This project was funded by the Simulation Training Center (STC) at the University of California, San Diego School of Medicine in La Jolla, CA. We would like to thank Blake Freechtle for his contributions to Figure 5.

For this project, authors JR and PS volunteered as ultrasound subjects, and verbal consent was obtained from both. For those following this protocol, obtain approval from an ethics committee or institutional review board (IRB) prior to using patients or human volunteers as study subjects.
1. Phantom design and silicone mold creation
<ol>
	<li>Creation of a reference ultrasound image
	<ol>
		<li>For each ultrasound phantom, have a physician with ultrasound sub-specialization ...

Building Custom Ballistic Gel Ultrasound Phantoms for Nerve Block Simulations

<ol>
	<li>Hocking, G., Hebard, S., Mitchell, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+review+of+the+benefits+and+pitfalls+of+phantoms+in+ultrasound-guided+regional+anesthesia.">A review of the benefits and pitfalls of phantoms in ultrasound-guided regional anesthesia.</a> Reg Anesth Pain Med. 36 (2), 162-170 (2011).</li><li>Culjat, M. O., Goldenberg, D., Tewari, P., Singh, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+review+of+tissue+substitutes+for+ultrasound+imaging.">A review of tissue substitutes for ultrasound imaging.</a> Ultrasound Med Biol. 36 (6), 861-873 (2010).</li><li>Grottke, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Virtual+reality-based+simulator+for+training+in+regional+anaesthesia.">Virtual reality-based simulator for training in regional anaesthesia.</a> Br J Anaesth. 103 (4), 594-600 (2009).</li><li>. Regional anesthesia ultrasound training block Available from: <a target="_blank" href="https://medicalskillstrainers.cae.com/regional-anesthesia-ultrasound-training-block/p">https://medicalskillstrainers.cae.com/regional-anesthesia-ultrasound-training-block/p</a> (2023)</li><li>CAE Healthcare. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Gen II femoral vascular access &amp; regional anesthesia ultrasound training model. , (2023).</li><li>Osmer, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+gelatine-based+ultrasound+phantom.">A gelatine-based ultrasound phantom.</a> Anaesthesia. 63 (1), 107 (2008).</li><li>Nicholson, R. A., Crofton, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Training+phantom+for+ultrasound+guided+biopsy.">Training phantom for ultrasound guided biopsy.</a> Br J Radiol. 70, 192-194 (1997).</li><li>Bude, R. O., Adler, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+easily+made,+low-cost,+tissue-like+ultrasound+phantom+material.">An easily made, low-cost, tissue-like ultrasound phantom material.</a> J Clin Ultrasound. 23 (4), 271-273 (1995).</li><li>Patel, A. S., Harrington, T. J., Saunt, K. S., Jones, W. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Construction+of+an+ultrasound+biopsy+phantom.">Construction of an ultrasound biopsy phantom.</a> Australas Radiol. 40 (2), 185-186 (1996).</li><li>Culp, W. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Relative+ultrasonographic+echogenicity+of+standard,+dimpled,+and+polymeric-coated+needles.">Relative ultrasonographic echogenicity of standard, dimpled, and polymeric-coated needles.</a> J Vasc Interv Radiol. 11 (3), 351-358 (2000).</li><li>Morehouse, H., Thaker, H. P., Persaud, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Addition+of+Metamucil+to+gelatin+for+a+realistic+breast+biopsy+phantom.">Addition of Metamucil to gelatin for a realistic breast biopsy phantom.</a> J Ultrasound Med. 26 (8), 1123-1126 (2007).</li><li>Phal, P. M., Brooks, D. M., Wolfe, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sonographically+guided+biopsy+of+focal+lesions:+a+comparison+of+freehand+and+probe-guided+techniques+using+a+phantom.">Sonographically guided biopsy of focal lesions: a comparison of freehand and probe-guided techniques using a phantom.</a> AJR Am J Roentgenol. 184 (5), 1652-1656 (2005).</li><li>McNamara, M. P., McNamara, M. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preparation+of+a+homemade+ultrasound+biopsy+phantom.">Preparation of a homemade ultrasound biopsy phantom.</a> J Clin Ultrasound. 17 (6), 456-458 (1989).</li><li>Gibson, R. N., Gibson, K. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+home-made+phantom+for+learning+ultrasound-guided+invasive+techniques.">A home-made phantom for learning ultrasound-guided invasive techniques.</a> Australas Radiol. 39 (4), 356-357 (1995).</li><li>Lollo, L., Stogicza, A. