Congenital heart defects (CHDs) are a group of structural abnormalities in the heart that are present at birth. The required surgical treatment to fix them can be extremely complex because of the pathological anatomy and the small size of the cardiovascular structures. For these reasons specific training like hands-on surgical training on physical simulators is necessary. Existing simulators are suboptimal as they have limitations in terms of materials and realism. The objective of this work is to design, prototype and test a physical simulator suitable for training in this field, exploiting the operative freedom of three-dimensional (3D) printing, with the aim of enhancing the solutions present in the literature. Qualitative cutting and suturing test executed by surgeons and quantitative uniaxial tensile test were carried out on standard samples of different materials to evaluate the most suitable material to replicate cardiac tissue, proving that silicone (Dragon Skin 20) has a general better behaviour compared to 3D-printed specific material (blend between VeroClear and Agilus30 Clear)(t-student test and ANOVA test have been used). A silicone heart was successfully produced with silicone molding with a new single-part printing process technique, which involves the use of a soluble material for the internal core of the mold and an external shell made by multiple parts. This allow to realize a silicone heart made in a single silicone piece. An innovative simulator environment was designed resembling the real dimensions and proportions of an infant's chest, having all the sufficient requirements to give the right information and competences to the attendee. Modular joints were designed to fix the heart and allow the simulator’s environment to accommodate various types of defects. Pilot test of the simulator involved inspection and performance of a surgeon's surgical action. Preliminary results showed that the proposed simulator has promising anatomical and functional characteristics to give a concrete help to the training process in this complex field.
I difetti cardiaci congeniti sono un gruppo di anomalie strutturali del cuore presenti alla nascita. Il trattamento chirurgico necessario per risolverli può essere estremamente complesso a causa dell'anatomia patologica e delle piccole dimensioni delle strutture cardiovascolari. Per questi motivi è necessaria una formazione specifica, che comprenda metodi di training pratici su simulatori fisici. I simulatori esistenti non sono ottimali in quanto presentano limitazioni nei materiali e nel realismo complessivo. L'obiettivo di questo lavoro è proporre un simulatore fisico adatto alla formazione in questo campo, sfruttando la libertà operativa della stampa tridimensionale (3D), con l'obiettivo di migliorare le soluzioni presenti in letteratura. Sono stati eseguiti test qualitativi di taglio e sutura con chirurghi e test quantitativi di trazione uniassiale su campioni standard di diversi materiali per valutare il materiale più adatto a replicare il tessuto cardiaco, dimostrando che il silicone (Dragon Skin 20) ha un comportamento generale migliore rispetto ad uno specifico materiale stampato in 3D (miscela tra VeroClear e Agilus30 Clear) (sono stati utilizzati il test t-student e il test ANOVA). Un cuore in silicone è stato prodotto con successo tramite stampaggio a iniezione con una tecnica finora non utilizzata in questo ambito. Questo processo prevede l'utilizzo di un materiale solubile per l'anima interna dello stampo e un guscio diviso in molteplici parti per la parte esterna, che permette di ottenere un cuore di silicone realizzato in un pezzo unico. È stato progettato un ambiente di simulazione innovativo basato sulle dimensioni e le proporzioni reali del torace di un neonato, avendo tutti i requisiti sufficienti per fornire le giuste informazioni e competenze al partecipante. I giunti modulari sono stati progettati per fissare il cuore e consentire all'ambiente del simulatore di adattarsi a vari tipi di difetti. Il simulatore è stato testato da un chirurgo tramite una simulazione di chirurgia. I risultati preliminari hanno mostrato che la soluzione proposta ha promettenti caratteristiche anatomiche e funzionali per dare un aiuto concreto al processo di formazione in questo complesso settore.
Feasibility of a novel simulator to train congenital heart defect repair
Marchini, Alessandro Maria
2022/2023
Abstract
Congenital heart defects (CHDs) are a group of structural abnormalities in the heart that are present at birth. The required surgical treatment to fix them can be extremely complex because of the pathological anatomy and the small size of the cardiovascular structures. For these reasons specific training like hands-on surgical training on physical simulators is necessary. Existing simulators are suboptimal as they have limitations in terms of materials and realism. The objective of this work is to design, prototype and test a physical simulator suitable for training in this field, exploiting the operative freedom of three-dimensional (3D) printing, with the aim of enhancing the solutions present in the literature. Qualitative cutting and suturing test executed by surgeons and quantitative uniaxial tensile test were carried out on standard samples of different materials to evaluate the most suitable material to replicate cardiac tissue, proving that silicone (Dragon Skin 20) has a general better behaviour compared to 3D-printed specific material (blend between VeroClear and Agilus30 Clear)(t-student test and ANOVA test have been used). A silicone heart was successfully produced with silicone molding with a new single-part printing process technique, which involves the use of a soluble material for the internal core of the mold and an external shell made by multiple parts. This allow to realize a silicone heart made in a single silicone piece. An innovative simulator environment was designed resembling the real dimensions and proportions of an infant's chest, having all the sufficient requirements to give the right information and competences to the attendee. Modular joints were designed to fix the heart and allow the simulator’s environment to accommodate various types of defects. Pilot test of the simulator involved inspection and performance of a surgeon's surgical action. Preliminary results showed that the proposed simulator has promising anatomical and functional characteristics to give a concrete help to the training process in this complex field.| File | Dimensione | Formato | |
|---|---|---|---|
|
2024_04_Marchini_ExecutiveSummary_02.pdf
accessibile in internet solo dagli utenti autorizzati
Descrizione: Executive summary
Dimensione
1.82 MB
Formato
Adobe PDF
|
1.82 MB | Adobe PDF | Visualizza/Apri |
|
2024_04_Marchini_Tesi_01.pdf
accessibile in internet solo dagli utenti autorizzati
Descrizione: Tesi
Dimensione
18.06 MB
Formato
Adobe PDF
|
18.06 MB | Adobe PDF | Visualizza/Apri |
I documenti in POLITesi sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
https://hdl.handle.net/10589/218424