Towards a New Standard in Medical Training and Vascular Surgical Simulation

Vascular surgery is an exact field where every millimeter can mean the difference between success and post-operative complications. Managing vascular conditions, particularly aortic aneurysms, relies on increasingly complex techniques that demand a high level of surgical skill and mastery of the most advanced medical devices.

However, current training and simulation tools have their limitations: the use of animal models whose anatomy differs from that of humans, digital simulators that lack haptic feedback, and rigid simulators that cannot replicate vascular biomechanics. These constraints slow down surgeons’ training and their ability to handle complex cases, leaving them in situations where they must still adapt in real-life conditions, with critical implications for patient safety.

In response to these challenges, a new generation of anatomical simulators is emerging, combining biomechanical realism, compatibility with the surgical environment, and the potential for standardization. These models mark the beginning of a new era in medical training and advanced surgical simulation, with a clear goal: to replace traditional methods with a proven standard that enhances intervention safety and accelerates the learning of complex surgical techniques.

A Project Supported by the 3Deus Challenge

In 2023, Dr. Alexandre Oliny, then a resident in vascular and endovascular surgery at the Hospices Civils de Lyon and a first-year PhD candidate in the Department of Innovation and Preclinical Research of Marie Lannelongue Innovation Center (MALIC), launched the 3D-PAM project to develop ultra-realistic vascular anatomical models for surgical training and to simulate complex procedures.

The 3Deus Challenge enabled him to leverage 3Deus Dynamics’ Dynamic Molding technology, enabling him to evaluate an initial model and lay the foundation for a clinically relevant and scientifically validated alternative to animal testing.

The Challenges of Treating Abdominal Aortic Aneurysms

Abdominal aortic aneurysms (AAA) represent a major medical and economic challenge, with a mortality rate of 80% in the event of rupture, and an aortic endoprosthesis market estimated at $2.4 billion in 2023.

These conditions are characterized by abnormal dilation of the aortic wall, which can lead to fatal rupture if not properly managed. Two surgical approaches are available:

  • Open surgery, an invasive procedure requiring a long recovery period.
  • Endovascular repair (EVAR), a minimally invasive technique that uses an endoprosthesis to stabilize the aneurysm and reduce the risk of rupture.

Comparison of a Healthy Aorta and an Aneurysmal Aorta. Source: https://picryl.com/media/aortic-aneurysm-e4dddb

While simple AAAs can be treated with standard EVARs, complex AAAs involving vital arteries require the use of fenestrated endoprostheses (F/BEVAR), where precise positioning is crucial to maintain blood flow to essential organs.

One of the major challenges in endovascular surgery remains managing endoleaks, complications in which blood continues to flow into the aneurysm despite the implant placement. Thorough surgical planning and the use of appropriate medical devices are essential to minimize these risks.

The Limitations of Current Medical Training Tools

To provide optimal patient care, vascular surgeons must master complex surgical techniques involving both precise planning and flawless execution. Today, several tools are used in their training, each with its advantages and limitations:

Digital tools integrate advanced predictive systems to model complex anatomies and anticipate potential complications. However, these surgical simulations remain purely visual and do not allow surgeons to exercise their haptic sensitivity or motor skills.
Animal models provide a dynamic environment and realistic tissue response. However, their anatomy differs from that of humans, limiting the transferability of techniques, and their use is increasingly restricted by ethical and regulatory constraints.
Physical models allow for the learning of technical skills but still require improvements to fully capture the dynamic viscoelastic behavior of a pathological aorta. A realistic surgical simulation demands models capable of replicating tissue resistance, elasticity, and response to stress in order to offer an immersive and relevant surgical experience.
Comparison of a human aorta with that of a pig
Comparison of a human aorta with that of a pig

The goal is clear: to develop a solution that combines the realism of biological tissues, the precision of digital simulations, and the reproducibility of physical models. By allowing surgeons to practice on patient-specific replicas, these models could become a “game changer” in medical training and case preparation, ranging from the simplest to the rarest and most complex cases, ensuring safer and more effective care in hybrid operating rooms.

