title: 3D Printout Models vs. 3D-Rendered Images: Which Is Better for Preoperative Planning?
abstract: BACKGROUND
  Correct interpretation of a patient's anatomy and changes that occurs secondary to a disease process are crucial in the preoperative process to ensure optimal surgical treatment. In this study, we presented 3 different pancreatic cancer cases to surgical residents in the form of 3D-rendered images and 3D-printed models to investigate which modality resulted in the most appropriate preoperative plan.
  
  
  METHODS
  We selected 3 cases that would require significantly different preoperative plans based on key features identifiable in the preoperative computed tomography imaging. 3D volume rendering and 3D printing were performed respectively to create 2 different training ways. A total of 30, year 1 surgical residents were randomly divided into 2 groups. Besides traditional 2D computed tomography images, residents in group A (n = 15) reviewed 3D computer models, whereas in group B, residents (n = 15) reviewed 3D-printed models. Both groups subsequently completed an examination, designed in-house, to assess the appropriateness of their preoperative plan and provide a numerical score of the quality of the surgical plan.
  
  
  RESULTS
  Residents in group B showed significantly higher quality of the surgical plan scores compared with residents in group A (76.4 ± 10.5 vs. 66.5 ± 11.2, p = 0.018). This difference was due in large part to a significant difference in knowledge of key surgical steps (22.1 ± 2.9 vs. 17.4 ± 4.2, p = 0.004) between each group. All participants reported a high level of satisfaction with the exercise.
  
  
  CONCLUSIONS
  Results from this study support our hypothesis that 3D-printed models improve the quality of surgical trainee's preoperative plans.
authors: Department of Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors: Yi-xiong
authors: YX
authors: Zheng
authors: Department of Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors: Di-fei
authors: DF
authors: Yu
authors: Department of Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors: Jian-gang
authors: JG
authors: Zhao
authors: Department of Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China. Electronic address: zyx_xxn@126.com.
authors: Yu-lian
authors: YL
authors: Wu
authors: Department of Surgery, Surgical Simulation Research Lab, University of Alberta, Edmonton, Alberta, Canada.
authors: Bin
authors: B
authors: Zheng
mesh_terms: D004503:Education, Medical, Graduate; D013502:General Surgery / Q000193:education*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007396:Internship and Residency; D008953:Models, Anatomic; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010347:Patient Care Planning; D066330:Printing, Three-Dimensional; D014057:Tomography, X-Ray Computed
keywords: 3-dimensional printing; Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; preoperative planning; rendered image; simulation; surgical education