cost-effective water supply chain

2021 ◽  
Vol 9 (3) ◽  
pp. 637-646 ◽  
Author(s):  
Hassan Rezazadeh ◽  
Zahra Tahmasebi
Keyword(s):  
Supply Chain ◽  
Water Resources ◽  
Water Supply ◽  
Water System ◽  
Cost Effective ◽  
Mixed Integer ◽  
Fixed Costs ◽  
Time Period ◽  
Proposed Model ◽  
Drinking Water System

Managing water resources is one of the most challenging problems in today’s world. There is an immense change in climate change, population growth, and environment, thereby increasing pressures on water resources. Due to future uncertainty and availability of resources, many priorities should be taken into account in the drinking-water system such as environmental impacts, distribution costs and fixed costs. This paper proposes a deterministic mixed-integer linear programming (MILP) model for planning and designing a water supply chain network in order to optimize multi-objective problems. The model considers costs which include fixed and variable costs, in addition, it considers sustainability in terms of environmental viewpoint. The applicability of the model is appraised through a case study whose data gathered from related articles and water and waste company reports in Iran, which consists of five candidate reservoir nodes and four dam nodes besides eleven candidate locations for treatment plants. Thereafter, the proposed model has been coded in GAMS® optimization software. The model could be an expedient tool in order to manage urban water supply chains in a cost-effective and sustainable manner to satisfy water demand at every time period.

scholarly journals Development of Patient Specific Conformal 3D-Printed Devices for Dose Verification in Radiotherapy

2021 ◽  
Vol 11 (18) ◽  
pp. 8657
Author(s):  
Antonio Jreije ◽  
Lalu Keshelava ◽  
Mindaugas Ilickas ◽  
Jurgita Laurikaitiene ◽  
Benas Gabrielis Urbonavicius ◽  
...  
Keyword(s):  
3D Printing ◽  
Radiation Treatment ◽  
Cost Effective ◽  
Skin Surface ◽  
Target Volume ◽  
Dose Assessment ◽  
Patient Specific ◽  
Tumor Control ◽  
Dose Verification ◽  
3D Printed

In radiation therapy, a bolus is used to improve dose distribution in superficial tumors; however, commercial boluses lack conformity to patient surface leading to the formation of an air gap between the bolus and patient surface and suboptimal tumor control. The aim of this study was to explore 3D-printing technology for the development of patient-specific conformal 3D-printed devices, which can be used for the radiation treatment of superficial head and neck cancer (HNC). Two 3D boluses (0.5 and 1.0 cm thick) for surface dose build-up and patient-specific 3D phantom were printed based on reconstruction of computed tomography (CT) images of a patient with HNC. The 3D-printed patient-specific phantom indicated good tissue equivalency (HU = −32) and geometric accuracy (DSC = 0.957). Both boluses indicated high conformity to the irregular skin surface with minimal air gaps (0.4–2.1 mm for 0.5 cm bolus and 0.6–2.2 mm for 1.0 cm bolus). The performed dose assessment showed that boluses of both thicknesses have comparable effectiveness, increasing the dose that covers 99% of the target volume by 52% and 26% for single field and intensity modulated fields, respectively, when compared with no bolus case. The performed investigation showed the potential of 3D printing in development of cost effective, patient specific and patient friendly conformal devices for dose verification in radiotherapy.

The utility of a multimaterial 3D printed model for surgical planning of complex deformity of the skull base and craniovertebral junction

2016 ◽  
Vol 125 (5) ◽  
pp. 1194-1197 ◽  
Author(s):  
Donato Pacione ◽  
Omar Tanweer ◽  
Phillip Berman ◽  
David H. Harter
Keyword(s):  
Skull Base ◽  
Surgical Planning ◽  
Cost Effective ◽  
Craniovertebral Junction ◽  
Specific Model ◽  
Patient Specific ◽  
Cost Effective Method ◽  
3D Printed ◽  
2D Imaging ◽  
Printing Techniques

Utilizing advanced 3D printing techniques, a multimaterial model was created for the surgical planning of a complex deformity of the skull base and craniovertebral junction. The model contained bone anatomy as well as vasculature and the previously placed occipital cervical instrumentation. Careful evaluation allowed for a unique preoperative perspective of the craniovertebral deformity and instrumentation options. This patient-specific model was invaluable in choosing the most effective approach and correction strategy, which was not readily apparent from standard 2D imaging. Advanced 3D multimaterial printing provides a cost-effective method of presurgical planning, which can also be used for both patient and resident education.

scholarly journals Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem
Keyword(s):  
Wall Thickness ◽  
Large Scale ◽  
Fused Deposition Modeling ◽  
Vascular Anatomy ◽  
3D Models ◽  
Patient Specific ◽  
Stl File ◽  
Fused Deposition ◽  
3D Printed ◽  
The Mean

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.

