3D printing in surgical simulation: emphasized importance in the COVID-19 pandemic era

Abstract

Historically, surgical training was an apprenticeship model of see one, do one, teach one. However, a proficiency-based training approach has become increasingly implemented for assessing surgical skills with performance scores used as benchmarks to track trainee proficiency [1]. Surgical simulators are starting to be utilized more to assess proficiency in trainees on certain procedures with many residency programs having simulation as a piece of their training curriculum. Today, simulation in surgical training takes many forms. Live animals and cadavers are often implemented since these simulators can simulate operating on realistic tissue and on human anatomy respectively. There are also basic simulators that are models that simulate a component of an operation such as suturing or knot-tying. These help trainees practice certain surgical skills necessary for completing a procedure. Some of these simulators have become more complex and simulate several steps or even an entire procedure such as joint replacements and fixating fractures [1]. With the increased availability in 3D printing technology and a push toward personalized medicine, 3D printing research has exponentially increased in recent years and has been an area of investigation for the development of surgical simulators [2]. Using a 3D printer to construct models for simulation leads to vast opportunity to customize the simulator while significantly reducing cost. Prior to the advent of 3D printing and additive manufacturing, computed tomography (CT) data were used to construct anatomic models using subtractive manufacturing with the first model made in 1979 [3]. Commercial 3D printers became available in the 1980s and were introduced into the medical field in 1994 [4]. Currently, 3D printing has several surgical applications including anatomic models for surgical planning, simulation and education; implants and prostheses; and surgical guides [3].