Ultra Low-cost, Homemade, Reusable Tumor Resection Model with Realistic Haptic Feedback and Photo-based Navigation for Neurosurgical Training

Introduction: Cost-effective and accessible simulators are increasingly used in surgical training, particularly for developing microscopic skills. Essential attributes include low cost, accessibility, reusability, and realism. Haptic feedback, crucial for effective neurosurgical training, enhances tissue simulation's realism.
This study aimed to design a cost-effective, reusable brain tumor dissection model with haptic feedback similar to brain parenchyma for neurosurgical residents and medical students.

Methods: Slime was used as a parenchymal analog, with phosphorus-mixed slime representing tumor tissue, and stretch film as the arachnoid mater. Haptic feedback was measured using a 0.01N precision dynamometer, sheep brain, and calibration weights.
Shaving foam enhanced the slime’s tissue-like consistency. The prepared slime was wrapped in stretch film and placed in glass containers. The frontal region of the sheep brain (3x3x4 cm) was sectioned and positioned similarly. A syringe, punctured and suspended with silk suture. Measurements were conducted on both sheep brain and model. distal end of syringe was placed on tissue/models, ensuring no gaps. Sequentially, 12g-14g-15g-19g-20g, 35g-39g-40g-50g- 60g weights were placed into syringe, and values read from dynamometer were recorded for both models.

For tumor creation, 30cc of slime mixed with 15g phosphorus powder was placed on a 270cc slime base. The model was marked to indicate the tumor side and photographed in the dark for photo-assisted navigation. Trainee was shown model and photographs, and instructions were provided on how to perform resection. Trainees practiced resection using the model, with extracted tissue volume and tumor proportion recorded, followed by a 20-question survey.

Results: Mann-Whitney U tests showed no significant difference in force responses between the "Brain" and "Model" (p > 0.05). Reliability was assessed using Cronbach’s Alpha: Detection Skill (0.66), Resection Skill (-0.08), Orientation Skill (0.86), and Overall Satisfaction (0.73). Material costs:Slime (500g)-$5.83, shaving foam(200ml) -$2.68, phosphorus powder(100g) - $11.40, plastic wrap- $0.96, plastic box-$1.52, totaling $22.39.

Conclusion : Results showed that the model provided haptic feedback at low cost and user satisfaction. The model's adaptability allows for tumor-specific resection and diversified anatomical training for various pathologies.