Creating Biofidelic Phantom Anatomies of the Colorectal Region for Innovations in Colorectal Surgery

Abstract

The aim of this research was to develop a replicated colorectal region for use in laparoscopic instrument innovation.Testing of both surgical skills and laparoscopic surgical instruments takes place in a controlled lab setting. Cadaverous tissue or laparoscopic simulators are the tools of choice for skill testing.However, in the instance of colorectal surgery, porcine intestines remain the gold standard for laparoscopic testing(Lamata et al. 2004). There exists data in current literature which discuss the use of anatomical simulators (also known as simulator boxes) for both researching surgical methods, and testing laparoscopic instruments. There is little focus in the literature on the materials used to create surrogate environments which mimic those of the real world. Simulator boxes exist, and are of high fidelity, but can be quite cumbersome, with some being left in storage areas indefinitely, with some remaining inaccessible for many centers around the world. There are also many peripheral devices which need to accompany these simulators, such as laparoscopes and external monitoring equipment for recording and review. As they are highly specialized pieces of research equipment, in the majority of cases, they are not designed to be portable or readily reconfigurable. These limitations make high end laparoscopic simulators inappropriate choices for early stage HFE (Human Factors Engineering) studies.The authors propose the creation of a laparoscopic simulator which contains anatomically accurate, 3D printed colorectal sections for use in both surgical training and instrument innovation. The colon is modeled from high quality CT data in DICOM format, using the Material Mimics Innovation Suite (Materialise, 2013). By creating virtual models of the internal anatomical structure of the colorectal region, it allows for a more accurate depiction of the anatomy encountered in a surgical setting. A maximum level of realism is required for a simulator to be effective(Lamata et al. 2004).The future application of this work lies in the validation of the 3D printed anatomy which will lead to innovation of new instruments or approaches to laparoscopic surgery.