1
|
Scherer-Quenzer AC, Beyers I, Kalisz A, Sauer ST, Zimmermann M, Wöckel A, Polat B, Schlaiss T, Schelbert S, Kiesel M. Evaluating the value of individualized 3D printed models for examination, diagnosis and treatment planning of cervical cancer. 3D Print Med 2024; 10:25. [PMID: 39066869 PMCID: PMC11282658 DOI: 10.1186/s41205-024-00229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND 3D printing holds great potential of improving examination, diagnosis and treatment planning as well as interprofessional communication in the field of gynecological oncology. In the current manuscript we evaluated five individualized, patient-specific models of cervical cancer FIGO Stage I-III, created with 3D printing, concerning their value for translational oncology. METHODS Magnetic resonance imaging (MRI) of the pelvis was performed on a 3.0 Tesla MRI, including a T2-weighted isotropic 3D sequence. The MRI images were segmented and transferred to virtual 3D models via a custom-built 3D-model generation pipeline and printed by material extrusion. The 3D models were evaluated by all medical specialties involved in patient care of cervical cancer, namely surgeons, radiologists, pathologists and radiation oncologists. Information was obtained from evaluated profession-specific questionnaires which were filled out after inspecting all five models. The questionnaires included multiple-select questions, questions based on Likert scales (1 = "strongly disagree " or "not at all useful " up to 5 = "strongly agree " or "extremely useful ") and dichotomous questions ("Yes" or "No"). RESULTS Surgeons rated the models as useful during surgery (4.0 out of 5) and for patient communication (4.7 out of 5). Furthermore, they believed that the models had the potential to revise the patients' treatment plan (3.7 out of 5). Pathologists evaluated with mean ratings of 3.0 out of 5 for the usefulness of the models in diagnostic reporting and macroscopic evaluation. Radiologist acknowledged the possibility of providing additional information compared to imaging alone (3.7 out of 5). Radiation oncologists strongly supported the concept by rating the models highly for understanding patient-specific pathological characteristics (4.3 out of 5), assisting interprofessional communication (mean 4.3 out of 5) and communication with patients (4.7 out of 5). They also found the models useful for improving radiotherapy treatment planning (4.3 out of 5). CONCLUSION The study revealed that the 3D printed models were generally well-received by all medical disciplines, with radiation oncologists showing particularly strong support. Addressing the concerns and tailoring the use of 3D models to the specific needs of each medical speciality will be essential for realizing their full potential in clinical practice.
Collapse
Affiliation(s)
- Anne Cathrine Scherer-Quenzer
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany.
| | - Inga Beyers
- Institute of Electric Power Systems (IfES), Leibniz University Hannover, Appelstraße 9A, Hannover, 30167, Germany
| | - Adam Kalisz
- Department of Electrical, Electronic and Communication Engineering, Information Technology (LIKE), Friedrich-Alexander-University Erlangen-Nuernberg, Am Wolfsmantel 33, Erlangen, Germany
| | - Stephanie Tina Sauer
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, Würzburg, 97080, Germany
| | - Marcus Zimmermann
- Department of Radiation Oncology, University Hospital Wuerzburg, Josef-Schneider-Str. 11, Würzburg, 97080, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany
| | - Bülent Polat
- Department of Radiation Oncology, University Hospital Wuerzburg, Josef-Schneider-Str. 11, Würzburg, 97080, Germany
| | - Tanja Schlaiss
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany
| | - Selina Schelbert
- Institute of Pathology, University of Wuerzburg, Josef-Schneider-Straße 2, Würzburg, 97080, Germany
| | - Matthias Kiesel
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany
| |
Collapse
|
2
|
Flaxman TE, Cooke CM, Miguel OX, Sheikh A, McInnes M, Duigenan S, Singh SS. The Value of Using Patient-Specific 3D-Printed Anatomical Models in Surgical Planning for Patients With Complex Multifibroid Uteri. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102435. [PMID: 38458270 DOI: 10.1016/j.jogc.2024.102435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES To compare surgeon responses regarding their surgical plan before and after receiving a patient-specific three-dimensional (3D)-printed model of a patient's multifibroid uterus created from their magnetic resonance imaging. METHODS 3D-printed models were derived from standard-of-care pelvic magnetic resonance images of patients scheduled for surgical intervention for multifibroid uterus. Relevant anatomical structures were printed using a combination of transparent and opaque resin types. 3D models were used for 7 surgical cases (5 myomectomies, 2 hysterectomies). A staff surgeon and 1 or 2 surgical fellow(s) were present for each case. Surgeons completed a questionnaire before and after receiving the model documenting surgical approach, perceived difficulty, and confidence in surgical plan. A postoperative questionnaire was used to assess surgeon experience using 3D models. RESULTS Two staff surgeons and 3 clinical fellows participated in this study. A total of 15 surgeon responses were collected across the 7 cases. After viewing the models, an increase in perceived surgical difficulty and confidence in surgical plan was reported in 12/15 and 7/15 responses, respectively. Anticipated surgical time had a mean ± SD absolute change of 44.0 ± 47.9 minutes and anticipated blood loss had an absolute change of 100 ± 103.5 cc. 2 of 15 responses report a change in pre-surgical approach. Intra-operative model reference was reported to change the dissection route in 8/15 surgeon responses. On average, surgeons rated their experience using 3D models 8.6/10 for pre-surgical planning and 8.1/10 for intra-operative reference. CONCLUSIONS Patient-specific 3D anatomical models may be a useful tool to increase a surgeon's understanding of complex gynaecologic anatomy and to improve their surgical plan. Future work is needed to evaluate the impact of 3D models on surgical outcomes in gynaecology.
Collapse
Affiliation(s)
- Teresa E Flaxman
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON
| | - Carly M Cooke
- University of Ottawa, Faculty of Medicine, Department of Obstetrics and Gynecology, Ottawa, ON
| | - Olivier X Miguel
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON
| | - Adnan Sheikh
- University of British Columbia, Faculty of Medicine, Department of Radiology, Vancouver, BC
| | - Matthew McInnes
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON; The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON
| | - Shauna Duigenan
- University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON; The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON
| | - Sukhbir Sony Singh
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Obstetrics and Gynecology, Ottawa, ON; The Ottawa Hospital, Department of Obstetrics, Gynecology and Newborn Care, Ottawa, ON.
| |
Collapse
|
3
|
Verkade C, Brouwers L, Stijns J, van Dal V, Wasowicz DK, de Kiefte M, van Tilborg F, Zimmerman DDE. Validation of a 3D-printed model of cryptoglandular perianal fistulas. Tech Coloproctol 2024; 28:59. [PMID: 38801550 DOI: 10.1007/s10151-024-02925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/31/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Visualising the course of a complex perianal fistula on imaging can be difficult. It has been postulated that three-dimensional (3D) models of perianal fistulas improve understanding of the perianal pathology, contribute to surgical decision-making and might even improve future outcomes of surgical treatment. The aim of the current study is to investigate the accuracy of 3D-printed models of perianal fistulas compared with magnetic resonance imaging (MRI). METHODS MRI scans of 15 patients with transsphincteric and intersphincteric fistulas were selected and then assessed by an experienced abdominal and colorectal radiologist. A standardised method of creating a 3D-printed anatomical model of cryptoglandular perianal fistula was developed by a technical medical physicist and a surgeon in training with special interest in 3D printing. Manual segmentation of the fistula and external sphincter was performed by a trained technical medical physicist. The anatomical models were 3D printed in a 1:1 ratio and assessed by two colorectal surgeons. The 3D-printed models were then scanned with a 3D scanner. Volume of the 3D-printed model was compared with manual segmentation. Inter-rater reliability statistics were calculated for consistency between the radiologist who assessed the MRI scans and the surgeons who assessed the 3D-printed models. The assessment of the MRI was considered the 'gold standard'. Agreement between the two surgeons who assessed the 3D printed models was also determined. RESULTS Consistency between the radiologist and the surgeons was almost perfect for classification (κ = 0.87, κ = 0.87), substantial for complexity (κ = 0.73, κ = 0.74) and location of the internal orifice (κ = 0.73, κ = 0.73) and moderate for the percentage of involved external anal sphincter in transsphincteric fistulas (ICC 0.63, ICC 0.52). Agreement between the two surgeons was substantial for classification (κ = 0.73), complexity (κ = 0.74), location of the internal orifice (κ = 0.75) and percentage of involved external anal sphincter in transsphincteric fistulas (ICC 0.77). CONCLUSIONS Our 3D-printed anatomical models of perianal fistulas are an accurate reflection of the MRI. Further research is needed to determine the added value of 3D-printed anatomical models in preoperative planning and education.
