Skull project

Discussion in 'Show off' started by Henry feldman, Nov 9, 2016.

  1. Henry feldman

    Henry feldman Well-Known Member

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    In our second 3D printed anatomy experiment of the day in the simulation center, we added "scalp" to our 3D printed craniotomy simulator (to practice drilling through the skull to evacuate bleeding - the procedure that would have saved Natasha Richardson from her subdural hematoma). We previously printed the skull, and since we had extra "skin" silicone from the 3D printed colon project, we created skin on the scalp as well. Looks/feels incredibly realistic in person.

    We found dripping the dragon-skin on provides a better surface (albeit very messy on the table)
    [​IMG]

    Looks incredible in person. The top part is what gets replaced each time (I need to reprint the base as the filament was sopping wet when I printed that so it looks like crap)
    [​IMG]
     
  2. mike01hu

    mike01hu Well-Known Member

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    Great stuff again Henry; it's really nice to see more sensible projects coming out of the technology. So, what filament are you printing with and how does that compare to bone for drilling etc.?
     
  3. Spoon Unit

    Spoon Unit Well-Known Member

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    "My god, man! Drilling holes in his head's not the answer! ...now put away your butcher knives and let me save this patient before it's too late!"

    'Bones' McCoy
     
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  4. Henry feldman

    Henry feldman Well-Known Member

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    Love that scene...
     
  5. Henry feldman

    Henry feldman Well-Known Member

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    So attempt 1 was just PLA/PHA, but I am going to print another with glass filled PLA as it will give the grit. The skill is somewhat soft but grit filled when you are alive (becomes all grit due to the loss of water when you just have bones). We want to simulate the live state which is why we aren't just using skulls.
     
  6. mike01hu

    mike01hu Well-Known Member

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    Thanks for that Henry. I had wondered why old skulls were not used. Filled filaments really are proving their worth in the specialist fields.
     
  7. UlrichKliegis

    UlrichKliegis Well-Known Member

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    Almost twenty years ago, a surgeon I was producing surgery planning models for tried a FDM sample that the friendly folks at stratasys made, based on one of my data sets. The goal was to simulate a LeFort IV osteotomy. This almost terminated the cooperation with that surgeon, he ruined two oscillating saw blades with the molten plastic. Just as a note of caution...

    Cheers,
    U.
     
  8. Henry feldman

    Henry feldman Well-Known Member

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    This is somewhat different. First off it is trivial to drill through PLA with a hardened steel bit. Also most emergency burr-hole craniotomies are actually done with a hand drill so really hasn't changed since roman times, but pretty hard to burn out a bit at a few RPM. We aren't trying to simulate OR based burr holes (since neurosurgeons know how to do it there and there is lots of supervision) it is more for emergency room physicians along with others who might be called on to do it in an emergency. The hand drill is more reliable in some ways since it is always ready for use (most EDs might do this once every few years) and being that it is slow it's slower to screw up. The OR is done with a nitrogen powered drill and zips through super fast.
     
  9. UlrichKliegis

    UlrichKliegis Well-Known Member

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    I am aware of the differences :) - just wanted to mention this for the case when people think of extending the simulation goals towards surgery beyond the drill. Plastic surgery of a different kind...

    Did you compare the learning effects to methods based on pressure- and force-sensitive passive robots (which actually are more active than active robots...) in a VR-environment? What method feels more 'realistic' to the student / future surgeon?
     
  10. Henry feldman

    Henry feldman Well-Known Member

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    So we have a whole bunch of those VR trainers for all sorts of activities. It's funny, resident much prefer hunks of silicone versus all the haptics/visuals. Blood on a screen somehow doesn't have the same anxiety producing factor as stage blood pumping out of a torn artery when you make a mistake. Also much harder to do team training (most of our training is team based) with VR. Not that we don't use it, just less favored. Also given that each trainer is $100,000 and most of them are single task (like the endoscopy trainer) and we can't try experimental procedures, etc on them, most people prefer physical models if possible
     
  11. Henry feldman

    Henry feldman Well-Known Member

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    Here are some images from our sim center (it's huge, but some representative images):

    [​IMG]
    Our Stryker laparoscopic task simulators. The stuff I am printing now will mostly go into those (to test a specific ACGME milestone on a rotation for instance)

    [​IMG]
    One of the simulated ORs (it's technically a full OR, but we'd have to clean it) with the $80,000 Laerdal sim mannequin under the drape with a special bleeding hip for this operation (there is a "hematoma" made of jello with powdered fake blood in the hip which seals a pumped tube which when the hematoma is removed blood starts pouring out until the resident oversews the vessel). Those are high school students who worked with me in the lab seeing the surgery. It's right next door to the fake ICU room, with another mannequin, there is also an OB one (which can actually deliver a baby - yuk)

    [​IMG]
    One of our $100,000 virtual endoscopy trainers
     
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  12. UlrichKliegis

    UlrichKliegis Well-Known Member

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    Thanks for that very explicit reply. It confirms my personal preferred opinion (tm). Given the interest and engagement in the (luxurious) choice of training options, the question for the subsequent degree of qualification derived from the different ways is interesting, yet beyond the range of this forum here. Thanks for the report anyway! When we presented our very first humerus model in 1985 in a conference of the german society for bioemedical technology and mentioned that these models i.a. could serve for the training of young surgeons, we saw many raised eyebrows...

    Oh well... ;)
     

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