Design and validation of a 3D-printed simulator for endoscopic third ventriculostomy

  • Junhao Zhu
  • Jin Yang
  • Chao Tang
  • Zixiang Cong
  • Xiangming Cai
  • Chiyuan MaEmail author
Original Article



Simulation-based training has been considered as the most promising curriculum for neurosurgical education to finally improve surgical skills with the greatest efficiency and safety. However, most of the simulators including physical models and virtual reality systems are relatively expensive, which limits their promotion. In this study, the authors tried to develop a realistic, low-cost, and reusable simulator for endoscopic third ventriculostomy (ETV) and evaluate its validity.


A 3D-printed rigid skull with the ventricular system originated from a de-identified patient with obstructive hydrocephalus was constructed. The third ventricular floor was designed as a replaceable module. Thirty-nine neurosurgeons tested the simulator and a rating system was established to assess their performance. All participants filled out questionnaires to evaluate the simulator after training. Five neurosurgical students were recruited to finish the whole training for ten times in order to explore the learning curve of ETV.


We found that (1) the more experienced surgeons performed obviously better than the rather inexperienced surgeons which verified that our model could reflect the ability of the trainees; (2) as the training progressed, the scores of the post-graduates increased and the fifth training average score was obviously higher than their first training average score. The feedback questionnaires showed the average scores for value of the simulator as a training tool and global rating were 3.15 and 3.54 (on a 4-point scale).


Our model was practical for ETV training. The results of our program showed that our model could precisely reflect the operators’ ability to perform ETV and could make it more efficient to master basic skills.


Simulator Third ventriculostomy Endoscopy 



We thank the teaching and research section of anatomy, Nanjing University, for technical support and equipment assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Junhao Zhu
    • 1
    • 2
  • Jin Yang
    • 1
    • 2
  • Chao Tang
    • 2
  • Zixiang Cong
    • 2
  • Xiangming Cai
    • 3
  • Chiyuan Ma
    • 1
    • 2
    Email author
  1. 1.School of MedicineNanjing Medical UniversityNanjingChina
  2. 2.Department of Neurosurgery, Jinling Hospital, School of MedicineNanjing UniversityNanjingChina
  3. 3.School of medicineSoutheast UniversityNanjingChina

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