Collapse
Affiliation(s)
- C Verkade
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - L Brouwers
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - J Stijns
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- Department of Surgery, University Hospital Brussels, Brussels, Belgium
| | - V van Dal
- Department of Radiology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - D K Wasowicz
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - M de Kiefte
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- 3D Laboratory, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - F van Tilborg
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- 3D Laboratory, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - D D E Zimmerman
- Colorectal Research Group, Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
| |
Collapse
|
4
|
Alaimo L, Marchese A, Vignola D, Roman D, Conci S, De Bellis M, Pedrazzani C, Campagnaro T, Manzini G, Guglielmi A, Ruzzenente A. The Role of Three-Dimensional Modeling to Improve Comprehension of Liver Anatomy and Tumor Characteristics for Medical Students and Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2024; 81:597-606. [PMID: 38388310 DOI: 10.1016/j.jsurg.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/27/2023] [Accepted: 12/30/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Studying liver anatomy can be challenging for medical students and surgical residents due to its complexity. Three-dimensional visualization technology (3DVT) allows for a clearer and more precise view of liver anatomy. We sought to assess how 3DVT can assist students and surgical residents comprehend liver anatomy. DESIGN Data from 5 patients who underwent liver resection for malignancy at our institution between September 2020 and April 2022 were retrospectively reviewed and selected following consensus among the investigators. Participants were required to complete an online survey to investigate their understanding of tumor characteristics and vascular variations based on patients' computed tomography (CT) and 3DVT. SETTING The study was carried out at the General and Hepato-Biliary Surgery Department of the University of Verona. PARTICIPANTS Among 32 participants, 13 (40.6%) were medical students, and 19 (59.4%) were surgical residents. RESULTS Among 5 patients with intrahepatic lesions, 4 patients (80.0%) had at least 1 vascular variation. Participants identified number and location of lesions more correctly when evaluating the 3DVT (84.6% and 80.9%, respectively) compared with CT scans (61.1% and 64.8%, respectively) (both p ≤ 0.001). The identification of any vascular variations was more challenging using the CT scans, with only 50.6% of correct answers compared with 3DVT (72.2%) (p < 0.001). Compared with CT scans, 3DVT led to a 23.5%, 16.1%, and 21.6% increase in the correct definition of number and location of lesions, and vascular variations, respectively. 3DVT allowed for a decrease of 50.8 seconds (95% CI 23.6-78.0) in the time needed to answer the questions. All participants agreed on the usefulness of 3DVT in hepatobiliary surgery. CONCLUSIONS The 3DVT facilitated a more precise preoperative understanding of liver anatomy, tumor location and characteristics.
Collapse
Affiliation(s)
- Laura Alaimo
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Andrea Marchese
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Damiano Vignola
- Department of Orthopaedics and Trauma Surgery, University of Verona, Verona, Italy
| | - Diletta Roman
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Simone Conci
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Mario De Bellis
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Corrado Pedrazzani
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Tommaso Campagnaro
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Gessica Manzini
- Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Alfredo Guglielmi
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy
| | - Andrea Ruzzenente
- Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital G.B. Rossi, Verona, Italy.
| |
Collapse
|
5
|
Keller-Biehl L, Otoya D, Khader A, Timmerman W, Fernandez L, Amendola M. Just the gastrointestinal stromal tumor: A case report of medical modeling of a rectal gastrointestinal stromal tumor. SAGE Open Med Case Rep 2024; 12:2050313X231211124. [PMID: 38500559 PMCID: PMC10946069 DOI: 10.1177/2050313x231211124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 10/13/2023] [Indexed: 03/20/2024] Open
Abstract
A 54-year-old African-American male presented to the colorectal surgery clinic with the chief complaint of a painful anal swelling that had been ongoing for several weeks. An adequate rectal examination was not possible due to severe pain. Therefore, he was taken to the operating room for an exam under anesthesia where a presacral mass was identified. A transgluteal core needle biopsy was performed which was consistent with gastrointestinal stromal tumor. Computed tomography imaging identified a 16 cm ×10 cm ×9 cmrectal gastrointestinal stromal tumor. Given the size and location, the patient began treatment with neoadjuvant Imatinib. His progress was followed with serial computed tomography scans and clinic visits. A 3D model was created the tumor and surrounding structures to aide in pre- and intraoperative planning. The model was utilized during patient education and found to valuable in describing the potential for levator invasion and framing potential post-operative outcomes. The patient was able to undergo rectal preservation via a robotic low anterior resection with a transanal total mesorectal excision, coloanal anastomosis, and diverting ileostomy.
Collapse
Affiliation(s)
- Lucas Keller-Biehl
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Surgery, Central Virginia VA Health Care System, Richmond, VA, USA
| | - Diana Otoya
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Surgery, Central Virginia VA Health Care System, Richmond, VA, USA
| | - Adam Khader
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Surgery, Central Virginia VA Health Care System, Richmond, VA, USA
| | - William Timmerman
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Surgery, Central Virginia VA Health Care System, Richmond, VA, USA
| | - Leopoldo Fernandez
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Surgery, Central Virginia VA Health Care System, Richmond, VA, USA
| | - Michael Amendola
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Surgery, Central Virginia VA Health Care System, Richmond, VA, USA
| |
Collapse
|
6
|
Kveller C, Jakobsen AM, Larsen NH, Lindhardt JL, Baad-Hansen T. First experiences of a hospital-based 3D printing facility - an analytical observational study. BMC Health Serv Res 2024; 24:28. [PMID: 38178068 PMCID: PMC10768152 DOI: 10.1186/s12913-023-10511-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE To identify the clinical impact and potential benefits of in-house 3D-printed objects through a questionnaire, focusing on three principal areas: patient education; interdisciplinary cooperation; preoperative planning and perioperative execution. MATERIALS AND METHODS Questionnaires were sent from January 2021 to August 2022. Participants were directed to rate on a scale from 1 to 10. RESULTS The response rate was 43%. The results of the rated questions are averages. 84% reported using 3D-printed objects in informing the patient about their condition/procedure. Clinician-reported improvement in patient understanding of their procedure/disease was 8.1. The importance of in-house placement was rated 9.2. 96% reported using the 3D model to confer with colleagues. Delay in treatment due to 3D printing lead-time was 1.8. The degree with which preoperative planning was altered was 6.9. The improvement in clinician perceived preoperative confidence was 8.3. The degree with which the scope of the procedure was affected, in regard to invasiveness, was 5.6, wherein a score of 5 is taken to mean unchanged. Reduction in surgical duration was rated 5.7. CONCLUSION Clinicians report the utilization of 3D printing in surgical specialties improves procedures pre- and intraoperatively, has a potential for increasing patient engagement and insight, and in-house location of a 3D printing center results in improved interdisciplinary cooperation and allows broader access with only minimal delay in treatment due to lead-time.
Collapse
Affiliation(s)
- Christian Kveller
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - Anders M Jakobsen
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Nicoline H Larsen
- Department of Dentistry, Section for Oral and Maxillofacial Surgery, Aarhus University, Aarhus, Denmark
| | - Joakim L Lindhardt
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Baad-Hansen
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
| |
Collapse
|
7
|
Pereda-Nuñez A, Manresa M, Webb SS, Pineda B, Espuña M, Ortega M, Rodríguez-Baeza A. Pelvic + Anatomy: A new interactive pelvic anatomy model. Prospective randomized control trial with first-year midwife residents. ANATOMICAL SCIENCES EDUCATION 2023; 16:843-857. [PMID: 37312278 DOI: 10.1002/ase.2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/15/2023]
Abstract
Detailed knowledge of female pelvic floor anatomy is essential for midwifery and other professionals in obstetrics. Physical models have shown great potential for teaching anatomy and enhancing surgical skills. In this article, we introduce an innovative physical anatomy model called "Pelvic+" to teach anatomical relationships in the female pelvis. The Pelvic+ model's value was compared to a traditional lecture in 61 first-year midwifery students randomly allocated to either the Pelvic+ (n = 30) or a control group (n = 32). The primary outcome measure was a quiz comprised of 15 multiple choice questions on pelvic anatomy. Participants were assessed at baseline (Pre-Test), upon completion of the intervention (Post-Test1) and 4 months afterward (Post-Test2). Satisfaction with the approach was assessed at Post-Test1. Increase in knowledge was greater and the approach more accepted among resident midwives when Pelvic+ was used instead of standard lectures. Four months after the intervention, the improvement in knowledge was preserved in the Pelvic+ group. This randomized study demonstrates that the Pelvic+ simulator is more effective than classical learning for pelvic anatomy education, and offers a higher level of satisfaction among students during the educational process. Medical students training in obstetrics and gynecology, or any professional who specializes in the female pelvic floor might also benefit from incorporation of the Pelvic+ model into their training program.
Collapse
Affiliation(s)
- Ana Pereda-Nuñez
- Gynaecology and Obstetrics Service, Hospital General of Granollers, Barcelona, Spain
| | - Margarita Manresa
- Department of Maternal Fetal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain
| | | | | | - Montserrat Espuña
- Department of Maternal Fetal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Marisa Ortega
- Institut Medicina Legal i Ciències Forenses de Catalunya (IMLCFC), Department of Morphological Sciences of School of Medicine, UAB, Barcelona, Spain
| | | |
Collapse
|
8
|
Lu F, Qiu L, Yu P, Xu DL, Miao YC, Wang G. Application of a three-dimensional printed pelvic model in laparoscopic radical resection of rectal cancer. Front Oncol 2023; 13:1195404. [PMID: 37404759 PMCID: PMC10315900 DOI: 10.3389/fonc.2023.1195404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction To investigate the application value of a three-dimensional (3D) printed pelvic model in laparoscopic radical resection of rectal cancer. Methods Clinical data of patients undergoing laparoscopic radical rectal cancer surgery in The Second People's Hospital of Lianyungang City from May 2020 to April 2022 were selected. Patients were randomly divided into general imaging examination group (control group, n=25) and 3D printing group (observation group, n=25) by random number table method, and the perioperative situation of patients in the two groups was compared. Results There was no significant difference in general data between the two groups (p>0.05). Operation time, intraoperative blood loss, intraoperative time to locate inferior mesenteric artery, intraoperative time to locate left colic artery, first postoperative exhaust time and length of hospital stay in the observation group were all lower than those in the control group (P < 0.05); There were no significant differences in the total number of lymph nodes and complications between the two groups (P > 0.05). Discussion The application of 3D printed pelvic model in laparoscopic radical resection of rectal cancer is conducive to understanding pelvic structure and mesenteric vascular anatomy, reducing intraoperative bleeding and shortening operation time, which is worthy of further clinical application.
