Development and Implementation of an Inexpensive, Easily Producible, Time Efficient External Ventricular Drain Simulator Using 3-Dimensional Printing and Image Registration

Oper Neurosurg (Hagerstown). 2019 Apr 1;16(4):496-502. doi: 10.1093/ons/opy142.

Abstract

Background: External ventricular drain (EVD) placement is one of the most commonly performed procedures in neurosurgery, frequently by the junior neurosurgery resident. Simulators for EVD placement are often costly, time-intensive to create, and complicated to set up.

Objective: To describe creation of a simulator that is inexpensive, time-efficient, and simple to set up.

Methods: This simulator involves printing a hollow head using a desktop 3-dimensional (3D) printer. This head is registered to a commercially available image-guidance system. A total of 11 participants volunteered for this simulation module. EVD placement was assessed at baseline, after verbal teaching, and after live 3D view instruction.

Results: Accurate placement of an EVD on the right side at the foramen of Monro or the frontal horn of the lateral ventricle increased from 44% to 98% with training. Similarly, accurate placement on the left increased from 42% to 85% with training.

Conclusion: During participation in the simulation, accurate placement of EVDs increased significantly. All participants believed that they had a better understanding of ventricular anatomy and that this module would be useful as a teaching tool for neurosurgery interns.

Keywords: 3D printing; External ventricular drain; Image registration; Simulation.

MeSH terms

  • Clinical Competence* / economics
  • Clinical Competence* / standards
  • Cost-Benefit Analysis / methods*
  • Cost-Benefit Analysis / standards
  • Drainage / economics
  • Drainage / methods*
  • Drainage / standards
  • Humans
  • Imaging, Three-Dimensional / economics
  • Imaging, Three-Dimensional / methods*
  • Imaging, Three-Dimensional / standards
  • Internship and Residency / economics
  • Internship and Residency / methods
  • Internship and Residency / standards
  • Neurosurgical Procedures / economics
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / standards
  • Printing, Three-Dimensional* / economics
  • Printing, Three-Dimensional* / standards
  • Time Factors
  • Tomography, X-Ray Computed / economics
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / standards