A Low-Cost Device for Teaching Surgical Techniques and Evaluating Technology in Minimally Invasive Surgery.

Minimally invasive surgery (MIS) spans multiple surgical disciplines and offers multiple benefits. Widespread adoption of MIS techniques has been hindered in part by technical challenges from steep learning curves and limited options for low-cost training for surgeons. This technical report describes the design and utility of a 3-D printed MIS simulator as a platform for acquiring skills in MIS techniques, as illustrated by the demonstration and comparison of multiple endoscopic dural repair techniques. The MIS simulator was constructed from 3-D printed and commercially available components, which provided the following attributes: (1) video perspective of the surgical target equivalent to endoscopic visualization; (2) variable access parameters, including portal size and angle of approach; and (3) adaptable surgical target to simulate the anatomy and physical characteristics of a particular surgical scenario. The estimated cost for the simulator was in the range of $200 to $300. The simulator was used to acquire technical skills and compare alternative techniques for MIS endoscopic durotomy repair. It allowed a comparison of different MIS techniques and demonstrated operator competency. The MIS simulator provides a portable, low-cost model for teaching MIS techniques by emulating the technical, anatomical, and physical characteristics of a common MIS encounter. The simulator can be readily modified to include multiple MIS settings and can be used for both training and technical development of instrumentation or novel surgical approaches. Due to its low cost and portability, the simulator is well-suited for care environments where limited tools and materials are available.