Collapse
Affiliation(s)
| | | | | | | | | | - Gang Wang
- *Correspondence: Yong-Chang Miao, ; Gang Wang,
| |
Collapse
|
9
|
Adnan S, Xiao J. A scoping review on the trends of digital anatomy education. Clin Anat 2023; 36:471-491. [PMID: 36583721 DOI: 10.1002/ca.23995] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
Digital technologies are changing the landscape of anatomy education. To reveal the trend of digital anatomy education across medical science disciplines, searches were performed using PubMed, EMBASE, and MEDLINE bibliographic databases for research articles published from January 2010 to June 2021 (inclusive). The search was restricted to publications written in English language and to articles describing teaching tools in undergraduate and postgraduate anatomy and pre-vocational clinical anatomy training courses. Among 156 included studies across six health disciplines, 35% used three-dimensional (3D) digital printing tools, 24.2% augmented reality (AR), 22.3% virtual reality (VR), 11.5% web-based programs, and 4.5% tablet-based apps. There was a clear discipline-dependent preference in the choice and employment of digital anatomy education. AR and VR were the more commonly adopted digital tools for medical and surgical anatomy education, while 3D printing is more broadly used for nursing, allied health and dental health education compared to other digital resources. Digital modalities were predominantly adopted for applied interactive anatomy education and primarily in advanced anatomy curricula such as regional anatomy and neuroanatomy. Moreover, there was a steep increase in VR anatomy combining digital simulation for surgical anatomy training. There is a consistent increase in the adoption of digital modalities in anatomy education across all included health disciplines. AR and VR anatomy incorporating digital simulation will play a more prominent role in medical education of the future. Combining multimodal digital resources that supports blended and interactive learning will further modernize anatomy education, moving medical education further away from its didactic history.
Collapse
Affiliation(s)
- Sharmeen Adnan
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Junhua Xiao
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,School of Allied Health, La Trobe University, Bundoora, Australia
| |
Collapse
|
10
|
Ravi P, Burch MB, Farahani S, Chepelev LL, Yang D, Ali A, Joyce JR, Lawera N, Stringer J, Morris JM, Ballard DH, Wang KC, Mahoney MC, Kondor S, Rybicki FJ. Utility and Costs During the Initial Year of 3D Printing in an Academic Hospital. J Am Coll Radiol 2023; 20:193-204. [PMID: 35988585 DOI: 10.1016/j.jacr.2022.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE There is a paucity of utility and cost data regarding the launch of 3D printing in a hospital. The objective of this project is to benchmark utility and costs for radiology-based in-hospital 3D printing of anatomic models in a single, adult academic hospital. METHODS All consecutive patients for whom 3D printed anatomic models were requested during the first year of operation were included. All 3D printing activities were documented by the 3D printing faculty and referring specialists. For patients who underwent a procedure informed by 3D printing, clinical utility was determined by the specialist who requested the model. A new metric for utility termed Anatomic Model Utility Points with range 0 (lowest utility) to 500 (highest utility) was derived from the specialist answers to Likert statements. Costs expressed in United States dollars were tallied from all 3D printing human resources and overhead. Total costs, focused costs, and outsourced costs were estimated. The specialist estimated the procedure room time saved from the 3D printed model. The time saved was converted to dollars using hospital procedure room costs. RESULTS The 78 patients referred for 3D printed anatomic models included 11 clinical indications. For the 68 patients who had a procedure, the anatomic model utility points had an overall mean (SD) of 312 (57) per patient (range, 200-450 points). The total operation cost was $213,450. The total cost, focused costs, and outsourced costs were $2,737, $2,180, and $2,467 per model, respectively. Estimated procedure time saved had a mean (SD) of 29.9 (12.1) min (range, 0-60 min). The hospital procedure room cost per minute was $97 (theoretical $2,900 per patient saved with model). DISCUSSION Utility and cost benchmarks for anatomic models 3D printed in a hospital can inform health care budgets. Realizing pecuniary benefit from the procedure time saved requires future research.
Collapse
Affiliation(s)
- Prashanth Ravi
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Michael B Burch
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Shayan Farahani
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Leonid L Chepelev
- Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | | | - Arafat Ali
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Jennifer R Joyce
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Nathan Lawera
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Jimmy Stringer
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | | | - David H Ballard
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, St Louis, Missouri
| | - Kenneth C Wang
- Department of Radiology, University of Maryland, Baltimore, Maryland; and Department of Radiology, Baltimore VA Medical Center, Baltimore, Maryland; and Co-Chair, ACR 3D Printing Registry Governance Committee
| | - Mary C Mahoney
- Chair, Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Shayne Kondor
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio
| | - Frank J Rybicki
- Vice Chair of Operations & Quality, Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio; and Co-Chair, ACR 3D Printing Registry Governance Committee.
| | | |
Collapse
|
11
|
Application of 3D printing technology for pre-operative evaluation, education and informed consent in pediatric retroperitoneal tumors. Sci Rep 2023; 13:1671. [PMID: 36717595 PMCID: PMC9886922 DOI: 10.1038/s41598-023-28423-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
To investigate usefulness of 3D printing for preoperative evaluations, student and resident education, and communication with parents or guardians of patients with pediatric retroperitoneal tumors. Ten patients planning retroperitoneal tumor resection between March and November 2019 were included. Preoperative computed tomography (CT) images were used for 3D reconstruction and printing. Surveyed items were understanding of preoperative lesions with 3 different modules (CT, 3D reconstruction, and 3D printing) by students, residents, and specialists; satisfaction of specialists; and comprehension by guardians after preoperative explanations with each module. The median age at operation was 4.2 years (range, 1.8-18.1), and 8 patients were diagnosed with neuroblastoma. The 3D printing was the most understandable module for all groups (for students, residents, and specialists, P = 0.002, 0.027, 0.013, respectively). No significant intraoperative adverse events or immediate postoperative complications occurred. All specialists stated that 3D printing enhanced their understanding of cases. Guardians answered that 3D printing were the easiest to comprehend among the 3 modules (P = 0.007). Use of 3D printing in treatment of pediatric patients with retroperitoneal tumors was useful for preoperative planning, education, and parental explaining with obtaining informed consents.
Collapse
|
12
|
Fidvi S, Holder J, Li H, Parnes GJ, Shamir SB, Wake N. Advanced 3D Visualization and 3D Printing in Radiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:103-138. [PMID: 37016113 DOI: 10.1007/978-3-031-26462-7_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Since the discovery of X-rays in 1895, medical imaging systems have played a crucial role in medicine by permitting the visualization of internal structures and understanding the function of organ systems. Traditional imaging modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (US) present fixed two-dimensional (2D) images which are difficult to conceptualize complex anatomy. Advanced volumetric medical imaging allows for three-dimensional (3D) image post-processing and image segmentation to be performed, enabling the creation of 3D volume renderings and enhanced visualization of pertinent anatomic structures in 3D. Furthermore, 3D imaging is used to generate 3D printed models and extended reality (augmented reality and virtual reality) models. A 3D image translates medical imaging information into a visual story rendering complex data and abstract ideas into an easily understood and tangible concept. Clinicians use 3D models to comprehend complex anatomical structures and to plan and guide surgical interventions more precisely. This chapter will review the volumetric radiological techniques that are commonly utilized for advanced 3D visualization. It will also provide examples of 3D printing and extended reality technology applications in radiology and describe the positive impact of advanced radiological image visualization on patient care.
Collapse
Affiliation(s)
- Shabnam Fidvi
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
| | - Justin Holder
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Hong Li
- Department of Radiology, Jacobi Medical Center, Bronx, NY, USA
| | | | | | - Nicole Wake
- GE Healthcare, Aurora, OH, USA
- Center for Advanced Imaging Innovation and Research, NYU Langone Health, New York, NY, USA
| |
Collapse
|
13
|
Stana J, Grab M, Kargl R, Tsilimparis N. 3D printing in the planning and teaching of endovascular procedures. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:28-33. [PMID: 36112173 DOI: 10.1007/s00117-022-01047-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The introduction of 3D printing in the medical field led to new possibilities in the planning of complex procedures, as well as new ways of training junior physicians. Especially in the field of vascular interventions, 3D printing has a wide range of applications. METHODOLOGICAL INNOVATIONS 3D-printed models of aortic aneurysms can be used for procedural training of endovascular aortic repair (EVAR), which can help boost the physician's confidence in the procedure, leading to a better outcome for the patient. Furthermore, it allows for a better understanding of complex anatomies and pathologies. In addition to teaching applications, the field of pre-interventional planning benefits greatly from the addition of 3D printing. Especially in the preparation for a complex endovascular aortic repair, prior orientation and test implantation of the stent grafts can further improve outcomes and reduce complications. For both teaching and planning applications, high-quality imaging datasets are required that can be transferred into a digital 3D model and subsequently printed in 3D. Thick slice thickness or suboptimal contrast agent phase can reduce the overall detail of the digital model, possibly concealing crucial anatomical details. CONCLUSION Based on the digital 3D model created for 3D printing, another new visualization technique might see future applications in the field of vascular interventions: virtual reality (VR). It enables the physician to quickly visualize a digital 3D model of the patient's anatomy in order to assess possible complications during endovascular repair. Due to the short transfer time from the radiological dataset into the VR, this technique might see use in emergency situations, where there is no time to wait for a printed model.
