Dartmouth Engineer - The Magazine of Thayer School of EngineeringDartmouth Engineer - The Magazine of Thayer School of Engineering

3D-Printed Organs Help Surgeons-in-Training

By Anna Fiorentino
January 2017 • CoolStuff

Imagine a surgeon performing a delicate prostate procedure using 18" robotic arms with tiny forceps that enter the abdomen through several 1 cm openings. This tricky minimally-invasive procedure just became easier to master with a creation by Dartmouth engineering professor Ryan Halter and his team: a 3D-printed model of part of the pelvic anatomy for surgeons-in-training.

Enabling surgical residents to first practice this surgery on models of the prostate and its surrounding anatomy is especially important because of how difficult it can be to sew the bladder neck to the distal urethra after prostate removal. If done incorrectly, this part of the surgery, called anastomosis, can cause incontinence.

"There is typically a significant learning curve associated with becoming proficient at implementing a reliable anastomosis," says Professor Halter. "The huge benefit of this is that training can be accomplished on devices instead of on patients. Once the resident starts performing on patients during live surgery, they will have already developed a level of competence that will enable them to create a more effective anastomosis."

model anastomosis
Silicone models of the bladder neck and distal urethra.

This work began in the summer of 2015 when Dartmouth-Hitchcock's Dr. Elias Hyams approached Halter about designing a device for residents to learn anastomosis technique during robot-assisted laparoscopic prostatectomy. Engineering PhD student Xiaotian "Dennis" Wu Th'14 designed and fabricated 3D-printed molds to make silicone models of the bladder neck and distal urethra. Ten junior surgeons were recruited to help test and refine the models during the development and evaluation phase.

"This solution provides a safe and easily repeatable approach to training," says Halter.

Before now, most training occurred in virtual simulators, cadavers, and live patients. The 3D models allow new surgeons and students to practice anastomosis indefinitely while accurately portraying the surgical situation. Additionally, the device will enable surgeons to practice the procedure on less common, complex anatomies.

"This way, if a complex case presents itself, the surgeon will have been exposed to a similar anatomy, at least in a simulated sense," says Halter.

Halter's device was funded in part by an Intuitive Surgical training grant received by Hyams.

Tags: design, engineering in medicine, faculty, research, students

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