手術可能な精密モデルとその応用

自己評価から遠隔指導まで

抄録

This paper reviews precise, dissectable, and inanimate patient models (simulators) for surgical skill training, mainly in minimally invasive surgery. Currently, such models have been developed for thoracoscopic surgery, endoscopic sinus surgery (ESS), arthroscopy, laparoscopy, temporal bone surgery, neurovascular intervention, and even for off-pump coronary artery bypass grafting on a beating heart. Many of them extract precise shape data from actual patient CT/MRI images and fabricate a tangible object utilizing rapid prototyping or three-dimensional printing technology with carefully chosen materials that give haptic feedback similar to live tissues in resection. Sharing many underlying technologies, such patient models surpass virtual reality simulators in reality of “look and feel” in operation, cost performance, and acceptance of wide variety of clinical instruments. A training system using real patient models for ESS that enables self-learning and remote teaching using a metaphor of a mirror is also introduced.