Collapse
Affiliation(s)
- J Stana
- Department of Vascular Surgery, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany.
| | - M Grab
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
| | - R Kargl
- Institute for Chemistry and Technology of Biobased System, (IBioSys), Graz University of Technology, Graz, Switzerland
| | - N Tsilimparis
- Department of Vascular Surgery, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
| |
Collapse
|
14
|
Fitzgerald K, Bindra R, Canning S, Tansley G, Lloyd DG, Zheng M, Quinn A, Maharaj J, Perevoshchikova N, Saxby DJ. A human-centred design approach to hybrid manufacturing of a scapholunate interosseous ligament medical practice rig. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
15
|
Ozturk AM, Ozer MA, Suer O, Derin O, Govsa F, Aktuglu K. Evaluation of the effects of using 3D - patient specific models of displaced intra - articular calcaneal fractures in surgery. Injury 2022; 53 Suppl 2:S40-S51. [PMID: 32456955 DOI: 10.1016/j.injury.2020.04.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/26/2020] [Accepted: 04/29/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND It was aimed to compare conventional surgery and three-dimensional (3D) model-assisted surgery used in the treatment of calcaneal fractures. MATERIALS & METHODS A total of 37 patients with unilateral calcaneal fractures were randomly divided into two groups as a conventional surgery group (n: 19) and a 3D model-assisted surgery group (n: 18). The preoperative, postoperative and last follow up angles of the Bohler and Gissane, calcaneal width and facet height were measured. The duration of the operation, blood loss volume, fluoroscopy usage, instrumentation time for both groups were recorded. Finally, the follow-up AOFAS scores were evaluated. A questionnaire was used to determine the perceptions of the resident doctors about the 3D model. RESULTS The duration of the operation, blood loss volume, fluoroscopy usage, instrumentation time for 3D model-assisted surgery group were 83.3 ± 4.6 minutes, 83.6 ± 4.6 ml, 6.8 ± 1.4 times and 13.0 ± 0.8 weeks, and as for conventional group they were 130.0 ± 5.8 minutes, 105.1 ± 5.6 minutes, 11.7 ± 1.5 ml, 22.2 ± 2.4 times and 13.3 ± 0.8 weeks, respectively (p < 0.0001). The both groups significantly restored Bohler angle, Gissane angle, calcaneal width and calcaneal facet height after operation (p < 0.0001). The 3D model-assisted group was significantly more succesful in restoration and protection of achieved correction of calcanel facet height (p < 0.0001). The difference was determined among the groups at the final follow-up examination with respect to the amount of change according the values achieved post-op. were significant in Bohler angle (p < 0.001), calcaneal facet height (p < 0.0001) and calcaneal widht (p = 0.017). There was no significant difference between AOFAS scores of the two groups at last follow-up. Resident doctors exhibited high scores of overall satisfaction with the use of a 3D printing model. CONCLUSIONS Compared to the conventional group, the 3D model-assisted group provide successful intervention and reduce operation, instrumentation time and the fluoroscopy usage with less blood loss. Performing 3D-assisted surgery helps the quality of reduction during the surgery and stability of internal fixation to protect achieved reduction at follow-up more succesfully.
Collapse
Affiliation(s)
- Anil Murat Ozturk
- Department of Ortopaedic Surgery, Faculty of Medicine, Ege University, Izmir, TURKEY
| | - Mehmet Asim Ozer
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, TURKEY
| | - Onur Suer
- Department of Ortopaedic Surgery, Faculty of Medicine, Ege University, Izmir, TURKEY
| | - Okan Derin
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, TURKEY
| | - Figen Govsa
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, TURKEY
| | - Kemal Aktuglu
- Department of Ortopaedic Surgery, Faculty of Medicine, Ege University, Izmir, TURKEY.
| |
Collapse
|
16
|
Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department. Healthcare (Basel) 2022; 10:healthcare10091791. [PMID: 36141403 PMCID: PMC9498605 DOI: 10.3390/healthcare10091791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: Three-dimensional printing has become a leading manufacturing technique in healthcare in recent years. Doubts in published studies regarding the methodological rigor and cost-effectiveness and stricter regulations have stopped the transfer of this technology in many healthcare organizations. The aim of this study was the evaluation and implementation of a 3D printing technology service in a radiology department. Methods: This work describes a methodology to implement a 3D printing service in a radiology department of a Spanish public hospital, considering leadership, training, workflow, clinical integration, quality processes and usability. Results: The results correspond to a 6-year period, during which we performed up to 352 cases, requested by 85 different clinicians. The training, quality control and processes required for the scaled implementation of an in-house 3D printing service are also reported. Conclusions: Despite the maturity of the technology and its impact on the clinic, it is necessary to establish new workflows to correctly implement them into the strategy of the health organization, adjusting it to the needs of clinicians and to their specific resources. Significance: This work allows hospitals to bridge the gap between research and 3D printing, setting up its transfer to clinical practice and using implementation methodology for decision support.
Collapse
|
17
|
Byrd CT, Lui NS, Guo HH. Applications of Three-Dimensional Printing in Surgical Oncology. Surg Oncol Clin N Am 2022; 31:673-684. [DOI: 10.1016/j.soc.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
18
|
Schlegel L, Ho M, Fields JM, Backlund E, Pugliese R, Shine KM. Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback. BMC MEDICAL EDUCATION 2022; 22:614. [PMID: 35953840 PMCID: PMC9373487 DOI: 10.1186/s12909-022-03581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND 3D printed models are becoming increasingly popular in healthcare as visual and tactile tools to enhance understanding of anatomy and pathology in medical trainee education, provide procedural simulation training, and guide surgical procedures. Patient-specific 3D models are currently being used preoperatively for trainee medical education in planning surgical approaches and intraoperatively to guide decision-making in several specialties. Our study group utilized a modified Delphi process to create a standardized assessment for trainees using patient-specific 3D models as a tool in medical education during pre-surgical planning. METHODS A literature review was conducted to identify survey questions administered to clinicians in published surgical planning studies regarding the use of patient-specific 3D models. A core study team reviewed these questions, removed duplicates, categorized them, mapped them to overarching themes, and, where applicable, modified individual questions into a form generalizable across surgical specialties. The core study panel included a physician, physician-scientist, social scientist, engineer/medical student, and 3D printing lab manager. A modified Delphi process was then used to solicit feedback on the clarity and relevance of the individual questions from an expert panel consisting of 12 physicians from specialties including anesthesiology, emergency medicine, radiology, urology, otolaryngology, and obstetrics/gynecology. When the Radiological Society of North America (RSNA)/American College of Radiology (ACR) 3D Printing Registry Data Dictionary was released, additional survey questions were reviewed. A final cross-disciplinary survey of the utility of 3D printed models in surgical planning medical education was developed. RESULTS The literature review identified 100 questions previously published in surveys assessing patient-specific 3D models for surgical planning. Following the review, generalization, and mapping of survey questions from these studies, a list of 24 questions was generated for review by the expert study team. Five additional questions were identified in the RSNA/ACR 3D Printing Registry Data Dictionary and included for review. A final questionnaire consisting of 20 questions was developed. CONCLUSIONS As 3D printed models become more common in medical education, the need for standardized assessment is increasingly essential. The standardized questionnaire developed in this study reflects the interests of a variety of stakeholders in patient-specific 3D models across disciplines.
Collapse
Affiliation(s)
- Lauren Schlegel
- Jefferson Health Design Lab, 925 Chestnut Street Basement Level, Philadelphia, PA, 19107, USA.
- Sidney Kimmel Medical College of Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 100, Philadelphia, PA, 19107, USA.
| | - Michelle Ho
- Jefferson Health Design Lab, 925 Chestnut Street Basement Level, Philadelphia, PA, 19107, USA
- Department of Medicine, Pennsylvania Hospital, University of Pennsylvania Health System, 800 Spruce Street, Philadelphia, PA, 19107, USA
| | - J Matthew Fields
- Department of Emergency Medicine, Thomas Jefferson University Hospitals, 1020 Sansom Street, Thompson Building, Suite 239, Philadelphia, PA, 19107, USA
| | - Erik Backlund
- Jefferson Health Design Lab, 925 Chestnut Street Basement Level, Philadelphia, PA, 19107, USA
| | - Robert Pugliese
- Jefferson Health Design Lab, 925 Chestnut Street Basement Level, Philadelphia, PA, 19107, USA
- Innovation Pillar, Thomas Jefferson University Hospitals, 925 Chestnut Street, Suite 110, Philadelphia, PA, 19107, USA
| | - Kristy M Shine
- Jefferson Health Design Lab, 925 Chestnut Street Basement Level, Philadelphia, PA, 19107, USA
- Sidney Kimmel Medical College of Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 100, Philadelphia, PA, 19107, USA
- Department of Emergency Medicine, Thomas Jefferson University Hospitals, 1020 Sansom Street, Thompson Building, Suite 239, Philadelphia, PA, 19107, USA
| |
Collapse
|
19
|
Cheng J, Wang Z, Liu J, Dou C, Yao W, Zhang C. Value of 3D printing technology combined with indocyanine green fluorescent navigation in complex laparoscopic hepatectomy. PLoS One 2022; 17:e0272815. [PMID: 35951521 PMCID: PMC9371281 DOI: 10.1371/journal.pone.0272815] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background Laparoscopic hepatectomy (LH) has achieved rapid progress over the last decade. However, it is still challenging to apply laparoscopy to lesions located in segments I, VII, VIII, and IVa and the hepatic hilar region due to difficulty operating around complex anatomical structures. In this study, we applied three-dimensional printing (3DP) and indocyanine green (ICG) fluorescence imaging technology to complex laparoscopic hepatectomy (CLH) to explore the effects and value of the modified procedure. Materials and methods From January 2019 to January 2021, 54 patients with complex hepatobiliary diseases underwent LH at our center. Clinical data were collected from these patients and retrospectively analyzed. Results A total of 30 patients underwent CLH using the conventional approach, whereas 24 cases received CLH with 3DP technology and ICG fluorescent navigation. Preoperative data were compared between the two groups. In the 3DP group, we modified the surgical strategy of four patients (4/24, 16.7%) due to real-time intraoperative navigation with 3DP and ICG fluorescent imaging technology. We did not modify the surgical strategy for any patient in the non-3DP group (P = 0.02). There were no significant differences between the non-3DP and 3DP groups regarding operating time (297.7±104.1 min vs. 328.8±110.9 min, P = 0.15), estimated blood loss (400±263.8 ml vs. 345.8±356.1 ml, P = 0.52), rate of conversion to laparotomy (3/30 vs. 2/24, P = 0.79), or pathological outcomes including the incidence of microscopical R0 margins (28/30 vs. 24/24, P = 0.57). Additionally, there were no significant differences in postoperative complications or recovery conditions between the two groups. No instances of 30- or 90-day mortality were observed. Conclusion The optimal surgical strategy for CLH can be chosen with the help of 3DP technology and ICG fluorescent navigation. This modified procedure is both safe and effective, but without improvement of intraoperative and short-term outcomes.
