Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 3/2016

01-04-2016 | Original Article

Adapting anatomy teaching to surgical trends: a combination of classical dissection, medical imaging, and 3D-printing technologies

Authors: Jean H. D. Fasel, Diego Aguiar, Daniel Kiss-Bodolay, Xavier Montet, Afksendiyos Kalangos, Bojan V. Stimec, Osman Ratib

Published in: Surgical and Radiologic Anatomy | Issue 3/2016

Login to get access

Abstract

Purpose

Many regions worldwide report difficulties in recruiting applicants to surgery. One strategy proposed to reverse this trend consists of early exposure of medical students to the field. Against this backdrop, the present study presents an innovative approach for anatomy teaching, integrating a surgically relevant trend: 3D printing.

Methods

Whole-body computed tomography (CT) was made of two cadavers. Twelve students performed measurements and 3D reconstructions of selected anatomical structures (Osirix, Mimics). 3D printed (3DP) models were obtained (ZPrinter 310 Plus), and the students completed the analogous measurements on these replicas. Finally, classical anatomical dissection was performed and the same parameters were measured. The differences between the values obtained by the three modalities were submitted to standard statistical analysis (Wilcoxon two-tail paired test).

Results

Qualitative comparison of the digital 3D reconstructions based on the students’ manual CT segmentation and the anatomical reality showed excellent correlation. Quantitatively, the values measured on the CT images and the physical models created by 3D printing differed from those measured on the cadavers by less than 2 mm. Students were highly appreciative of the approach (CT, 3DP, cadaver). Their average satisfaction score was 5.8 on a 1–6 scale.

