A carregar...
Publicação
Cirurgia endoscópica endonasal transesfenoidal : o impacto da tecnologia de impressão 3D
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 1.86 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Introdução: A cirurgia endoscópica endonasal transesfenoidal (CEET) é uma técnica cirúrgica de abordagem da base do crânio. Atualmente, os recursos de treino de CEET são limitados. Neste estudo foi desenvolvido um modelo multimaterial obtido por tecnologia de impressão 3D para treino de CEET.
Objetivos: Avaliar o impacto do modelo produzido na aprendizagem da anatomia da base do crânio e no treino cirúrgico.
Métodos: O modelo 3D foi criado a partir de imagens de tomografia computorizada (TC) de um doente com macroadenoma não funcionante da hipófise. Para simular a consistência real das várias estruturas anatómicas, as peças do modelo, depois de segmentadas e pós-processadas, foram construídas com diferentes materiais: as partes ósseas com Z-ULTRAT e resina; as partes moles com silicone. O modelo foi validado por uma equipa multidisciplinar e aplicado num curso dirigido a onze participantes. Neste curso avaliou-se o desempenho prático dos participantes e o impacto do modelo desenvolvido na aprendizagem da anatomia da base do crânio e no treino cirúrgico. Obtiveram-se também dados dos participantes relativos ao seu nível de treino em neurocirurgia e à sua experiência prévia de CEET.
Resultados: Construiu-se um modelo 3D com grande precisão anatómica. O curso desenvolvido contou com participantes em diferentes níveis da sua formação em Neurocirurgia. Todos conseguiram identificar no modelo as estruturas anatómicas pré-selecionadas. No entanto, existiram erros durante a abordagem prática. Dez dos participantes não tinham disponível um método de treino de CEET no hospital onde exercem funções. Apenas cinco dos participantes já tinham tido uma intervenção prática numa CEET, apesar de não ter sido como cirurgião principal.
Conclusão: A utilização de modelos obtidos por tecnologia de impressão 3D é um método prático, económico e fidedigno de treino. Esta tecnologia tem um impacto benéfico no treino de CEET.
Background: Endoscopic endonasal transsphenoidal surgery (EETS) is a surgical technique to approach the skull base. Currently, EETS training resources are limited. In this study, multimaterial model was obtained by 3D printing technology for EETS training. Objectives: To evaluate the impact of the produced model in learning the anatomy of the skull base and in surgical training. Methods: 3D model was created from computed tomography (CT) images of a patient with non-functioning pituitary macroadenoma. To simulate the real consistence of the various anatomical structures, the model was produced with different materials: the bone parts with Z-ULTRAT and resin; the soft parts with silicone. The model was validated by a multidisciplinary team and applied in a course addressed to eleven participants. In this course, the practical performance of the participants and the impact of the model in learning anatomy of the skull base and in surgical training were evaluated. Data on the degree of specialization in neurosurgery and previous experience in EETS were also obtained. Results: Model was built with great anatomical precision. Course participants were in different stages of their training in Neurosurgery. Participants were able to identify pre-selected anatomical structures. However, they made mistakes when approaching the model. Ten participants did not have EETS training available at their hospital. Only five participants had already a practical intervention in an EETS, despite not having been a main surgeon. Conclusion: The use of models obtained by 3D printing technology is a practical, economical and reliable method of training. This technology has a beneficial impact in the acquisition of skills that allow the improvement of EETS performance.
Background: Endoscopic endonasal transsphenoidal surgery (EETS) is a surgical technique to approach the skull base. Currently, EETS training resources are limited. In this study, multimaterial model was obtained by 3D printing technology for EETS training. Objectives: To evaluate the impact of the produced model in learning the anatomy of the skull base and in surgical training. Methods: 3D model was created from computed tomography (CT) images of a patient with non-functioning pituitary macroadenoma. To simulate the real consistence of the various anatomical structures, the model was produced with different materials: the bone parts with Z-ULTRAT and resin; the soft parts with silicone. The model was validated by a multidisciplinary team and applied in a course addressed to eleven participants. In this course, the practical performance of the participants and the impact of the model in learning anatomy of the skull base and in surgical training were evaluated. Data on the degree of specialization in neurosurgery and previous experience in EETS were also obtained. Results: Model was built with great anatomical precision. Course participants were in different stages of their training in Neurosurgery. Participants were able to identify pre-selected anatomical structures. However, they made mistakes when approaching the model. Ten participants did not have EETS training available at their hospital. Only five participants had already a practical intervention in an EETS, despite not having been a main surgeon. Conclusion: The use of models obtained by 3D printing technology is a practical, economical and reliable method of training. This technology has a beneficial impact in the acquisition of skills that allow the improvement of EETS performance.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Endoscopia Modelo multimaterial Neurocirurgia Tecnologia 3D Treino