Collapse
Affiliation(s)
- Jian Cheng
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Zhifei Wang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jie Liu
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Changwei Dou
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Weifeng Yao
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Chengwu Zhang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- * E-mail:
| |
Collapse
|
20
|
Tejo-Otero A, Valls-Esteve A, Fenollosa-Artés F, Siles-Hinojosa A, Nafria B, Ayats M, Buj-Corral I, Otero MC, Rubio-Palau J, Munuera J, Krauel L. Patient comprehension of oncologic surgical procedures using 3D printed surgical planning prototypes. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
21
|
Kiesel M, Beyers I, Kalisz A, Wöckel A, Quenzer A, Schlaiß T, Wulff C, Diessner J. Evaluating the value of a 3D printed model for hands-on training of gynecological pelvic examination. 3D Print Med 2022; 8:20. [PMID: 35793005 PMCID: PMC9261074 DOI: 10.1186/s41205-022-00149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Simulation in the field of gynecological pelvic examination with educational purposes holds great potential. In the current manuscript we evaluate a 3D printed model of the female pelvis, which improves practical teaching of the gynecological pelvic examination for medical staff. Methods We evaluated the benefit of a 3D printed model of the female pelvis (Pelvisio®) as part of a seminar (“skills training”) for teaching gynecological examination to medical students. Each student was randomly assigned to Group A or B by picking a ticket from a box. Group A underwent the skills training without the 3D printed model. Group B experienced the same seminar with integration of the model. Both groups evaluated the seminar by answering five questions on Likert scales (1–10, 1 = “very little” or “very poor”, 10 equals “very much” or “very good”). Additionally, both groups answered three multiple-choice questions concerning pelvic anatomy (Question 6 to 8). Finally, Group B evaluated the 3D printed model with ten questions (Question 9 to 18, Likert scales, 1–10). Results Two of five questions concerning the students’ satisfaction with the seminar and their gained knowledge showed statistically significant better ratings in Group B (6.7 vs. 8.2 points and 8.1 vs. 8.9 points (p < 0.001 and p < 0.009). The other three questions showed no statistically significant differences between the traditional teaching setting vs. the 3D printed model (p < 0.411, p < 0.344 and p < 0.215, respectively). The overall mean score of Question 1 to 5 showed 8.4 points for Group B and 7.8 points for Group A (p < 0.001). All three multiple-choice questions, asking about female pelvic anatomy, were answered more often correctly by Group B (p < 0.001, p < 0.008 and p < 0.001, respectively). The mean score from the answers to Questions 9 to 18, only answered by Group B, showed a mean of 8.6 points, indicating, that the students approved of the model. Conclusion The presented 3D printed model Pelvisio® improves the education of female pelvic anatomy and examination for medical students. Hence, training this pivotal examination can be supported by a custom designed anatomical model tailored for interactive and explorative learning.
Collapse
Affiliation(s)
- Matthias Kiesel
- University Hospital Würzburg department of Gynecology, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.
| | - Inga Beyers
- Institute of Electric Power Systems (IfES), Leibniz Universität Hannover, Appelstraße 9A, 30167, Hannover, Germany
| | - Adam Kalisz
- Department of Electrical, Electronic and Communication Engineering, Information Technology (LIKE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Am Wolfsmantel 33, Erlangen, Germany
| | - Achim Wöckel
- University Hospital Würzburg department of Gynecology, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Anne Quenzer
- University Hospital Würzburg department of Gynecology, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Tanja Schlaiß
- University Hospital Würzburg department of Gynecology, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Christine Wulff
- University Hospital Würzburg department of Gynecology, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Joachim Diessner
- University Hospital Würzburg department of Gynecology, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| |
Collapse
|
22
|
Xie Y, Wu G, Liang Y, Fan G. Three-Dimensional Physical Model in Urologic Cancer. Front Surg 2022; 9:757337. [PMID: 35693309 PMCID: PMC9174564 DOI: 10.3389/fsurg.2022.757337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Three-dimensional (3D) printing, as an evolving technology, enables the creation of patient-specific physical models with high precision; thus, it is widely used in various clinical practices, especially urologic cancer. There is an increasing need to clarify the contribution of 3D printing in the practice of urological cancer in order to identify various applications and improve understanding its benefits and challenges in clinical practice. Researches have focused on the use of 3D-printed models in patient and trainee education, surgical simulation, as well as surgical planning and guidance. This mini review will present the most recently published studies on the topic, including the applications of 3D-printed models, feasibility of performed procedures, possible simulated organs, application outcomes, and challenges involved in urologic cancer, to provide potential directions for future research.
Collapse
Affiliation(s)
- Yu Xie
- Department of Urology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University and the Clinical Research Center for Renal Tumor in Hunan Province, Changsha, China
- The Clinical Research Center for Renal Tumor in Hunan Province, The Hunan Cancer Hospital and the Hunan Provincial Science and Technology Department, Central South University, Changsha, China
| | - Guanlin Wu
- Department of Pathology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yu Liang
- Department of Urology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University and the Clinical Research Center for Renal Tumor in Hunan Province, Changsha, China
| | - Gang Fan
- Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
- *Correspondence: Gang Fan
| |
Collapse
|
23
|
A 3D printed model of the female pelvis for practical education of gynecological pelvic examination. 3D Print Med 2022; 8:13. [PMID: 35511353 PMCID: PMC9069962 DOI: 10.1186/s41205-022-00139-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background Pelvic palpation is a core component of every Gynecologic examination. It requires vigorous training, which is difficult due to its intimate nature, leading to a need of simulation. Up until now, there are mainly models available for mere palpation which do not offer adequate visualization of the concerning anatomical structures. In this study we present a 3D printed model of the female pelvis. It can improve both the practical teaching of gynecological pelvic examination for health care professionals and the spatial understanding of the relevant anatomy. Methods We developed a virtual, simplified model showing selected parts of the female pelvis. 3D printing was used to create a physical model. Results The life-size 3D printed model has the ability of being physically assembled step by step by its users. Consequently, it improves teaching especially when combining it with commercial phantoms, which are built solely for palpation training. This is achieved by correlating haptic and visual sensations with the resulting feedback received. Conclusion The presented 3D printed model of the female pelvis can be of aid for visualizing and teaching pelvic anatomy and examination to medical staff. 3D printing provides the possibility of creating, multiplying, adapting and sharing such data worldwide with little investment of resources. Thus, an important contribution to the international medical community can be made for training this challenging examination.
Collapse
|
24
|
Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
Collapse
Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
| | | |
Collapse
|
25
|
The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063331. [PMID: 35329016 PMCID: PMC8953417 DOI: 10.3390/ijerph19063331] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 12/19/2022]
Abstract
Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.
Collapse
|
26
|
Bastawrous S, Wu L, Liacouras PC, Levin DB, Ahmed MT, Strzelecki B, Amendola MF, Lee JT, Coburn J, Ripley B. Establishing 3D Printing at the Point of Care: Basic Principles and Tools for Success. Radiographics 2022; 42:451-468. [PMID: 35119967 DOI: 10.1148/rg.210113] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
As the medical applications of three-dimensional (3D) printing increase, so does the number of health care organizations in which adoption or expansion of 3D printing facilities is under consideration. With recent advancements in 3D printing technology, medical practitioners have embraced this powerful tool to help them to deliver high-quality patient care, with a focus on sustainability. The use of 3D printing in the hospital or clinic at the point of care (POC) has profound potential, but its adoption is not without unanticipated challenges and considerations. The authors provide the basic principles and considerations for building the infrastructure to support 3D printing inside the hospital. This process includes building a business case; determining the requirements for facilities, space, and staff; designing a digital workflow; and considering how electronic health records may have a role in the future. The authors also discuss the supported applications and benefits of medical 3D printing and briefly highlight quality and regulatory considerations. The information presented is meant to be a practical guide to assist radiology departments in exploring the possibilities of POC 3D printing and expanding it from a niche application to a fixture of clinical care. An invited commentary by Ballard is available online. ©RSNA, 2022.