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Low-cost,+high-fidelity+ultrasound+phantom+gels+for+regional+anesthesia+training+programs.">Low-cost, high-fidelity ultrasound phantom gels for regional anesthesia training programs.</a> MedEdPORTAL. 8, (2023).</li><li>Rathbun, K. M., Brader, W. T., Norbury, J. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+simple,+realistic,+inexpensive+nerve+phantom.">A simple, realistic, inexpensive nerve phantom.</a> J Ultrasound Med. 38 (8), 2203-2207 (2019).</li><li>. Mold Star&#8482; 16 FAST Product Information Available from: <a target="_blank" href="https://www.smooth-on.com/products/mold-star-16-fast/">https://www.smooth-on.com/products/mold-star-16-fast/</a> (2023)</li><li>Wojty&#322;a, S., Klama, P., Baran, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+3D+printing+safe?+Analysis+of+the+thermal+treatment+of+thermoplastics:+ABS,+PLA,+PET,+and+nylon.">Is 3D printing safe? Analysis of the thermal treatment of thermoplastics: ABS, PLA, PET, and nylon.</a> J Occup Environ Hyg. 14 (6), D80-D85 (2017).</li><li>. Original Prusa i3 MK3S+ 3D Printer kit Available from: <a target="_blank" href="https://www.prusa3d.com/product/original-prusa-i3-mk3s-3d-printer-kit/">https://www.prusa3d.com/product/original-prusa-i3-mk3s-3d-printer-kit/</a> (2023)</li><li>. Original Prusa MINI+ kit Available from: <a target="_blank" href="https://www.prusa3d.com/product/original-prusa-mini-kit-2/">https://www.prusa3d.com/product/original-prusa-mini-kit-2/</a> (2023)</li><li>. FreeCAD: Your own 3D parametric modeler Available from: <a target="_blank" href="https://www.freecad.org/">https://www.freecad.org/</a> (2023)</li><li>Xu, D., Abbas, S., Chan, V. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+phantom+for+hands-on+practice.">Ultrasound phantom for hands-on practice.</a> Reg Anesth Pain Med. 30 (6), 593-594 (2005).</li><li>de Oliveira Filho, G. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Learning+curves+and+mathematical+models+for+interventional+ultrasound+basic+skills.">Learning curves and mathematical models for interventional ultrasound basic skills.</a> Anesth Analg. 106 (2), 568-573 (2008).</li><li>Koscielniak-Nielsen, Z. J., Rasmussen, H., Hesselbjerg, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+animal+model+for+teaching+ultrasound-guided+peripheral+nerve+blocks.">An animal model for teaching ultrasound-guided peripheral nerve blocks.</a> Reg Anesth Pain Med. 34 (4), 379-380 (2009).</li><li>Pollard, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+model+for+learning+ultrasound-guided+needle+to+target+localization.">New model for learning ultrasound-guided needle to target localization.</a> Reg Anesth Pain Med. 33 (4), 360-362 (2008).</li><li>Wells, M., Goldstein, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+polony+phantom:+a+cost-effective+aid+for+teaching+emergency+ultrasound+procedures.">The polony phantom: a cost-effective aid for teaching emergency ultrasound procedures.</a> Int J Emerg Med. 3 (2), 115-118 (2010).</li><li>van Geffen, G. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+needle+guidance+device+compared+to+free+hand+technique+in+an+ultrasound-guided+interventional+task+using+a+phantom.">A needle guidance device compared to free hand technique in an ultrasound-guided interventional task using a phantom.</a> Anaesthesia. 63 (9), 986-990 (2008).</li><li>Liu, Y., Glass, N. L., Power, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technical+communication:+new+teaching+model+for+practicing+ultrasound-guided+regional+anesthesia+techniques:+no+perishable+food+products.">Technical communication: new teaching model for practicing ultrasound-guided regional anesthesia techniques: no perishable food products.</a> Anesth Analg. 110 (4), 1233-1235 (2010).</li><li>Sultan, S., Iohom, G., Shorten, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+phantom+for+teaching+and+learning+ultrasound-guided+needle+manipulation.">A novel phantom for teaching and learning ultrasound-guided needle manipulation.</a> J Med Ultrasound. 21 (3), 152-155 (2013).</li><li>Micheller, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+low-fidelity,+high-functionality,+inexpensive+ultrasound-guided+nerve+block+model.">A low-fidelity, high-functionality, inexpensive ultrasound-guided nerve block model.</a> CJEM. 19 (1), 58-60 (2017).</li><li>Sparks, S., Evans, D., Byars, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+low+cost,+high+fidelity+nerve+block+model.">A low cost, high fidelity nerve block model.</a> Crit Ultrasound J. 6 (1), 12 (2014).</li></ol>

