Jorge Sanz-Guerrero Cosulich is a visiting researcher involved in the creation and manufacturing of medical simulation devices. These devices allow medical students to learn difficult procedures, and sharpen and maintain existing skills, without using expensive cadavers or worse, a real patient. Cosulich has developed simulations for procedures in radiology, neurosurgery, urology, and cardiology using technology at the UM3D Lab. Mimics creates accurate anatomical models from real patient data, and the quick print of the bone structure is taken to consult with surgeons as to how the simulator should develop. The design is modeled in SolidWorks, refined in Magics, and then printed using Rapid Prototyping to form the first simulation model that students practice on.
One of the first simulators was for a femoral artery procedure, in which the surgeon must thread a guidewire and catheter toward the heart. This device was developed through collaboration between cardiology and catheterization units at the University of Michigan, Henry Ford, Belmont, St. John’s hospital systems, and will be distributed to 1-8 more hospitals in the next year.
For neurosurgery, the team has developed devices for three different procedures. The endonasal procedure removes a brain tumor on the front of one’s brain by going through the nose to drill the skull bone and remove the tumor. The device to simulate this procedure is a skull base printed in ABS plastic, with an insert printed in plaster with an apoxy resin that replicates the feel of bone remarkably well. A silicon mask overlays the skull to mimic the sensation of threading a needle up the nose. The second neurosurgical device is for a ventriculostomy—a procedure that requires the surgeon poke through the brain to drain the fluid that gathers in the ventriculous. A real brain, solidified with a chemical solution, was scanned with the 3D laser scanner to create a mould for the jelly brain in the simulation. Finally, the minimally invasive spinal surgery simulator allows students to practice removing a herniated spinal disk. Heavy strain on the back can put an intervertebral disk under extreme pressure, pinching the nerves next to it. The procedure to remedy this requires drilling into the spine, through the vertebra and root nerve, to expose the herniated disk. The surgeon then removes what is compressing the nerve.
The procedures for radiology require inserting a needle, similar to the femoral artery procedure, to then drain fluid retained in the form of yeast or abscess. This particular simulator is an entire torso, and allows teachers or students to put the abscess anywhere in the body, training different techniques and procedures.
These devices provide a safe alternative for medical students to learn through trial and error, and would not have been possible without the prototyping services at the 3D lab. Specific measurements were modeled with 3D scanning, real patient data was converted into models with Mimics, bone structure and customized parts for the devices were printed using Rapid Prototyping. Cosulich says without this technology, his work would have been impossible. “If we had to machine all those molds, it’s simply impossible. I know people that carve that are artists, that could make it in one month.” While big companies can hire artists and make finely detailed moulds and iterations, and afford to wait, research at this level would be impossible to do without affordable and efficient 3D technology.
By Josephine Keenan