3D Printing for Healthcare is the topic of our next event, AMA: Healthcare 2026 on June 4th.
A French collaborative team presented the case for 3D printed surgical simulators at AMA: Healthcare 2025, walking attendees through the development of Otosurg, a multi-material ear surgery training model that combines clinical realism, anatomical customization, and validated competency assessment.
The project brings together Mael Duportal, Additive Manufacturing and CAD Engineer, M3DPrint, Juliette Prebot, Lead R&D Engineer, PRIM3D at AP-HP (Greater Paris University Hospitals), and ENT Consultant François from AP-HP and Professor at Université Paris Cité, and sits at the intersection of a pressing clinical problem: how do you train surgeons on procedures they have never performed, without putting patients at risk?
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The Problem With How Surgeons Learn
Duportal explained that the phrase “never the first time on a patient” sounds straightforward until you examine it closely.
“There are multiple first times,” Simon noted, a point that reframes the entire premise of surgical simulation. Training is not a single threshold to cross but a continuous series of firsts: the first time performing a procedure, the first time without a mentor present, the first time encountering a complication. “I think all these solutions, simulators, have their role at many different steps,” he added.
The conventional tools available to surgical educators each carry limitations. Human cadavers raise ethical constraints that vary by country. In France, for instance, regulations restrict how body parts can be used and they cannot replicate pathology. Animal models offer live tissue but anatomically diverge from human patients and face growing regulatory and ethical scrutiny. Virtual reality can deliver repeatable procedural exposure but lacks credible tactile feedback, and its fixed parameters make it most useful for beginners.
Catalog simulators produced by large manufacturers share the same limitation, useful at the entry level, but closed ecosystems that cannot adapt to specific diseases or individual learning needs.
The fundamental gap is variability. Real surgical cases present with different anatomy, different pathologies, and different levels of complexity. No single static model can replicate that range, which is precisely where 3D printing enters the picture.
How Otosurg Serves Both Beginners and Seasoned Surgeons
The Otosurg simulator was designed specifically for transcanal ear surgery, a technique that uses an endoscope inserted directly into the ear canal, rather than incisions behind the ear. The shift from microscope to endoscope represents an entirely new skill set, and the simulator was built to serve two distinct user groups simultaneously: residents encountering otologic surgery for the first time, and experienced surgeons with decades of microscope-based practice who need to retrain for endoscopic technique.
“They can do at least six to eight cases in a day, which is not possible on a cadaveric model,” Simon explained. The logic is sequential: a full day on the simulator across different pathologies and disease variants, followed by cadaveric work the next day. By that point, trainees already know the steps, where to make the incision, what to expect. “They’ve already gained considerable experience and confidence on that first day, and then they take all they can out of the cadaveric subject.”
The simulator also allows instructors to tailor the experience to the individual, printing anatomical structures in non-physiological colors to highlight specific landmarks, or removing elements like the tympanic membrane entirely to isolate a particular stage of the procedure.
From CT Scan to Cartridge: The Engineering Behind Otosurg
Prebot described the development process as methodical and iterative. It began with a requirements analysis and continued with direct observation in the operating theater and cadaver sessions.
The design phase used open-source tools: 3D Slicer for segmenting CT scan data into anatomical structures, and Blender for adapting those structures to manufacturing constraints. The ossicles, for example, are extremely fine in reality and had to be slightly enlarged to remain printable. The model was built as a modular system, a reusable base with interchangeable cartridges, and went through at least five full design iterations before reaching a validated version. Total development time was approximately one year.
The final model uses Stratasys’ PolyJet printing for the anatomically critical zones, where multiple materials can be combined in a single build to replicate both hard and soft tissue. “We’re mixing technologies by taking pros and cons of each of them,” said Prebot, “to produce models with better cost control, easier logistics, and reduced delay.”
A key functional feature is the ability to add theatrical blood to the simulation, changing texture, introducing tissue adhesion, and replicating the visual complexity of a bleeding surgical field. Cartridges can be printed with color-coded anatomical structures to guide beginners, or stripped of specific elements, such as the tympanic membrane, to isolate particular stages of a procedure for focused training.
Validation, Competency Assessment, and Scale
Clinical credibility was built into the project from the start. The team conducted a formal validation study with a panel of experts and students, published in Otology & Neurotology, a prominent peer-reviewed journal in the field. The training framework built around Otosurg incorporates OSATS evaluations: Objective Structured Technical Scores, a validated instrument for assessing surgical competency step by step.
The simulator is now part of a blended training course developed in collaboration with the University of Toronto, and is commercially distributed through M3DPrint across Europe, Canada, and the United States. Rather than a finished product, the collaboration between clinical, engineering, and commercial partners functions as an ongoing cycle, the model is continuously refined based on user feedback from surgeons and institutions in the field.
Future development points toward a customizable catalog, allowing institutions to order cartridges tailored to specific pathologies or training objectives, and a broader product line applying the same multi-material, clinically validated methodology to other surgical specialties.
Industry Needs to Catch Up
When asked what they would like to see from technology providers, the M3DPrint team pointed to openness. Current high-end systems like PolyJet are largely closed ecosystems, proprietary software, proprietary material, which constrains the range of tissue simulations that can be developed.
Duportal cited the Digital Anatomy Processor feature as a step in the right direction, allowing custom material blending, but called for software platforms that give developers greater freedom to design outside predefined parameters. The cost gap between accessible technologies like FDM and high-fidelity multi-material systems also remains a barrier, particularly for institutions in lower-resource settings trying to build training programs without large capital budgets.
The broader implication is clear: the hardware exists to produce clinically meaningful surgical simulators. The limiting factors are software flexibility, material openness, and the sustained clinical-engineering partnerships needed to turn anatomical data into validated training tools. Otosurg is one proof of what that collaboration can produce.
Beyond the Cadaver: 3D Printing Fills the Gap in Surgical Training
Surgical education has long relied on a narrow set of tools, cadavers, animal models, and virtual reality, each of which addresses part of the problem while leaving critical gaps. The result is a training landscape where surgeons routinely encounter procedures for the first time in a live clinical setting.
The market response is beginning to address this gap. Addion, an Austrian company using Stratasys PolyJet technology, is producing 3D printed replicas of the human eye and surrounding tissues for surgical training at the Anatomical Institute of the University of Innsbruck, with models designed to represent rare and complex conditions that trainees would rarely encounter in standard clinical rotations.
Elsewhere, researchers at the University of Minnesota and the University of Washington have developed a 3D printing method that replicates the directional mechanics of human tissue, bringing greater realism to medical simulation and surgical training.
What these efforts share with Otosurg is a recognition that anatomical accuracy alone is no longer the benchmark. The value of a surgical simulator lies in disease specificity, tactile realism, and the ability to tailor the training experience to the individual learner and procedure. Otosurg is one of the more developed examples of what that transition looks like in practice.
3D Printing Industry is inviting speakers for its 2026 Additive Manufacturing Applications (AMA) series, covering Energy, Healthcare, Automotive and Mobility, Aerospace, Space and Defense, and Software. Each online event focuses on real production deployments, qualification, and supply chain integration. Practitioners interested in contributing can complete the call for speakers form here.
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