These custom ballistic gel-based phantoms provide trainees with medium-fidelity median, femoral, suprainguinal fascia iliaca plane, and serratus anterior plane nerve block training for a fraction of the cost of commercially available nerve block phantoms (Table 1). Our first median and femoral nerve block trainers were made in-house for 12% and 9% of the price of the cheapest commercially available median and femoral nerve block trainers, respectively. None of the available femoral nerve block phantoms a...

Ultrasound phantoms - alternatives to live human tissue - give learners the opportunity to practice medical procedures, including ultrasound-guided regional anesthesia (UGRA), without introducing undue risk to patients1. While most commonly manufactured via injection molding of liquid silicone rubber, custom phantoms can be homemade using versatile materials at lower cost. Organic tissues such as tofu, pork, and beef are inexpensive but spoil quickly and are challenging to craft2. Human cadaveric tissue is ideal for anatomic accuracy but is difficult and costly to obtain and preserve1. More recently, virtual reality has been used to provide UGRA training; however, haptic feedback is a key component of procedural learning and is rarely implemented. Even when a hardware-software hybrid model provides high visual fidelity and tactile feedback, the hardware and software required to carry out such training are frequently cost-prohibitive3. Gelatin-based phantoms strike a balance between cost, longevity, and fidelity2.
Ballistic gelatin models are available commercially but are expensive for a perishable resource that is highly utilized in medical simulation centers. Small, simple, gel-based ultrasound phantoms with homogeneous parenchyma and two or three simulated vessels retail for hundreds of dollars. For example, the CAE Blue Phantom basic ultrasound training block costs upwards of $8004. Higher-fidelity phantoms specific to individual nerve block procedures cost thousands of dollars. The CAE Blue Phantom femoral regional anesthesia ultrasound training model costs $5,000 (Table 1)5. To bring down costs, educators have experimented with custom-made phantoms using gelatin or other low-cost or reusable materials6,7,8. Additives such as flour, corn starch, graphite powder, and Metamucil can be used to opacify the gelatin and customize the echogenicity of the phantom, thus increasing its fidelity8,9,10,11,12,13,14.
Previous attempts at homemade gelatin-based nerve block trainers were either unable to adequately recreate the appearance of nerves under ultrasound or utilized perishable items, thus limiting shelf life15,16. Even without these drawbacks, previous iterations did not include relevant anatomical landmarks and fascial planes that would allow trainees to practice specific nerve block procedures. Here, we investigate the production of durable, low-cost, ballistic gel ultrasound phantoms for median, femoral, suprainguinal fascia iliaca plane, and serratus anterior plane nerve blocks, as well as a methodology for producing a phantom for any ultrasound-guided nerve block procedure.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>ABS Filament - 1.75 m+B+A2:A14</td>
			<td>Hatchbox (Pomona, CA)</td>
			<td></td>
			<td>https://www.hatchbox3d.com/collections/abs-1-75mm</td>
		</tr>
		<tr>
			<td>Adobe Photoshop</td>
			<td>Adobe (San Jose, CA)</td>
			<td></td>
			<td>https://www.adobe.com/products/photoshop.html</td>
		</tr>
		<tr>
			<td>Amber Tone Dye</td>
			<td>Humimic Medical (Greenville, SC)</td>
			<td>852844007925</td>
			<td>Ballistic gel dye; https://humimic.com/product/amber-tone-dye/</td>
		</tr>
		<tr>
			<td>Fusion 360</td>
			<td>Autodesk (San Franciso, CA)</td>
			<td></td>
			<td>Computer-assisted design (CAD) software; https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&#38;tab=subscription&#38;plc=F360</td>
		</tr>
		<tr>
			<td>Gelatin #1 - Medical Gel by the Pound</td>
			<td>Humimic Medical (Greenville, SC)</td>
			<td>852844007406</td>
			<td>Ballistic gel; https://humimic.com/product/gelatin-1-medical-gelatin-by-the-pound/</td>
		</tr>
		<tr>
			<td>Gluten-Free All-Purpose Flour</td>
			<td>Arrowhead Mills (Hereford, TX)</td>
			<td></td>
			<td>Flour for echogenicity; https://arrowheadmills.com/products/gluten-free/organic-gluten-free-all-purpose-flour/</td>
		</tr>
		<tr>
			<td>Microsoft PowerPoint</td>
			<td>Microsoft (Redmond, WA)</td>
			<td></td>
			<td>https://www.microsoft.com/en-us/microsoft-365/powerpoint</td>
		</tr>
		<tr>
			<td>Mold Star 16 FAST Pourable Silicone Rubber</td>
			<td>Smooth-On (Macungie, PA)</td>
			<td></td>
			<td>Pourable silicone rubber; https://www.smooth-on.com/products/mold-star-16-fast/</td>
		</tr>
		<tr>
			<td>Peach Tone Dye</td>
			<td>Humimic Medical (Greenville, SC)</td>
			<td>852844007895</td>
			<td>Ballistic gel dye; https://humimic.com/product/peach-tone-dye/</td>
		</tr>
		<tr>
			<td>PLA Filament - 1.75 mm</td>
			<td>Hatchbox (Pomona, CA)</td>
			<td></td>
			<td>https://www.hatchbox3d.com/collections/pla-1-75mm</td>
		</tr>
		<tr>
			<td>Prusa Original i3 MK3S+ printer</td>
			<td>Prusa Research (Prague, Czech Republic)</td>
			<td></td>
			<td>3D printer; https://www.prusa3d.com/category/original-prusa-i3-mk3s/</td>
		</tr>
		<tr>
			<td>Prusa Slicer 2.6.1</td>
			<td>Prusa Research (Prague, Czech Republic)</td>
			<td></td>
			<td>3D printer slicer software; https://www.prusa3d.com/page/prusaslicer_424/</td>
		</tr>
		<tr>
			<td>Wool-Ease Thick &#38; Quick Yarn</td>
			<td>Lion Brand Yarn (Lyndhurst, NJ)</td>
			<td>640-610B</td>
			<td>Yarn for simulated nerves; https://www.lionbrand.com/products/wool-ease-thick-and-quick-yarn?variant=32420963516509</td>
		</tr>
	</tbody>
</table>