Conclusions

This study shows that the approach proposed can be achieved. The results obtained also show that CT-based 3D printed models are close to the authentic anatomic reality. The program allows early and interactive exposure of medical students to a surgically relevant trend—in this case 3D printing.
Literature
1.
go back to reference Alsaif HA, Ramadan WS (2010) An anatomical study of the aortic arch variations. JKAU Med Sci 17:37–54CrossRef Alsaif HA, Ramadan WS (2010) An anatomical study of the aortic arch variations. JKAU Med Sci 17:37–54CrossRef
2.
go back to reference Angelini P (2007) Coronary artery anomalies. An entity in search of an identity. Circulation 115:1296–1305PubMed Angelini P (2007) Coronary artery anomalies. An entity in search of an identity. Circulation 115:1296–1305PubMed
3.
go back to reference Are C, Stoddard HA, Thompson JS, Todd GL (2010) The influence of surgical demonstrations during an anatomy course on the perceptions of first-year medical students toward surgeons and a surgical career. J Surg Educ 67:320–324CrossRefPubMed Are C, Stoddard HA, Thompson JS, Todd GL (2010) The influence of surgical demonstrations during an anatomy course on the perceptions of first-year medical students toward surgeons and a surgical career. J Surg Educ 67:320–324CrossRefPubMed
4.
go back to reference Babademez MA, Günbey E, Ozmen E, Celik E (2013) Anomalous relationship of coexisting ipsilateral recurrent and nonrecurrent inferior laryngeal nerves during thyroid surgery. J Craniofac Surg 24:e190–e192CrossRefPubMed Babademez MA, Günbey E, Ozmen E, Celik E (2013) Anomalous relationship of coexisting ipsilateral recurrent and nonrecurrent inferior laryngeal nerves during thyroid surgery. J Craniofac Surg 24:e190–e192CrossRefPubMed
5.
go back to reference Bezerra AS, D’Ippolito G, Faintuch S, Szejnfeld J, Ahmed M (2005) Determination of splenomegaly by CT: is there a place for a single measurement? AJR 184:1510–1513CrossRefPubMed Bezerra AS, D’Ippolito G, Faintuch S, Szejnfeld J, Ahmed M (2005) Determination of splenomegaly by CT: is there a place for a single measurement? AJR 184:1510–1513CrossRefPubMed
6.
go back to reference Bland KI, Isaacs G (2002) Contemporary trends in student selection of medical specialties: the potential impact on general surgery. Arch Surg 137:259–267PubMed Bland KI, Isaacs G (2002) Contemporary trends in student selection of medical specialties: the potential impact on general surgery. Arch Surg 137:259–267PubMed
7.
go back to reference Cesmebasi A, Du Plessis M, Iannatuono M, Shah S, Tubbs RS, Loukas M (2014) A review of the anatomy and clinical significance of adrenal veins. Clin Anat 27:1253–1263CrossRefPubMed Cesmebasi A, Du Plessis M, Iannatuono M, Shah S, Tubbs RS, Loukas M (2014) A review of the anatomy and clinical significance of adrenal veins. Clin Anat 27:1253–1263CrossRefPubMed
9.
go back to reference Deedar-Ali-Khawaja R, Khan SM (2010) Trends of surgical selection among medical students and graduates: a global perspective. J Surg Educ 67:237–248CrossRefPubMed Deedar-Ali-Khawaja R, Khan SM (2010) Trends of surgical selection among medical students and graduates: a global perspective. J Surg Educ 67:237–248CrossRefPubMed
10.
go back to reference Dodge JT, Brown BG, Bolson EL, Dodge HT (1992) Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation 86:232–246CrossRefPubMed Dodge JT, Brown BG, Bolson EL, Dodge HT (1992) Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation 86:232–246CrossRefPubMed
11.
go back to reference Esses SJ, Berman P, Bloom AI, Sosna J (2011) Clinical applications of physical 3D models derived from MDCT data and created by rapid prototyping. Am J Roentgenol (AJR) 196:W683–W688CrossRef Esses SJ, Berman P, Bloom AI, Sosna J (2011) Clinical applications of physical 3D models derived from MDCT data and created by rapid prototyping. Am J Roentgenol (AJR) 196:W683–W688CrossRef
12.
go back to reference Fanucci A, Cerro P, Fanucci E (1988) Normal small-bowel measurements by enteroclysis. Scand J Gastroenterol 23:574–576CrossRefPubMed Fanucci A, Cerro P, Fanucci E (1988) Normal small-bowel measurements by enteroclysis. Scand J Gastroenterol 23:574–576CrossRefPubMed
14.
go back to reference Fasel J, Mentha G, De Maeseneer J (2014) Teaching clinical anatomy: from general practice to state-of-the-art surgery. Eur J Anat 18:49–54 Fasel J, Mentha G, De Maeseneer J (2014) Teaching clinical anatomy: from general practice to state-of-the-art surgery. Eur J Anat 18:49–54
15.
go back to reference Fasel JHD, Morel P, Gailloud P (2005) A survival strategy for anatomy. The Lancet 365(9461):754CrossRef Fasel JHD, Morel P, Gailloud P (2005) A survival strategy for anatomy. The Lancet 365(9461):754CrossRef
16.
go back to reference Gawad N, Moussa F, Christakis GT, Rutka JT (2013) Planting the “sead”: early comprehensive exposure to surgery for medical students. J Surg Educ 70:487–494CrossRefPubMed Gawad N, Moussa F, Christakis GT, Rutka JT (2013) Planting the “sead”: early comprehensive exposure to surgery for medical students. J Surg Educ 70:487–494CrossRefPubMed
17.
go back to reference Hager A, Kaemmerer H, Rapp-Bernhardt U, Blücher S, Rapp K, Bernhardt TM, Galanski M, Hess J (2002) Diameters of the thoracic aorta throughout life as measured with helical computed tomography. J Thorac Cardiovasc Surg 123:1060–1066CrossRefPubMed Hager A, Kaemmerer H, Rapp-Bernhardt U, Blücher S, Rapp K, Bernhardt TM, Galanski M, Hess J (2002) Diameters of the thoracic aorta throughout life as measured with helical computed tomography. J Thorac Cardiovasc Surg 123:1060–1066CrossRefPubMed
18.