Comparison of a human aorta with that of a pig. Source: Oliny, A. (2024, March). 3Deus Challenge 3D-PAM: 3D-Printed Aortic Models

Use Case – Clinical Evaluation of the 3Deus Dynamics Model in the Hybrid Operating Room

Towards a Revolution in Surgeon Training

In a field where every movement matters, the training of vascular surgeons still relies on limited methods:

Learning on real patients is risky and limited by ethical constraints.
Animal models are flawed and ethically questionable.
Rigid simulators are far removed from the biomechanical realities of human tissues.


With the evaluation of the 3D-printed model using 3Deus Dynamics’ Dynamic Molding silicone technology in the hybrid operating room, a breakthrough is taking place: for the first time, an anatomical model faithfully replicating the elasticity and vascular behavior of human tissue is being tested in immersive conditions identical to those of an operating room.

This evaluation, conducted in January 2025 at Marie Lannelongue Hospital by Prof. Stephan Haulon, Professor of Vascular Surgery and Head of the Aortic Center at Marie Lannelongue Hospital, and Dr. Oliny, marks the beginning of a rigorous clinical validation process aimed at establishing a new standard in medical training.

Why is this evaluation a key milestone?

This first test has validated:

An immersive and realistic environment: The model is integrated into a hybrid operating room, allowing surgeons to train with the same constraints as on a real patient.
Accurate biomechanics: Perfused under pulsed flow (80-150 mmHg) at 37°C, it simulates the deformation and dynamic resistance of aortic tissues, essential for surgical procedures.
Compatibility with interventional tools: Its radiotransparency allows precise monitoring of procedures under imaging, a crucial advantage for endovascular surgery.
Unprecedented reusability: Multiple successive procedures can be performed on the same model, optimizing training.
Abdominal aorta on a test bench

A Turning Point for Vascular Surgeon Training

  • Standardizing learning by offering models tailored to different levels of training:
    • Providing ready-to-use models for common and complex cases.
    • Allowing for patient-specific replicas to practice on rare and complex cases.
  • Strengthening ongoing training and surgical expertise by allowing experienced practitioners to:
    • Test different surgical strategies on complex cases.
    • Practice the placement of innovative medical devices before using them on a patient.
  • Ensuring adherence to the principle “Never the first time on the patient” by providing an immersive tool where errors have no clinical consequences.

A Model for the Evaluation and Validation of Medical Devices

Beyond training, these models open up a revolutionary field of application for the medical device industry. Currently, preclinical evaluation still heavily relies on animal models with known limitations:

Different anatomies make results difficult to translate to humans.
Expensive, lengthy tests, subject to strict regulations, and raising ethical concerns.
Inability to replicate certain complex pathologies, limiting the relevance of trials.

Thanks to the advanced models developed and validated through the collaboration between the teams at 3Deus Dynamics and MALIC, the industry will be able to:

Test, refine, and validate medical devices in realistic conditions, simulating interactions with human tissues.
Accelerate the market launch of endoprostheses and vascular devices by gradually replacing animal testing.
Develop a standardized benchmark for comparing the effectiveness of innovations within a reproducible scientific framework.

Towards a Gold Standard for Medical Training and Clinical Evaluation

The goal is clear: to establish a new proven standard, both for surgeon training and the evaluation of medical devices.

📢 Next step: Advanced clinical validation!
After this initial phase in the hybrid operating room, a new evaluation campaign will begin in February 2025, incorporating improved models based on functional criteria such as:

  • Optimized endoluminal glide, to faithfully replicate the behavior of endoprostheses and provide a procedural sensation as close to real patient conditions as possible.
  • Refined and characterized biomechanical properties, ensuring even more accurate interaction with vascular tissues.
  • Complete standardization, facilitating adoption by training centers and the medical device industry.

Join us in this medical revolution!

Are you a surgeon? Take advantage of an unprecedented training tool to refine your skills and enhance your surgical precision.
Are you working in the industry? Optimize the validation and approval of your medical devices with a scientifically proven alternative to animal models.

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