An evaluation of a shoulder rehabilitation class in a UK hospital following evidence-based modifications

2021 ◽  
pp. 1-8
Author(s):  
Emily Kell ◽  
John A. Hammond ◽  
Sophie Andrews ◽  
Christina Germeni ◽  
Helen Hingston ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Shoulder Pain ◽  
Management Strategies ◽  
Cost Effective ◽  
Rehabilitation Programme ◽  
Patient Specific ◽  
Satisfaction Survey ◽  
Evidence Based ◽  
Patient Satisfaction Survey ◽  
Significant Difference

OBJECTIVES: Shoulder pain is a common musculoskeletal disorder, which carries a high cost to healthcare systems. Exercise is a common conservative management strategy for a range of shoulder conditions and can reduce shoulder pain and improve function. Exercise classes that integrate education and self-management strategies have been shown to be cost-effective, offer psycho-social benefits and promote self-efficacy. This study aimed to examine the effectiveness of an 8-week educational and exercise-based shoulder rehabilitation programme following the introduction of evidence-based modifications. METHODS: A retrospective evaluation of a shoulder rehabilitation programme at X Trust was conducted, comparing existing anonymised Shoulder Pain and Disability Index (SPADI) and Patient-Specific Functional Scale (PSFS) scores from two cohorts of class participants from 2017-18 and 2018-19 that were previously collected by the physiotherapy team. Data from the two cohorts were analysed separately, and in comparison, to assess class efficacy. Descriptive data were also analysed from a patient satisfaction survey from the 2018-19 cohort. RESULTS: A total of 47 patients completed the 8-week shoulder rehabilitation programme during the period of data collection (2018-2019). The 2018-19 cohort showed significant improvements in SPADI (p 0.001) and PSFS scores (p 0.001). No significant difference was found between the improvements seen in the 2017-18 cohort and the 2018-19 cohort. 96% of the 31 respondents who completed the patient satisfaction survey felt the class helped to achieve their goals. CONCLUSION: A group-based shoulder rehabilitation class, which included loaded exercises and patient education, led to improvements in pain, disability and function for patients with rotator cuff related shoulder pain (RCRSP) in this outpatient setting, but anticipated additional benefits based on evidence were not observed.

scholarly journals Total Meniscus Reconstruction Using a Polymeric Hybrid-Scaffold: Combined with 3D-Printed Biomimetic Framework and Micro-Particle

Polymers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 1910
Author(s):  
Hun-Jin Jeong ◽  
Se-Won Lee ◽  
Myoung Wha Hong ◽  
Young Yul Kim ◽  
Kyoung Duck Seo ◽  
...  
Keyword(s):  
Shape Matching ◽  
Femoral Condyle ◽  
Immunohistochemical Analysis ◽  
Cartilage Degeneration ◽  
Patient Specific ◽  
Hybrid Scaffold ◽  
Meniscus Tissue ◽  
Cell Source ◽  
3D Printed ◽  
Meniscus Regeneration

The meniscus has poor intrinsic regenerative capability, and its injury inevitably leads to articular cartilage degeneration. Although there are commercialized off-the-shelf alternatives to achieve total meniscus regeneration, each has its own shortcomings such as individualized size matching issues and inappropriate mechanical properties. We manufactured a polycaprolactone-based patient-specific designed framework via a Computed Tomography scan images and 3D-printing technique. Then, we completed the hybrid-scaffold by combining the 3D-printed framework and mixture micro-size composite which consists of polycaprolactone and sodium chloride to create a cell-friendly microenvironment. Based on this hybrid-scaffold with an autograft cell source (fibrochondrocyte), we assessed mechanical and histological results using the rabbit total meniscectomy model. At postoperative 12-week, hybrid-scaffold achieved neo-meniscus tissue formation, and its shape was maintained without rupture or break away from the knee joint. Histological and immunohistochemical analysis results showed obvious ingrowth of the fibroblast-like cells and chondrocyte cells as well as mature lacunae that were embedded in the extracellular matrix. Hybrid-scaffolding resulted in superior shape matching as compared to original meniscus tissue. Histological analysis showed evidence of extensive neo-meniscus cell ingrowth. Additionally, the hybrid-scaffold did not induce osteoarthritis on the femoral condyle surface. The 3D-printed hybrid-scaffold may provide a promising approach that can be applied to those who received total meniscal resection, using patient-specific design and autogenous cell source.

