Development and Evaluation of 3D-Printed Models of Human Tracheobronchial System for Training in Flexible Bronchoscopy

Objective: To develop a 3D-printed model of human tracheobronchial system for assessment and training of cardiothoracic residents in flexible bronchoscopy.

Methods: A dedicated 3D-imaging/engineering software (Mimics Innovation Suite, Materialise) was used to extract the tracheobronchial system from representative CT-datasets of the chest and to subsequently generate a hollow 3D-model which then was printed on an Ultimaker II 3D-printer in PLA and mounted on a stand. In a group of 10 residents the time for bronchoscopy of given ostia using a monitor-equipped flexible bronchoscope (aScope3/aView, Ambu) was measured before and after training. Furthermore, time for retrieval of foreign body from tracheobronchial system was measured before and after training.

Results: Three different 3D-printed models of human tracheobronchial system were generated from representative CT-datasets of the chest. The time for intubation of given ostia (Model 1) at initial assessment varied from 19 to 123 second. Then, the participants were allowed a training period of 15 minute (Model 2). Subsequently, intubation of given ostia was repeated in a different model (Model 3) and ranged from 15 to 19 second documenting a highly significant improvement (p < 0.0001). In addition, identification and retrieval of an artificially placed foreign body in the tracheobronchial system (peanut) showed a significant reduction (p=.006) of bronchoscopy time after training. The study participants uniformly confirmed the value of the training for their performance in patient bronchoscopy.

Conclusion: Representative and realistic models of human tracheobronchial system can be generated using 3D-engineering software and 3D-printing technology. With this models, assessment and training of cardiothoracic residents in flexible bronchoscopy can be performed safely with subsequent significant improvement of handling capability.

No conflict of interest has been declared by the author(s).