go back to reference Insull PJ, Kejriwal R, Blyth P (2006) Surgical inclination and anatomy teaching at the University of Auckland. ANZ J Surg 76:1056–1059CrossRefPubMed Insull PJ, Kejriwal R, Blyth P (2006) Surgical inclination and anatomy teaching at the University of Auckland. ANZ J Surg 76:1056–1059CrossRefPubMed
19.
go back to reference Kahn D, Pillay S, Veller MG, Panieri E, Westcott MJ (2006) General surgery in crisis—the critical shortage. S Afr J Surg 44:108–112PubMed Kahn D, Pillay S, Veller MG, Panieri E, Westcott MJ (2006) General surgery in crisis—the critical shortage. S Afr J Surg 44:108–112PubMed
20.
go back to reference Kang KY, Lee YJ, Park SC, Yang CW, Kim YS, Moon IS, Koh YB, Bang BK, Choi BS (2007) A comparative study of methods of estimating kidney length in kidney transplantation donors. Nephrol Dial Transpl 22:2322–2327CrossRef Kang KY, Lee YJ, Park SC, Yang CW, Kim YS, Moon IS, Koh YB, Bang BK, Choi BS (2007) A comparative study of methods of estimating kidney length in kidney transplantation donors. Nephrol Dial Transpl 22:2322–2327CrossRef
21.
go back to reference Krejza J, Arkuszewski M, Kasner SE, Weigele J, Ustymowicz A, Hurst RW, Cucchiara BL, Messe SR (2006) Carotid artery diameter in men and women and the relation to body and neck size. Stroke 37:1103–1105CrossRefPubMed Krejza J, Arkuszewski M, Kasner SE, Weigele J, Ustymowicz A, Hurst RW, Cucchiara BL, Messe SR (2006) Carotid artery diameter in men and women and the relation to body and neck size. Stroke 37:1103–1105CrossRefPubMed
22.
go back to reference Malik HH, Darwood AR, Shaunak S, Kulatilake P, El-Hilly AA, Mulki O, Baskaradas A (2015) Three-dimensional printing in surgery: a review of current surgical applications. J Surg Res. doi:10.1016/j.jss.2015.06.051 (Epub ahead of print) PubMed Malik HH, Darwood AR, Shaunak S, Kulatilake P, El-Hilly AA, Mulki O, Baskaradas A (2015) Three-dimensional printing in surgery: a review of current surgical applications. J Surg Res. doi:10.​1016/​j.​jss.​2015.​06.​051 (Epub ahead of print) PubMed
23.
go back to reference Mashiko T, Otani K, Kawano R, Konno T, Kaneko N, Ito Y, Watanabe E (2015) Development of three-dimensional hollow elastic model for cerebral aneurysm clipping simulation enabling rapid and low cost prototyping. World Neurosurg 83:351–361CrossRefPubMed Mashiko T, Otani K, Kawano R, Konno T, Kaneko N, Ito Y, Watanabe E (2015) Development of three-dimensional hollow elastic model for cerebral aneurysm clipping simulation enabling rapid and low cost prototyping. World Neurosurg 83:351–361CrossRefPubMed
25.
go back to reference Patterson NW, Teates CD (1985) CT measurements of the anterior portions of the diaphragm with illustrative abnormal cases. Comput Radiol 9:61–65CrossRefPubMed Patterson NW, Teates CD (1985) CT measurements of the anterior portions of the diaphragm with illustrative abnormal cases. Comput Radiol 9:61–65CrossRefPubMed
26.
go back to reference Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, Giesel FL (2010) 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 5:335–341CrossRefPubMed Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, Giesel FL (2010) 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 5:335–341CrossRefPubMed
27.
go back to reference Salik E, Daftary A, Tal MG (2007) Three-dimensional anatomy of the left central veins: implications for dialysis catheter placement. J Vasc Interv Radiol 18:361–364CrossRefPubMed Salik E, Daftary A, Tal MG (2007) Three-dimensional anatomy of the left central veins: implications for dialysis catheter placement. J Vasc Interv Radiol 18:361–364CrossRefPubMed
28.
go back to reference Seyfer AE, Welling D, Fox JP (2007) The value of surgeons teaching anatomy to first-year medical students. Bull Am Coll Surg 92:8–14PubMed Seyfer AE, Welling D, Fox JP (2007) The value of surgeons teaching anatomy to first-year medical students. Bull Am Coll Surg 92:8–14PubMed
29.
go back to reference Shabana W, Peeters E, De Maeseneer M (2006) Measuring thyroid gland volume: should we change the correction factor? Am J Roentgenol (AJR) 186:234–236CrossRef Shabana W, Peeters E, De Maeseneer M (2006) Measuring thyroid gland volume: should we change the correction factor? Am J Roentgenol (AJR) 186:234–236CrossRef
31.
go back to reference Tartière D, Seguin P, Juhel C, Laviolle B, Mallédant Y (2009) Estimation of the diameter and cross-sectional area of the internal jugular veins in adult patients. Crit Care 13:R197CrossRefPubMedPubMedCentral Tartière D, Seguin P, Juhel C, Laviolle B, Mallédant Y (2009) Estimation of the diameter and cross-sectional area of the internal jugular veins in adult patients. Crit Care 13:R197CrossRefPubMedPubMedCentral
32.
go back to reference Wanhainen A, Bergqvist D, Björck M (2002) Measuring the abdominal aorta with ultrasonography and computed tomography – difference and variability. Eur J Vasc Endovasc Surg 24:428–434CrossRefPubMed Wanhainen A, Bergqvist D, Björck M (2002) Measuring the abdominal aorta with ultrasonography and computed tomography – difference and variability. Eur J Vasc Endovasc Surg 24:428–434CrossRefPubMed
33.
go back to reference Watson RA (2014) A low-cost surgical application of additive fabrication. J Surg Educ 71:A2–A3CrossRef Watson RA (2014) A low-cost surgical application of additive fabrication. J Surg Educ 71:A2–A3CrossRef
Metadata
Title
Adapting anatomy teaching to surgical trends: a combination of classical dissection, medical imaging, and 3D-printing technologies
Authors
Jean H. D. Fasel
Diego Aguiar
Daniel Kiss-Bodolay
Xavier Montet
Afksendiyos Kalangos
Bojan V. Stimec
Osman Ratib
Publication date
01-04-2016
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 3/2016
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-015-1588-3

Other articles of this Issue 3/2016

Surgical and Radiologic Anatomy 3/2016 Go to the issue