Integrating 3D Printing in Surgical Teaching: A Novel, Low-Cost Method for Prospective Cardiac Surgeons

Objectives: Recruitment of (prospective) residents in cardiac surgery has become increasingly challenging. Applying innovative, low-cost, and easily accessible models for surgical training is another burden for many teaching hospitals. As 3D printing is an established tool for additional preoperative planning at our department, we developed a wet lab equivalent for surgical aortic valve replacement (SAVR) using 3D-printed aortic valves and a self-made training concept. To evaluate a low-cost and easily reproducible model was the aim of our study.

Methods: Materials needed for constructing the heart of the simulator include a sharps container, two knitting needles, a small rope, water-resistant superglue, surgical tools, and adequate suture material. Pigs’ hearts were obtained from a local butcher. Small valve models were printed in different sizes ranging from 19 to 25 mm using the 3DGence Industry F340 3D printer. After lid removal of the sharps container, four opposing holes were drilled allowing positioning of the pig’s heart for SAVR. The surrounding suture ring of the valve is reconstructed by the use of rope materials and attached by superglue. Performance of students has been evaluated by a senior cardiac surgeon.

Results: 3D-printed valves were easily integrated in our surgical training model. The printing cost for a single heart valve was less than 1¢. Most parts of our model are reusable. Every participant could gain first surgical experience in SAVR. Neither experienced participants nor senior cardiac surgeons reported disadvantages of our model compared to conventional/ industrial models. The importance of practice in surgery was highlighted. Due to its practicability, our model has been integrated into the courses of the university.

Conclusion: Our self-made, low-cost wet lab equivalent is an easy and reproducible method, which can be integrated in surgical training of (prospective) residents. It overcomes the financial and logistic burden of current, industry-dependent models and motivates students to start their career path in cardiac surgery.