building affordable, durable, medium-fidelity ballistic gel phantoms for ultrasound-guided nerve block training

Ultrasound phantoms - alternatives to live human tissue - give learners the opportunity to practice ultrasound-guided regional anesthesia without introducing undue risk to patients. Gelatin-based phantoms provide educators with durable and reusable task trainers; however, commercially available gel-based phantoms are expensive. Here, we investigate the production of durable, low-cost, ballistic gel-based ultrasound phantoms for median, femoral, suprainguinal fascia iliaca plane, and serratus anterior plane nerve blocks, as well as a methodology for producing a phantom for any ultrasound-guided nerve block procedure.
Computer-aided design (CAD) software was utilized to design four phantoms replicating the anatomy of median, femoral, suprainguinal fascia iliaca plane, and serratus anterior plane nerve blocks, including relevant landmarks and tissue planes. Plastic models of the desired tissue planes were 3D printed and used to create silicone molds. Ballistic gel was melted and mixed with flour and dye to create a liquid, echogenic ballistic gel, which was poured into the silicone molds. Vessels were simulated by creating negative space in the ballistic gel using metal rods. Nerves were simulated using yarn submerged in ultrasound gel. Simulated bones were designed using CAD and 3D printed.
Ballistic gel is a versatile, durable medium that can be used to simulate a variety of tissues and can be melted and molded into any shape. Under ultrasound, these phantoms provide realistic tissue planes that represent the borders between different layers of skin, muscle, and fascia. The echogenicity of the muscle tissue layers, nerves, vessels, and bones is realistic, and bones have significant posterior shadowing as would be observed in a human subject. These phantoms cost $200 each for the first phantom and $60 for each subsequent phantom. These phantoms require some technical skill to design, but they can be built for just 4% of the cost of their commercial counterparts.

