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Program Number: B070
Session Name: Poster Session

Resident-Led Virtual Surgical Planning and 3D Printing Training Program: A Pilot Study Evaluating Feasibility and Educational Impact

Daron B Harrison; Travis J Clarke; Aaron L Zebolsky; Anas A Eid; John P Gleysteen; C. Burton Wood; University of Tennessee Health Science Center

Importance Virtual surgical planning (VSP) is the gold standard for planning mandibular reconstruction with microvascular grafts in otolaryngology. Complex defects, often resulting from the resection of tumors, trauma, or osteonecrosis of the jaw, lead to functional impairments and adversely impact health-related quality of life. Functional and aesthetic reconstruction is, therefore, a critical component of surgical planning. VSP, while effective, is often cost-prohibitive and inaccessible for underinsured populations. In response to these challenges, our department developed a resident-led VSP and 3D printing training program using freely available open-source software to improve access to care while simultaneously promoting surgical education.

Objectives This study aims to evaluate the feasibility and educational impact of a resident-led VSP and 3D printing training program. We sought to assess whether otolaryngology residents could effectively learn and apply VSP and 3D printing techniques using open-source tools and an in-house stereolithography 3D printer. Additionally, we aimed to evaluate a single department’s capacity to successfully implement this program.

Design, Setting, and Participants A cohort of 9 otolaryngology residents participated in the training program. The curriculum consisted of structured hands-on learning modules including image acquisition, image processing and 3D data conversion, creation of mandible and fibula cuts, and 3D printing for surgical guide fabrication. The program was designed as two instructor-led sessions spaced two months apart, with hands-on follow-along exercises. Participants were also given a comprehensive training manual developed by the department for independent study.

Pre-training assessments were conducted to evaluate the residents’ knowledge and confidence regarding VSP and 3D printing using written tests and Likert scale confidence surveys. A final group-based practical exam will require residents to collaboratively produce a VSP plan, 3D models, and surgical guides for a simulated patient case.

Main Outcomes and Results A total of 9 residents (2 PGY2s, 2 PGY3s, 3 PGY4s, 2 PGY5s) participated in this study. Pre-course assessment test results demonstrated an average score of 63.8%, while the confidence survey revealed that all 9 residents rated their baseline confidence as “not confident” (1/5 on a Likert scale) in their ability to apply Virtual Surgical Planning (VSP) and 3D printing techniques using open-source tools. Following the first hands-on instructional course, which focused on image acquisition, image processing, and 3D data conversion, all 9 residents were able to master the key concepts, successfully creating ready-to-print 3D anatomical models from patient imaging studies with a high level of accuracy and completeness (Figures 1 and 2). The second part of the course will be held prior to the meeting, and post-training assessment results will be analyzed and compared to baseline pre-assessments.

Conclusions and Relevance This resident-led VSP and 3D printing training program improved otolaryngology residents’ surgical planning skills and simultaneously produced a means for improving healthcare accessibility for underserved populations given the utilization of open-source software. Future research will evaluate the clinical impact of these planning methods and compare the cost-effectiveness of these techniques to those of third-party vendors.

Figure 1. Segmented mandible and fibula from patient’s CT scan.

 

Figure 2. 3D printed mandible from patient’s CT.

 

 

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