The extremely realistic model they have developed is essentially a 3D-printed object that can be used to simulate the surgical removal of the gland.
In a few professions, such as pilots, simulators offer an initial experience to students before being their skills are "unleashed" on people. But nothing comes close so far to such a possibility in surgery, not to mention urology.
This is indeed surprising because the success and after-effects of prostate surgery are still very much linked to the experience of the respective surgeon. Patients may survive their prostate cancer but could suffer for the rest of their lives from the consequences of such an operation, which may include incontinence and erectile dysfunction.
Optimized and standardized training is needed to ensure a common foundation of skills across physicians. Operation results must also be quantitatively measurable in any training simulator and thus comparable for the individual surgeons.
For this reason, researchers at the Max Planck Institute for Intelligent Systems and the University of Stuttgart have further developed a first organ model that enables surgeons to experience a realistic simulation of a prostate transurethral resection. The dummy prostate consists of materials that behave like real tissue.
In an initial practical test at the University Hospital of Freiburg’ Urology Department, the surgical results achieved with the model prostate gland could be clearly visualized by the individual surgeons. Thanks to this possibility, surgeons can be provided with much more accurate training feedback immediately after the simulated intervention.
Almost 8 out of 10 men develop benign prostate hyperplasia (BPH) within their lifetime, which can or must be treated surgically, depending on the size and symptoms. The most common way to treat it is with transurethral resection of the prostate (TURP).
TURP is a surgical procedure in which the prostate is resected completely or partially via the urethra. The operation usually requires a rigid endoscope, which is guided via the patient's urethra directly to the site of the procedure.
A high-frequency electrical loop then enables the surgeon to cut off the tissue and at the same time to manage the incisions. The main purpose of this procedure is to "peel out" the inside of the prostate while preserving the peripheral zone. Experienced surgeons feel the transition from the inner to the outer zone, as the tactile feedback of the endoscope changes. However, in order to be able to feel this fine tissue difference in a reliable way, countless hours of practice are required, which physicians have so far only been able to undergo directly on the patient, in the operating room.
However, the newly developed dummy prostate now helps to gain valuable experience without a patient. The model is a 1:1 3D print that realistically simulates the gland, including its internal structures. For this purpose, the dummy prostate is made of special biomimetic materials. Altogether, the dummy prostate provides natural textures and a realistic appearance, as well as ensuring a lifelike interaction with the surgical instruments.
Choi E et al., A High-Fidelity Phantom for the Simulation and Quantitative Evaluation of Transurethral Resection of the Prostate. Annals Biomedical Engineering 2019; https://doi.org/10.1007/s10439-019-02361-7