Collapse
Affiliation(s)
- Sarah Bastawrous
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Lei Wu
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Peter C Liacouras
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Dmitry B Levin
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Mohamed Tarek Ahmed
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Brian Strzelecki
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Michael F Amendola
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - James T Lee
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - James Coburn
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Beth Ripley
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| |
Collapse
|
27
|
Olejnik A, Semba JA, Kulpa A, Dańczak-Pazdrowska A, Rybka JD, Gornowicz-Porowska J. 3D Bioprinting in Skin Related Research: Recent Achievements and Application Perspectives. ACS Synth Biol 2022; 11:26-38. [PMID: 34967598 PMCID: PMC8787816 DOI: 10.1021/acssynbio.1c00547] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
![]()
In recent years,
significant progress has been observed in the
field of skin bioprinting, which has a huge potential to revolutionize
the way of treatment in injury and surgery. Furthermore, it may be
considered as an appropriate platform to perform the assessment and
screening of cosmetic and pharmaceutical formulations. Therefore,
the objective of this paper was to review the latest advances in 3D
bioprinting dedicated to skin applications. In order to explain the
boundaries of this technology, the architecture and functions of the
native skin were briefly described. The principles of bioprinting
methods were outlined along with a detailed description of key elements
that are required to fabricate the skin equivalents. Next, the overview
of recent progress in 3D bioprinting studies was presented. The article
also highlighted the potential applications of bioengineered skin
substituents in various fields including regenerative medicine, modeling
of diseases, and cosmetics/drugs testing. The advantages, limitations,
and future directions of this technology were also discussed.
Collapse
Affiliation(s)
- Anna Olejnik
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland
| | - Julia Anna Semba
- Center for Advanced Technology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 10, 61-614 Poznań, Poland
- Faculty of Biology, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
| | - Adam Kulpa
- Center for Advanced Technology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 10, 61-614 Poznań, Poland
- Faculty of Biology, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 6, 61-614 Poznań, Poland
| | | | - Jakub Dalibor Rybka
- Center for Advanced Technology, Adam Mickiewicz University, Uniwersytetu Poznańskiego 10, 61-614 Poznań, Poland
| | - Justyna Gornowicz-Porowska
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medicinal Sciences, Mazowiecka 33, 60-623 Poznań, Poland
| |
Collapse
|
28
|
Methods and Applications of 3D Patient-Specific Virtual Reconstructions in Surgery. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1356:53-71. [PMID: 35146617 DOI: 10.1007/978-3-030-87779-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
3D modelling has been highlighted as one of the key digital technologies likely to impact surgical practice in the next decade. 3D virtual models are reconstructed using traditional 2D imaging data through either direct volume or indirect surface rendering. One of the principal benefits of 3D visualisation in surgery relates to improved anatomical understanding-particularly in cases involving highly variable complex structures or where precision is required.Workflows begin with imaging segmentation which is a key step in 3D reconstruction and is defined as the process of identifying and delineating structures of interest. Fully automated segmentation will be essential if 3D visualisation is to be feasibly incorporated into routine clinical workflows; however, most algorithmic solutions remain incomplete. 3D models must undergo a range of processing steps prior to visualisation, which typically include smoothing, decimation and colourization. Models used for illustrative purposes may undergo more advanced processing such as UV unwrapping, retopology and PBR texture mapping.Clinical applications are wide ranging and vary significantly between specialities. Beyond pure anatomical visualisation, 3D modelling offers new methods of interacting with imaging data; enabling patient-specific simulations/rehearsal, Computer-Aided Design (CAD) of custom implants/cutting guides and serves as the substrate for augmented reality (AR) enhanced navigation.3D may enable faster, safer surgery with reduced errors and complications, ultimately resulting in improved patient outcomes. However, the relative effectiveness of 3D visualisation remains poorly understood. Future research is needed to not only define the ideal application, specific user and optimal interface/platform for interacting with models but also identify means by which we can systematically evaluate the efficacy of 3D modelling in surgery.
Collapse
|
29
|
Przedlacka A, Pellino G, Fletcher J, Bello F, Tekkis PP, Kontovounisios C. Current and future role of three-dimensional modelling technology in rectal cancer surgery: A systematic review. World J Gastrointest Surg 2021; 13:1754-1769. [PMID: 35070078 PMCID: PMC8727188 DOI: 10.4240/wjgs.v13.i12.1754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/09/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) modelling technology translates the patient-specific anatomical information derived from two-dimensional radiological images into virtual or physical 3D models, which more closely resemble the complex environment encountered during surgery. It has been successfully applied to surgical planning and navigation, as well as surgical training and patient education in several surgical specialties, but its uptake lags behind in colorectal surgery. Rectal cancer surgery poses specific challenges due to the complex anatomy of the pelvis, which is difficult to comprehend and visualise.
AIM To review the current and emerging applications of the 3D models, both virtual and physical, in rectal cancer surgery.
METHODS Medline/PubMed, Embase and Scopus databases were searched using the keywords “rectal surgery”, “colorectal surgery”, “three-dimensional”, “3D”, “modelling”, “3D printing”, “surgical planning”, “surgical navigation”, “surgical education”, “patient education” to identify the eligible full-text studies published in English between 2001 and 2020. Reference list from each article was manually reviewed to identify additional relevant papers. The conference abstracts, animal and cadaveric studies and studies describing 3D pelvimetry or radiotherapy planning were excluded. Data were extracted from the retrieved manuscripts and summarised in a descriptive way. The manuscript was prepared and revised in accordance with PRISMA 2009 checklist.
RESULTS Sixteen studies, including 9 feasibility studies, were included in the systematic review. The studies were classified into four categories: feasibility of the use of 3D modelling technology in rectal cancer surgery, preoperative planning and intraoperative navigation, surgical education and surgical device design. Thirteen studies used virtual models, one 3D printed model and 2 both types of models. The construction of virtual and physical models depicting the normal pelvic anatomy and rectal cancer, was shown to be feasible. Within the clinical context, 3D models were used to identify vascular anomalies, for surgical planning and navigation in lateral pelvic wall lymph node dissection and in management of recurrent rectal cancer. Both physical and virtual 3D models were found to be valuable in surgical education, with a preference for 3D printed models. The main limitations of the current technology identified in the studies were related to the restrictions of the segmentation process and the lack of 3D printing materials that could mimic the soft and deformable tissues.
CONCLUSION 3D modelling technology has potential to be utilised in multiple aspects of rectal cancer surgery, however, it is still at the experimental stage of application in this setting.
Collapse
Affiliation(s)
- Anna Przedlacka
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
- Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona 08029, Spain
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
| | - Jordan Fletcher
- Department of Surgery and Cancer, St Mark’s Hospital Academic Institute, Imperial College London, London HA1 3UJ, United Kingdom
| | - Fernando Bello
- Centre for Engagement and Simulation Science, Imperial College London, London SW10 9NH, United Kingdom
| | - Paris P Tekkis
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
- Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
| | - Christos Kontovounisios
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
- Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
| |
Collapse
|
30
|
Individualized 3D printing-assisted repair and reconstruction of neoplastic bone defects at irregular bone sites: exploration and practice in the treatment of scapular aneurysmal bone cysts. BMC Musculoskelet Disord 2021; 22:984. [PMID: 34823490 PMCID: PMC8620964 DOI: 10.1186/s12891-021-04859-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The irregular anatomical shape and complex structures of irregular bones make it more difficult to repair and reconstruct bone defects in irregular bones than in the long bones of the extremities. Three-dimensional (3D) printing technology can help to overcome the technical limitations of irregular bone repair by generating simulations that enable structural integration of the lesion area and bone structure of the donor site in all directions and at multiple angles. Thus, personalized and accurate treatment plans for restoring anatomical structure, muscle attachment points, and maximal function can be made. The present study aimed to investigate the ability of 3D printing technology to assist in the repair and reconstruction of scapular aneurysmal ABC defects. METHODS The study included seven patients with ABCs of the scapula. Based on computed tomography (CT) data for the patient, the scapula (including the defect) and pelvis were reconstructed using Mimics Medical software. The reconstructed scapula model was printed using a 3D printer. Before the operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and radius of the plate and the number and direction of screws, and to determine the bone mass of the ilium and develop reasonable strategies for segmentation and distribution. The operation time, amount of bleeding, length and radius of the plate, and direction and number of screws were recorded. RESULTS The average duration of follow-up was 25.6 months, and none of the seven patients experienced recurrence during the follow-up period. The surgical approach, the length and radius of internal fixation, and the number and direction of screws were consistent with the designed operation plan. Patients gradually recovered the anatomical structure of the scapula and function of the shoulder joint. CONCLUSIONS In the treatment of bone defects caused by irregular bone tumors, 3D printing technology combined with surgery has the advantages of less trauma, short operation time, less bleeding and reducing the difficulty of operation, which can reduce the waste of bone graft, and more complete reconstruction of the anatomical structure of the defective bone.
Collapse
|
31
|
Pal AK, Mohanty AK, Misra M. Additive manufacturing technology of polymeric materials for customized products: recent developments and future prospective. RSC Adv 2021; 11:36398-36438. [PMID: 35494368 PMCID: PMC9043570 DOI: 10.1039/d1ra04060j] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/09/2021] [Indexed: 12/12/2022] Open
Abstract
The worldwide demand for additive manufacturing (AM) is increasing due to its ability to produce more challenging customized objects based on the process parameters for engineering applications. The processing of conventional materials by AM processes is a critically demanded research stream, which has generated a path-breaking scenario in the rapid manufacturing and upcycling of plastics. The exponential growth of AM in the worldwide polymer market is expected to exceed 20 billion US dollars by 2021 in areas of automotive, medical, aerospace, energy and customized consumer products. The development of functional polymers and composites by 3D printing-based technologies has been explored significantly due to its cost-effective, easier integration into customized geometries, higher efficacy, higher precision, freedom of material utilization as compared to traditional injection molding, and thermoforming techniques. Since polymers are the most explored class of materials in AM to overcome the limitations, this review describes the latest research conducted on petroleum-based polymers and their composites using various AM techniques such as fused filament fabrication (FFF), selective laser sintering (SLS), and stereolithography (SLA) related to 3D printing in engineering applications such as biomedical, automotive, aerospace and electronics.
