Acta Cirúrgica Brasileira

Sumário Anterior Atual Seguinte

Technical Skill • Acta Bras Cir 41 • 2026 • https://doi.org/10.1590/acb413826 linkcopy

Development and preliminary evaluation of a camera-assisted endovascular simulator using a three-dimensional printing

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose: This study described the development and preliminary evaluation of a simulator that combines a three-dimensional-printed vascular model with a camera-assisted system for training basic endovascular skills.

Methods: A hollow mannequin torso housed a transparent, three-dimensional-printed aorta. Guidewire and catheter manipulation were visualized in real time using a manually controlled camera. Fifteen medical students (novices) and five vascular surgeons (experts) performed simulated tasks in two sessions. Experts also assessed realism and educational value.

Results: Novices demonstrated shorter completion times across all exercises in session 2, particularly in exercise 4, with mean time decreasing from 229.3 ± 134.8 to 83.5 ± 31.1 seconds, a mean difference of 145.8 seconds (p = 0.001). Experts showed no significant improvement in most tasks, although exercise 3 improved from 115.4 ± 29.7 to 91.6 ± 21.5 seconds, a mean difference of 23.8 seconds (p = 0.012). Performance differed between groups (construct validity). Surgeons provided favorable ratings for the realism and usefulness (face and content validity).

Conclusion: This preliminary device appears feasible and may facilitate early skill acquisition in low-resource educational settings without radiation exposure.

Key words
Endovascular Procedures; Radiology, Interventional; Simulation Training; Patient Simulation

	Novice group (n = 15)	Expert group (n = 5)
Age, years	23 ± 3	34 ± 2
Previous contact with endovascular simulator
No	15 (100)	0 (0)
Yes	0 (0)	5 (100)
Complete years of endovascular practice**
0–2	-	0 (0)
3–4	-	2 (40)
5–6	-	1 (20)
7 or more	-	2 (40)
Current year in medical school ^†
Second	3 (20)	-
Third	6 (40)	-
Fourth	4 (26.7)	-
Fifth	2 (13.3)	-
Previous graduation ^†
No	13 (86.7)	-
Yes	2 (13.3)	-
Interest in surgical residency ^†
No	0 (0)	-
Yes	15 (100)	-

	Novice group (n = 15)	Expert group (n = 5)	Difference of means (s)	95%CI of difference (s)*	p -value
Session 1 (seconds)
Exercise 1	44 ± 15.8	22.2 ± 6.3	21.8	6.3–37.3	0.008
Exercise 2	318.3 ± 104.2	64.6 ± 15.6	253.7	153.6–353.7	< 0.001
Exercise 3	339.9 ± 79.1	115.4 ± 29.7	224.5	147.3–301.6	< 0.001
Exercise 4	229.3 ± 134.8	37.8 ± 21.3	191.5	62.1–320.9	0.006
Exercise 5	269.9 ± 55.7	87 ± 24.6	182.9	128.2–237.7	< 0.001
Session 2 (seconds)
Exercise 1	21.7 ± 7.7	16 ± 5.4	5.7	−2.1–13.6	0.143
Exercise 2	142 ± 43.8	54 ± 16.1	88.0	45.3–130.7	< 0.001
Exercise 3	222.7 ± 70.1	91.6 ± 21.5	131.1	63.1–199.1	0.001
Exercise 4	83.5 ± 31.1	45.2 ± 37	38.3	3.0–73.5	0.035
Exercise 5	190.8 ± 64.3	85.2 ± 16.4	105.6	43.5–167.7	0.002

Execution time	Novice group (n = 15)		Difference of means (s)	95%CI of difference (s)*	p -value
Execution time	Session 1 (s)	Session 2 (s)	Difference of means (s)	95%CI of difference (s)*	p -value
Exercise 1	44 ± 15.8	21.7 ± 7.7	22.3	14.3–30.3	< 0.001
Exercise 2	318.3 ± 104.2	142 ± 43.8	176.3	129.1–223.5	< 0.001
Exercise 3	339.9 ± 79.1	222.7 ± 70.1	117.2	72.7–161.7	< 0.001
Exercise 4	229.3 ± 134.8	83.5 ± 31.1	145.8	73.8–218.0	0.001
Exercise 5	269.9 ± 55.7	190.8 ± 64.3	79.1	42.5–115.8	< 0.001
Execution time	Expert group (n = 5)		Difference of means (s)	95%CI of difference (s)*	p -value
Execution time	Session 1 (s)	Session 2 (s)	Difference of means (s)	95%CI of difference (s)*	p -value
Exercise 1	22.2 ± 6.3	16 ± 5.4	6.2	-0.8–13.2	0.070
Exercise 2	64.6 ± 15.6	54 ± 16.1	10.6	-16.4–37.6	0.337
Exercise 3	115.4 ± 29.7	91.6 ± 21.5	23.8	8.8–38.8	0.012
Exercise 4	37.8 ± 21.3	45.2 ± 37	-7.4	-55.2–40.4	0.689
Exercise 5	87 ± 24.6	85.2 ± 16.4	1.8	-37.2–40.8	0.904

Training tool usefulness (content)*	Median score (range)
This simulator is suitable for training basic endovascular skills	5 (4–5)
My training during residency would have been optimized using this device	5 (4–5)
I performed all tasks without technical limitations related to the device’s structure	5 (5–5)
Time reserved to perform those exercises is compatible with most vascular training programs	5 (4–5)
I consider that skills improved using this simulator might be transferred to real life scenarios	5 (5–5)
User realism (face)†
General configuration	8 (8–10)
Projected image	8 (8–10)
Exercises performed	10 (9–10)
Guidewires and catheters manipulation	10 (9–10)

location_on

Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia https://actacirbras.com.br/ - São Paulo - SP - Brazil
E-mail: actacirbras@gmail.com

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Reportar erro