title: Cerebral Aneurysm Clipping Surgery Simulation Using Patient-Specific 3D Printing and Silicone Casting.
abstract: BACKGROUND
  Neurosurgery simulator development is growing as practitioners recognize the need for improved instructional and rehearsal platforms to improve procedural skills and patient care. In addition, changes in practice patterns have decreased the volume of specific cases, such as aneurysm clippings, which reduces the opportunity for operating room experience.
  
  
  OBJECTIVE
  The authors developed a hands-on, dimensionally accurate model for aneurysm clipping using patient-derived anatomic data and three-dimensional (3D) printing. Design of the model focused on reproducibility as well as adaptability to new patient geometry.
  
  
  METHODS
  A modular, reproducible, and patient-derived medical simulacrum was developed for medical learners to practice aneurysmal clipping procedures. Various forms of 3D printing were used to develop a geometrically accurate cranium and vascular tree featuring 9 patient-derived aneurysms. 3D printing in conjunction with elastomeric casting was leveraged to achieve a patient-derived brain model with tactile properties not yet available from commercial 3D printing technology. An educational pilot study was performed to gauge simulation efficacy.
  
  
  RESULTS
  Through the novel manufacturing process, a patient-derived simulacrum was developed for neurovascular surgical simulation. A follow-up qualitative study suggests potential to enhance current educational programs; assessments support the efficacy of the simulacrum.
  
  
  CONCLUSIONS
  The proposed aneurysm clipping simulator has the potential to improve learning experiences in surgical environment. 3D printing and elastomeric casting can produce patient-derived models for a dynamic learning environment that add value to surgical training and preparation.
authors.affiliation: School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA; Cardiac 3D Print Lab, Phoenix Children's Hospital, Phoenix, Arizona, USA. Electronic address: jrryan@asu.edu.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Ryan
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
authors.forename: Kaith K
authors.initials: KK
authors.lastname: Almefty
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Nakaji
authors.affiliation: School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA; Cardiac 3D Print Lab, Phoenix Children's Hospital, Phoenix, Arizona, USA; School of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, Arizona, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Frakes
mesh_terms: D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery*; D008953:Models, Anatomic; D009493:Neurosurgery / Q000193:education*; D066230:Patient-Specific Modeling; D066330:Printing, Three-Dimensional; D012828:Silicones / Q000737:chemistry; D014656:Vascular Surgical Procedures / Q000379:methods
chemical_list: D012828:Silicones
keywords: 3D printing; Anatomical modeling; Aneurysms; Surgical simulation