Collapse
Affiliation(s)
- Akhilesh Kumar Pal
- Bioproducts Discovery and Development Centre, Department of Plant Agriculture, University of Guelph Crop Science Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
| | - Amar K Mohanty
- Bioproducts Discovery and Development Centre, Department of Plant Agriculture, University of Guelph Crop Science Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
- School of Engineering, University of Guelph Thornbrough Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
| | - Manjusri Misra
- Bioproducts Discovery and Development Centre, Department of Plant Agriculture, University of Guelph Crop Science Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
- School of Engineering, University of Guelph Thornbrough Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
| |
Collapse
|
32
|
Nica DF, Gabor AG, Duma VF, Tudericiu VG, Tudor A, Sinescu C. Sinus Lift and Implant Insertion on 3D-Printed Polymeric Maxillary Models: Ex Vivo Training for In Vivo Surgical Procedures. J Clin Med 2021; 10:jcm10204718. [PMID: 34682841 PMCID: PMC8538196 DOI: 10.3390/jcm10204718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives: The aim of this study is to demonstrate the increased efficiency achieved by dental practitioners when carrying out an ex vivo training process on 3D-printed maxillaries before performing in vivo surgery. Materials and Methods: This developed ex vivo procedure comprises the following phases: (i) scanning the area of interest for surgery; (ii) obtaining a 3D virtual model of this area using Cone Beam Computed Tomography (CBCT); (iii) obtaining a 3D-printed model (based on the virtual one), on which (iv) the dental practitioner simulates/rehearses ex vivo (most of) the surgery protocol; (v) assess with a new CBCT the 3D model after simulation. The technical steps of sinus augmentation and implant insertion could be performed on the corresponding 3D-printed hemi-maxillaries prior to the real in vivo surgery. Two study groups were considered, with forty patients divided as follows: Group 1 comprises twenty patients on which the developed simulation and rehearsal procedure was applied; Group 2 is a control one which comprises twenty patients on which similar surgery was performed without this procedure (considered in order to compare operative times without and with rehearsals). Results: Following the ex vivo training/rehearsal, an optimal surgery protocol was developed for each considered case. The results of the surgery on patients were compared with the results obtained after rehearsals on 3D-printed models. The performed quantitative assessment proved that, using the proposed training procedure, the results of the in vivo surgery are not significantly different (p = 0.089) with regard to the ex vivo simulation for both the mezio-distal position of the implant and the distance from the ridge margin to sinus window. On the contrary, the operative time of Group 1 was reduced significantly (p = 0.001), with an average of 20% with regard to in vivo procedures performed without rehearsals (on the control Group 2). Conclusions: The study demonstrated that the use of 3D-printed models can be beneficial to dental surgeon practitioners, as well as to students who must be trained before performing clinical treatments.
Collapse
Affiliation(s)
- Diana Florina Nica
- School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300070 Timisoara, Romania;
| | - Alin Gabriel Gabor
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| | - Virgil-Florin Duma
- 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, 2 Elena Dragoi, 310177 Arad, Romania
- Doctoral School, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania
- Correspondence: ; Tel.: +40-751-511451
| | | | - Anca Tudor
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| | - Cosmin Sinescu
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (A.G.G.); (A.T.); (C.S.)
| |
Collapse
|
33
|
Facilitating Student Understanding through Incorporating Digital Images and 3D-Printed Models in a Human Anatomy Course. EDUCATION SCIENCES 2021. [DOI: 10.3390/educsci11080380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Combining classical educational methods with interactive three-dimensional (3D) visualization technology has great power to support and provide students with a unique opportunity to use them in the study process, training, and/or simulation of different medical procedures in terms of a Human Anatomy course. In 2016, Rīga Stradiņš University (RSU) offered students the 3D Virtual Dissection Table “Anatomage” with possibilities of virtual dissection and digital images at the Department of Morphology. The first 3D models were printed in 2018 and a new printing course was integrated into the Human Anatomy curriculum. This study was focused on the interaction of students with digital images, 3D models, and their combinations. The incorporation and use of digital technologies offered students great tools for their creativity, increased the level of knowledge and skills, and gave them a possibility to study human body structures and to develop relationships between basic and clinical studies.
Collapse
|
34
|
Daoud GE, Pezzutti DL, Dolatowski CJ, Carrau RL, Pancake M, Herderick E, VanKoevering KK. Establishing a point-of-care additive manufacturing workflow for clinical use. JOURNAL OF MATERIALS RESEARCH 2021; 36:3761-3780. [PMID: 34248272 PMCID: PMC8259775 DOI: 10.1557/s43578-021-00270-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
Additive manufacturing, or 3-Dimensional (3-D) Printing, is built with technology that utilizes layering techniques to build 3-D structures. Today, its use in medicine includes tissue and organ engineering, creation of prosthetics, the manufacturing of anatomical models for preoperative planning, education with high-fidelity simulations, and the production of surgical guides. Traditionally, these 3-D prints have been manufactured by commercial vendors. However, there are various limitations in the adaptability of these vendors to program-specific needs. Therefore, the implementation of a point-of-care in-house 3-D modeling and printing workflow that allows for customization of 3-D model production is desired. In this manuscript, we detail the process of additive manufacturing within the scope of medicine, focusing on the individual components to create a centralized in-house point-of-care manufacturing workflow. Finally, we highlight a myriad of clinical examples to demonstrate the impact that additive manufacturing brings to the field of medicine.
Collapse
Affiliation(s)
| | | | | | - Ricardo L. Carrau
- The Ohio State University College of Medicine, Columbus, OH USA
- The Ohio State University James Comprehensive Cancer Center, Columbus, OH 43210 USA
- Department of Otolaryngology, The Ohio State University, Columbus, OH USA
| | - Mary Pancake
- Department of Engineering, The Ohio State University, Columbus, OH USA
| | - Edward Herderick
- Department of Engineering, The Ohio State University, Columbus, OH USA
| | - Kyle K. VanKoevering
- The Ohio State University College of Medicine, Columbus, OH USA
- The Ohio State University James Comprehensive Cancer Center, Columbus, OH 43210 USA
- Department of Otolaryngology, The Ohio State University, Columbus, OH USA
| |
Collapse
|
35
|
Flaxman TE, Cooke CM, Miguel OX, Sheikh AM, Singh SS. A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery. 3D Print Med 2021; 7:17. [PMID: 34224043 PMCID: PMC8256564 DOI: 10.1186/s41205-021-00107-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited. Main text This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery. Conclusion Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.
Collapse
Affiliation(s)
- Teresa E Flaxman
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada. .,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Carly M Cooke
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Olivier X Miguel
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada.,Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Adnan M Sheikh
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada.,Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sukhbir S Singh
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada
| |
Collapse
|
36
|
Condino S, Cutolo F, Cattari N, Colangeli S, Parchi PD, Piazza R, Ruinato AD, Capanna R, Ferrari V. Hybrid Simulation and Planning Platform for Cryosurgery with Microsoft HoloLens. SENSORS 2021; 21:s21134450. [PMID: 34209748 PMCID: PMC8272062 DOI: 10.3390/s21134450] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022]
Abstract
Cryosurgery is a technique of growing popularity involving tissue ablation under controlled freezing. Technological advancement of devices along with surgical technique improvements have turned cryosurgery from an experimental to an established option for treating several diseases. However, cryosurgery is still limited by inaccurate planning based primarily on 2D visualization of the patient’s preoperative images. Several works have been aimed at modelling cryoablation through heat transfer simulations; however, most software applications do not meet some key requirements for clinical routine use, such as high computational speed and user-friendliness. This work aims to develop an intuitive platform for anatomical understanding and pre-operative planning by integrating the information content of radiological images and cryoprobe specifications either in a 3D virtual environment (desktop application) or in a hybrid simulator, which exploits the potential of the 3D printing and augmented reality functionalities of Microsoft HoloLens. The proposed platform was preliminarily validated for the retrospective planning/simulation of two surgical cases. Results suggest that the platform is easy and quick to learn and could be used in clinical practice to improve anatomical understanding, to make surgical planning easier than the traditional method, and to strengthen the memorization of surgical planning.
Collapse
Affiliation(s)
- Sara Condino
- Information Engineering Department, University of Pisa, 56126 Pisa, Italy; (F.C.); (V.F.)
- Correspondence:
| | - Fabrizio Cutolo
- Information Engineering Department, University of Pisa, 56126 Pisa, Italy; (F.C.); (V.F.)
| | - Nadia Cattari
- EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (N.C.); (R.P.); (A.D.R.)
| | - Simone Colangeli
- Orthopaedic and Traumatology Division, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56124 Pisa, Italy; (S.C.); (P.D.P.); (R.C.)
| | - Paolo Domenico Parchi
- Orthopaedic and Traumatology Division, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56124 Pisa, Italy; (S.C.); (P.D.P.); (R.C.)
| | - Roberta Piazza
- EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (N.C.); (R.P.); (A.D.R.)
| | - Alfio Damiano Ruinato
- EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (N.C.); (R.P.); (A.D.R.)
| | - Rodolfo Capanna
- Orthopaedic and Traumatology Division, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56124 Pisa, Italy; (S.C.); (P.D.P.); (R.C.)
| | - Vincenzo Ferrari
- Information Engineering Department, University of Pisa, 56126 Pisa, Italy; (F.C.); (V.F.)
