LAUSR

Surgical proficiency is classically acquired through live experience in the operating room. Trainee exposure to cases and complex pathologies is highly variable between training programs1. Currently, there is not a standard for neurosurgical skill assessment for specific operative techniques for trainees. Cadaveric simulation has been utilized to demonstrate surgical technique as well as assess resident skill, but often presents a significant financial and facility burden2-4. Three-dimensional (3D) printing is an alternative to cadaveric tissue in providing high quality representation of surgical anatomy, however this technology has significant limitations in replicating conductive soft tissue structures for the use of cauterization devices and haptic learning for proper tissue manipulation5-7. Our team has combined novel synthesis methods of conductive thermoplastic polymerization and 3D printed cervical spine models to produce a layered biomimetic simulation that provides cost-effective and anatomically accurate education for neurosurgical trainees. This is accomplished through virtual modeling, and layered simulator construction methods by placing the individual polymer layers according to anatomical location of the simulated in-vivo structures. The consistency of the thermoplastics can be tailored according to the desired soft tissue structures (skin, fat, fascia, muscle) according to the degree of polymerization. This cost-effective simulation was designed to represent the material and biomechanical properties of the cervical spine cortico-cancellous interface as well as individual soft tissue components with specific anatomic details of muscle tendinous and ligamentous insertion. These features allow for representative start-to-finish surgical simulation that have not yet been made widely available to neurosurgical training programs.