Author Spotlight: Developing Cost-Effective and Durable Ultrasound-Guided 3D-Printed Nerve Block Trainers

Building Affordable, Durable, Medium-Fidelity Ballistic Gel Phantoms for Ultrasound-Guided Nerve Block Training

So we leveraged the latest technology such as computer-aided design and 3D printing to make custom, durable, ultrasound-guided nerve block trainers with relatively low cost materials. In doing so, we explored questions relating to the durability and cost effectiveness of nerve block trainers while maximizing the fidelity and accessibility of these trainers. Currently, medical educators and simulation centers must either pay thousands of dollars for hands-on nerve block trainers, or save money using perishable materials that spoil rapidly.Our nerve block trainers use affordable materials that last for months to years, all while simulating anatomy more accurately than other low cost simulators. Other attempts to create homemade nerve block trainers have generally involved perishable materials such as animal meat, which spoils quickly, or homemade gelatin, which grows mold within weeks, even with refrigeration. Our trainers last years with minimal maintenance and cost a fraction of the price of commercial trainers.We're working to develop these nerve block trainers for a variety of other procedures within the operating room in an emergency room. Additionally, we're using infrared tracking in a variety of software options to record metrics about how physicians perform these procedures so that we can analyze the results and try to correlate those to clinical performance.

Four ultrasound phantoms were successfully designed and built using the methods described above. An ultrasound cross-section of each model aligned with an ultrasound of equivalent human anatomy is shown in Figure 5. Under ultrasound, these phantoms provide realistic tissue planes, which represent the borders between different layers of skin, muscle, and fascia. The muscle tissue is appropriately and homogeneously echogenic. This echogenicity can be adjusted based on the amount of flour added...

Read this Scientific Article Protocol about Author Spotlight: Developing Cost-Effective and Durable Ultrasound-Guided 3D-Printed Nerve Block Trainers at JoVE.com

Here, we demonstrate the design and creation of four custom ballistic gelatin ultrasound phantoms for ultrasound-guided regional anesthesia training. We designed the phantoms using computer-aided design software, used 3D-printed models to create silicone molds, and then poured melted ballistic gel into the molds to create custom tissue layers.

Ultrasound phantoms - alternatives to live human tissue - give learners the opportunity to practice ultrasound-guided regional anesthesia without ...

building-affordable-durable-medium-fidelity-ballistic-gel-phantoms

Research

JoVE Journal

Medicine

864 vues.  University of California, San Diego School of Medicine. Nous avons donc tiré parti des dernières technologies telles que la conception assistée par ordinateur et l’impression 3D pour fabriquer des entraîneurs de blocs nerveux personnalisés, durables et guidés par ultrasons avec des matériaux relativement peu coûteux. Ce faisant, nous avons exploré des questions relatives à la durabilité et à la rentabilité des entraîneurs de bloc nerveux tout en maximisant la fidélité et l’accessibilité de ces entraîneurs. Actuellement, les ?...

Vidéo: Pleins feux sur l’auteur : Développer des entraîneurs de bloc nerveux imprimés en 3D, guidés par échographie et durables, rentables et durables

Here, we demonstrate the design and creation of four custom ballistic gelatin ultrasound phantoms for ultrasound-guided regional anesthesia training. We designed the phantoms using computer-aided design software, used 3D-printed models to create silicone molds, and then poured melted ballistic gel into the molds to create custom tissue...

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3d ultrasound imaging: fast and cost-effective morphometry of musculoskeletal tissue

3D Ultrasound Imaging: Fast and Cost-effective Morphometry of Musculoskeletal Tissue

3D ultrasound imaging (3DUS) allows fast and cost-effective morphometry of musculoskeletal tissues. We present a protocol to measure muscle volume and fascicle length using...

clinical effects of ultrasound-guided acupotomy in knee osteoarthritis treatment

Author Spotlight: Minimally Invasive Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment

This paper introduces the operation method of ultrasound-guided acupotomy for knee osteoarthritis, which can reduce synovial thickness and improve knee joint function. It has the advantages of precise target, low treatment risk, few complications, and high...

Managing Knee Osteoarthritis Using Ultrasound-Guided Acupotomy

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rapid and low-cost prototyping of medical devices using 3d printed molds for liquid injection molding

Rapid and Low-cost Prototyping of Medical Devices Using 3D Printed Molds for Liquid Injection Molding

We have devised a method for low-cost and rapid prototyping of liquid elastomer rubber injection molded devices by using fused deposition modeling 3D printers for mold design and a modified desiccator as a liquid injection...

optimizing the modified no-scalpel vasectomy technique

Author Spotlight: Advancing Vasectomy Techniques 

A modified no-scalpel vasectomy technique reduces the postoperative recanalization rate. This protocol describes a modified no-scalpel vasectomy technique that can reduce the postoperative recanalization...