scholarly journals 3D printed microfluidic lab-on-a-chip device for fiber-based dual beam optical manipulation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Haoran Wang ◽  
Anton Enders ◽  
John-Alexander Preuss ◽  
Janina Bahnemann ◽  
Alexander Heisterkamp ◽  
...  
Keyword(s):  
Optical Fibers ◽  
Single Cells ◽  
Lab On A Chip ◽  
Cost Effective ◽  
Optical Manipulation ◽  
Hydrodynamic Focusing ◽  
Trapping Region ◽  
Dual Beam ◽  
3D Printed ◽  
On Chip

Abstract3D printing of microfluidic lab-on-a-chip devices enables rapid prototyping of robust and complex structures. In this work, we designed and fabricated a 3D printed lab-on-a-chip device for fiber-based dual beam optical manipulation. The final 3D printed chip offers three key features, such as (1) an optimized fiber channel design for precise alignment of optical fibers, (2) an optically clear window to visualize the trapping region, and (3) a sample channel which facilitates hydrodynamic focusing of samples. A square zig–zag structure incorporated in the sample channel increases the number of particles at the trapping site and focuses the cells and particles during experiments when operating the chip at low Reynolds number. To evaluate the performance of the device for optical manipulation, we implemented on-chip, fiber-based optical trapping of different-sized microscopic particles and performed trap stiffness measurements. In addition, optical stretching of MCF-7 cells was successfully accomplished for the purpose of studying the effects of a cytochalasin metabolite, pyrichalasin H, on cell elasticity. We observed distinct changes in the deformability of single cells treated with pyrichalasin H compared to untreated cells. These results demonstrate that 3D printed microfluidic lab-on-a-chip devices offer a cost-effective and customizable platform for applications in optical manipulation.

Design, Fabrication, and Accuracy of a Novel Noncovering Lock-Mechanism Bilateral Patient-Specific Drill Guide Template for Nondeformed and Deformed Thoracic Spines

2021 ◽  
pp. 155633162199633
Author(s):  
Mehran Ashouri-Sanjani ◽  
Shima Mohammadi-Moghadam ◽  
Parisa Azimi ◽  
Navid Arjmand
Keyword(s):  
Thoracic Spine ◽  
Sagittal Plane ◽  
Ct Scanning ◽  
Entry Point ◽  
In Vivo Studies ◽  
Patient Specific ◽  
Plane Angle ◽  
Severe Scoliosis ◽  
3D Printed

Background: Pedicle screw (PS) placement has been widely used in fusion surgeries on the thoracic spine. Achieving cost-effective yet accurate placements through nonradiation techniques remains challenging. Questions/Purposes: Novel noncovering lock-mechanism bilateral vertebra-specific drill guides for PS placement were designed/fabricated, and their accuracy for both nondeformed and deformed thoracic spines was tested. Methods: One nondeformed and 1 severe scoliosis human thoracic spine underwent computed tomographic (CT) scanning, and 2 identical proportions of each were 3-dimensional (3D) printed. Pedicle-specific optimal (no perforation) drilling trajectories were determined on the CT images based on the entry point/orientation/diameter/length of each PS. Vertebra-specific templates were designed and 3D printed, assuring minimal yet firm contacts with the vertebrae through a noncovering lock mechanism. One model of each patient was drilled using the freehand and one using the template guides (96 pedicle drillings). Postoperative CT scans from the models with the inserted PSs were obtained and superimposed on the preoperative planned models to evaluate deviations of the PSs. Results: All templates fitted their corresponding vertebra during the simulated operations. As compared with the freehand approach, PS placement deviations from their preplanned positions were significantly reduced: for the nonscoliosis model, from 2.4 to 0.9 mm for the entry point, 5.0° to 3.3° for the transverse plane angle, 7.1° to 2.2° for the sagittal plane angle, and 8.5° to 4.1° for the 3D angle, improving the success rate from 71.7% to 93.5%. Conclusions: These guides are valuable, as the accurate PS trajectory could be customized preoperatively to match the patients’ unique anatomy. In vivo studies will be required to validate this approach.

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