Can high-fidelity 3D models be a good alternative for cadaveric materials in skill assessment for endoscopic sinus surgery? A comparison study in assessment for surgical performance in 3D models and cadavers

Masanobu Suzuki; Ryosuke Watanabe; Akira Nakazono; Yuji Nakamaru; Takayoshi Suzuki; Shogo Kimura; Kotaro Matoba; Manabu Murakami; Dominik Hinder; A J Psaltis; Akihiro Homma; P J Wormald

doi:10.3389/fmed.2024.1301511

Can high-fidelity 3D models be a good alternative for cadaveric materials in skill assessment for endoscopic sinus surgery? A comparison study in assessment for surgical performance in 3D models and cadavers

Front Med (Lausanne). 2024 Oct 17:11:1301511. doi: 10.3389/fmed.2024.1301511. eCollection 2024.

Authors

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
² Department of Forensic Medicine, Faculty of Medicine and Graduate School of Medicine Hokkaido University, Sapporo, Japan.
³ Center for Medical Education and International Relations, Hokkaido University, Sapporo, Japan.
⁴ Department of Surgery-Otorhinolaryngology Head and Neck Surgery, Central Adelaide Local Health Network and the University of Adelaide, Adelaide, SA, Australia.

Abstract

Introduction: Traditionally formal assessment of surgical skills has not been part of a surgeon's accreditation process. The widely adopted apprentice model of "on-the-job training" does create additional risk for the patients. In the past surgical training has used cadavers, but these are expensive, require dedicated wet-lab facilities and are in increasingly short supply. In many countries religious and cultural practices also preclude cadaveric use. Recent 3D-printed technology allows mass reproduction of high-fidelity 3D models. In this study, we examined the utility of 3D sinus models compared to cadaver dissection for surgical skill assessment for endoscopic sinus surgery (ESS).

Materials and methods: A total of 17 otolaryngologists performed Endoscopic Sinus Surgery (ESS) on 3D printed sinus models and then repeated these procedures on cadavers. Their surgical performance was assessed with the Objective Structured Assessment of Technical Skills (OSATS) score for ESS and time was taken to complete an ESS procedure. Their performance on the 3D models and cadavers was compared.

Results: There were no significant differences in the OSATS score between 3D models and cadavers (50.41 ± 13.31 vs. 48.29 ± 16.01, p = 0.36). There was a strong positive correlation between the score in 3D models and those in cadavers (r = 0.84, p < 0.001). No significant differences were found in time for a mini-ESS (21:29 ± 0:10 vs. 20:33 ± 0:07, p = 0.53). There were positive correlations between 3D models and cadavers in time taken for a mini-ESS (r = 0.55, p = 0.04).

Conclusion: The surgical performance on the 3D models was comparable to that on cadavers. This supports the utility of the 3D models as an inexhaustible alternative for cadavers in ESS surgical skill assessment.

Keywords: 3D printer; cadaver surgery; endoscopic surgery; surgical education; surgical training.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was partially supported by JSPS Grant-in-Aid for Scientific Research JP18H04102, 22K16923, and 22K10599.