Bilateral Spermatic Nerve Blocks and Vasectomy Procedures in Males

bulk electroacupuncture operation for mice or young rats

Author Spotlight: Using a 3D-Printed Holder for Simultaneous Multiple Electroacupuncture Operation

Here, we present a protocol for efficient and rapid electroacupuncture (EA) in mice or young rats using a three-dimensional (3D) printed holder. This technique allows simultaneous operation on multiple animals, saving time and increasing experimental...

Using a 3D Printed Holder for Bulk Electroacupuncture in Small Animals

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real-time imaging of bonding in 3d-printed layers

Author Spotlight: Real-Time Imaging of Bonding in 3D-Printed Layers  

With a non-invasive and real-time technique, nanoscopic polymer motion inside a polymer filament is imaged during 3D printing. Fine-tuning this motion is crucial for producing constructs with optimal performance and appearance. This method reaches the core of plastic layer fusion, thus offering insights into optimal printing conditions and material design...

Visualizing Polymer Dynamics for Optimizing 3D Printing Quality

systematic endobronchial ultrasound - the six landmarks approach

Author Spotlight: Demonstrating Systematic Endobronchial Ultrasound to New Endoscopists 

Endobronchial ultrasound-guided sampling using transbronchial needle aspiration plays a key role in staging and diagnosing lung cancer. We propose a systematic stepwise approach dividing the procedure into six landmarks that should be taught to new operators.

Simulation-Based Training of EBUS-TBNA

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endoscopic ultrasound-guided biliary drainage: endoscopic ultrasound-guided hepaticogastrostomy in malignant biliary obstruction

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Endoscopic Ultrasound-Guided Biliary Drainage (EUS-BD) is an alternative method of biliary decompression in malignant biliary obstruction. Here we describe the technique of EUS guided-Hepaticogastrostomy (EUS-HGS) in a case of unresectable malignant hilar biliary...

designing and creating silicone molds and 3d-printed tissue layer models for ultrasound phantom simulation

Designing and Creating Silicone Molds and 3D-Printed Tissue Layer Models for Ultrasound Phantom Simulation

ultrasound-guided needle release combined with corticosteroid injection for the treatment of supinator syndrome

Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome  

The deep branch of the radial nerve can easily be compressed at the arcade of Frohse due to its anatomical features. Ultrasound-guided needle release combined with corticosteroid injection is an effective and safe treatment for deep branch radial nerve...

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection

3d bioprinting phototunable hydrogels to study fibroblast activation

Author Spotlight: Understanding Chronic Lung Diseases Using 3D Printed Phototunable Hydrogels 

This article describes how to 3D bioprint phototunable hydrogels to study extracellular matrix stiffening and fibroblast activation.

Phototunable Bioprinted Hydrogels to Probe Cellular Responses to ECM Stiffening

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ex vivo perfusion culture of large blood vessels in a 3d printed bioreactor

Author Spotlight: EasyFlow - An Economical and Adaptable Perfusion Bioreactor for Large Blood Vessel Culture 

This protocol presents the setup and operation of a newly developed, 3D printed bioreactor for the ex vivo culture of blood vessels in perfusion. The system is designed to be easily adopted by other users, practical, affordable, and adaptable to different experimental applications, such as basic biology and pharmacological studies.

A Novel 3D Printed Bioreactor for Ex Vivo Culture of Blood Vessels in Perfusion

a cost effective and adaptable scratch migration assay

A Cost Effective and Adaptable Scratch Migration Assay

We present a cost-effective method to the scratch migration assay that provides a new approach for determining cell migration without the use of equipment-intensive methods. While fibroblasts were used in this protocol, it can be adapted and utilized to study additional cell types and influences on cell...

scalable, flexible, and cost-effective seedling grafting

Scalable, Flexible, and Cost-Effective Seedling Grafting

This protocol describes a robust seedling grafting method that requires no prior experience or training and can be executed at a very low cost using materials easily accessible in most molecular biology...

balloon tag manufacturing technique for sensor fish and live fish recovery

Author Spotlight: Developing Cost-Effective and Customizable Balloon Tags for Fish Passage Studies 

A protocol is presented for designing and manufacturing balloon tags to recover Sensor Fish and live fish, allowing assessment of their physical condition and biological performance in hydraulic structures. The method optimizes balloon tag performance by considering factors such as balloon volume, inflation/deflation times, component selection, and the characteristics of the injected...

Optimizing Balloon Tag Assembly to Recover Sensor Fish and Live Fish

non-intubated video-assisted thoracoscopic surgery

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia 

Here, we present a non-intubated protocol for performing video-assisted thoracoscopic surgery with preserved autonomic...