| |
Collapse
|
37
|
Roth CJ, Clunie DA, Vining DJ, Berkowitz SJ, Berlin A, Bissonnette JP, Clark SD, Cornish TC, Eid M, Gaskin CM, Goel AK, Jacobs GC, Kwan D, Luviano DM, McBee MP, Miller K, Hafiz AM, Obcemea C, Parwani AV, Rotemberg V, Silver EL, Storm ES, Tcheng JE, Thullner KS, Folio LR. Multispecialty Enterprise Imaging Workgroup Consensus on Interactive Multimedia Reporting Current State and Road to the Future: HIMSS-SIIM Collaborative White Paper. J Digit Imaging 2021; 34:495-522. [PMID: 34131793 PMCID: PMC8329131 DOI: 10.1007/s10278-021-00450-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
Diagnostic and evidential static image, video clip, and sound multimedia are captured during routine clinical care in cardiology, dermatology, ophthalmology, pathology, physiatry, radiation oncology, radiology, endoscopic procedural specialties, and other medical disciplines. Providers typically describe the multimedia findings in contemporaneous electronic health record clinical notes or associate a textual interpretative report. Visual communication aids commonly used to connect, synthesize, and supplement multimedia and descriptive text outside medicine remain technically challenging to integrate into patient care. Such beneficial interactive elements may include hyperlinks between text, multimedia elements, alphanumeric and geometric annotations, tables, graphs, timelines, diagrams, anatomic maps, and hyperlinks to external educational references that patients or provider consumers may find valuable. This HIMSS-SIIM Enterprise Imaging Community workgroup white paper outlines the current and desired clinical future state of interactive multimedia reporting (IMR). The workgroup adopted a consensus definition of IMR as “interactive medical documentation that combines clinical images, videos, sound, imaging metadata, and/or image annotations with text, typographic emphases, tables, graphs, event timelines, anatomic maps, hyperlinks, and/or educational resources to optimize communication between medical professionals, and between medical professionals and their patients.” This white paper also serves as a precursor for future efforts toward solving technical issues impeding routine interactive multimedia report creation and ingestion into electronic health records.
Collapse
Affiliation(s)
| | | | - David J Vining
- Department of Abdominal Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - Seth J Berkowitz
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre - University Health Network, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Jean-Pierre Bissonnette
- Departments of Radiation Oncology and Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Shawn D Clark
- University of Miami Hospitals and Clinics, Miami, FL, USA
| | - Toby C Cornish
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Monief Eid
- eHealth & Digital Transformation Agency, Ministry of Health, Riyadh, Saudi Arabia
| | - Cree M Gaskin
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | | | | | - David Kwan
- Health Technology and Information Management, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Damien M Luviano
- Department of Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Morgan P McBee
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | | | - Abdul Moiz Hafiz
- Division of Cardiology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ceferino Obcemea
- Radiation Research Program, National Cancer Institute, Bethesda, MD, USA
| | - Anil V Parwani
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Veronica Rotemberg
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Erik S Storm
- Department of Radiology and Medical Education, Salem VA Medical Center, Salem, VA, USA
| | - James E Tcheng
- Department of Medicine, Division of Cardiology, Duke University, Durham, NC, USA
| | | | - Les R Folio
- Lead CT Radiologist, NIH Clinical Center, Bethesda, MD, USA
| |
Collapse
|
38
|
Haleem A, Javaid M, Suman R, Singh RP. 3D Printing Applications for Radiology: An Overview. Indian J Radiol Imaging 2021; 31:10-17. [PMID: 34316106 PMCID: PMC8299499 DOI: 10.1055/s-0041-1729129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) printing technologies are part of additive manufacturing processes and are used to manufacture a 3D physical model from a digital computer-aided design model as per the required shape and size. These technologies are now used for advanced radiology applications by providing all information through 3D physical model. It provides innovation in radiology for clinical applications, treatment planning, procedural simulation, medical and patient education. Radiological advancements have been made in diagnosis and communication through medical digital imaging techniques like computed tomography, magnetic resonance imaging. These images are converted into Digital Imaging and Communications in Medicine in Standard Triangulate Language file format, easily printable in 3D printing technologies. This 3D model provides in-depth information about pathologic and anatomic states. It is useful to create new opportunities related to patient care. This article discusses the potential of 3D printing technology in radiology. The steps involved in 3D printing for radiology are discussed diagrammatically, and finally identified 12 significant applications of 3D printing technology for radiology with a brief description. A radiologist can incorporate this technology to fulfil different challenges such as training, planning, guidelines, and better communications.
Collapse
Affiliation(s)
- Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Rajiv Suman
- Department of Industrial and Production Engineering, G.B. Pant University of Agriculture and Technology, Pantnagar, Uttarakhand, India
| | - Ravi Pratap Singh
- Department of Industrial and Production Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar, Punjab, India
| |
Collapse
|
39
|
Tenewitz C, Le RT, Hernandez M, Baig S, Meyer TE. Systematic review of three-dimensional printing for simulation training of interventional radiology trainees. 3D Print Med 2021; 7:10. [PMID: 33881672 PMCID: PMC8059217 DOI: 10.1186/s41205-021-00102-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
RATIONALE AND OBJECTIVES Three-dimensional (3D) printing has been utilized as a means of producing high-quality simulation models for trainees in procedure-intensive or surgical subspecialties. However, less is known about its role for trainee education within interventional radiology (IR). Thus, the purpose of this review was to assess the state of current literature regarding the use of 3D printed simulation models in IR procedural simulation experiences. MATERIALS AND METHODS A literature query was conducted through April 2020 for articles discussing three-dimensional printing for simulations in PubMed, Embase, CINAHL, Web of Science, and the Cochrane library databases using key terms relating to 3D printing, radiology, simulation, training, and interventional radiology. RESULTS We identified a scarcity of published sources, 4 total articles, that appraised the use of three-dimensional printing for simulation training in IR. While trainee feedback is generally supportive of the use of three-dimensional printing within the field, current applications utilizing 3D printed models are heterogeneous, reflecting a lack of best practices standards in the realm of medical education. CONCLUSIONS Presently available literature endorses the use of three-dimensional printing within interventional radiology as a teaching tool. Literature documenting the benefits of 3D printed models for IR simulation has the potential to expand within the field, as it offers a straightforward, sustainable, and reproducible means for hands-on training that ought to be standardized.
Collapse
Affiliation(s)
- Chase Tenewitz
- Mercer University School of Medicine, Savannah, GA, USA.
| | - Rebecca T Le
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Saif Baig
- UF Health Jacksonville, Jacksonville, FL, USA
| | | |
Collapse
|
40
|
Guler E, Ozer MA, Bati AH, Govsa F, Erozkan K, Vatansever S, Ersin MS, Elmas NZ. Patient-centered oncosurgical planning with cancer models in subspecialty education. Surg Oncol 2021; 37:101537. [PMID: 33711767 DOI: 10.1016/j.suronc.2021.101537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 01/20/2021] [Accepted: 03/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND A fundamental aspect of oncosurgical planning in organ resections is the identification of feeder vessel details to preserve healthy organ tissue while fully resecting the tumors. The purpose of this study was to determine whether three-dimensional (3D) cancer case models of computed tomography (CT) images will assist resident-level trainees in making appropriate operative plans for organ resection surgery. METHODS This study was based on the perception of surgery residents who were presented with 5 different oncosurgical scenarios. A five-station carousel including cases of liver mass, stomach mass, annular pancreas, pelvic mass and mediastinal mass was formed for the study. The residents were required to compare their perception level of the cases with their CT images, and 3D models in terms of identifying the invasion of the mass, making differential diagnosis and preoperative planning stage. RESULTS All residents have given higher scores for models. 3D models provided better understanding of oncopathological anatomy and improved surgical planning. In all scenarios, 70-80% of the residents preferred the model for preoperative planning. For surgical choice, compared to the CT, the model provided a statistically significant difference in terms of visual assessment, such as tumor location, distal or proximal organotomy (p:0.009). In the evaluation of presacral mass, the perception of model was significantly better than the CT in terms of bone-foramen relationship of chondrosarcoma, its origin, geometric shape, localization, invasion, and surgical preference (p:0.004). The model statistically significantly provided help to evaluate and prepare the case together with the colleagues performing surgery (p:0.007). Commenting on the open-ended question, they stated that the tumor-vessel relationship was clearly demonstrated in the 3D model, which has been very useful. CONCLUSIONS With the help of 3D printing technology in this study, it is possible to implement and evaluate a well-structured real patient scenario setup in cancer surgery training. It can be used to improve the understanding of pathoanatomical changes of multidisciplinary oncologic cases. Namely, it is used in guiding the surgical strategy and determining whether patient-specific 3D models change pre-operative planning decisions made by surgeons in complex cancer mass surgical procedures.
Collapse
Affiliation(s)
- Ezgi Guler
- Department of Radiology, Ege University Faculty of Medicine, Turkey
| | - Mehmet Asim Ozer
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Ege University Faculty of Medicine, Turkey
| | - Ayse Hilal Bati
- Department of Medical Education, Ege University Faculty of Medicine, Turkey
| | - Figen Govsa
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Ege University Faculty of Medicine, Turkey.
| | - Kamil Erozkan
- Department of General Surgery, Ege University Faculty of Medicine, Turkey
| | - Safa Vatansever
- Department of General Surgery, Ege University Faculty of Medicine, Turkey
| | - Muhtar Sinan Ersin
- Department of General Surgery, Ege University Faculty of Medicine, Turkey
| | | |
Collapse
|
41
|
Lezhnev AA, Ryabtsev DV, Hamanturov DB, Barskiy VI, Yatsyk SP. Silicone models of the aortic root to plan and simulate interventions. Interact Cardiovasc Thorac Surg 2021; 31:204-209. [PMID: 32463865 DOI: 10.1093/icvts/ivaa068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/20/2020] [Accepted: 03/18/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The objective of this work was to develop technology to create 'soft' patient-specific models of semilunar heart valves, the aortic valve in particular, suitable for training and simulation of surgical and endovascular interventions. METHODS Data obtained during routine cardiac contrast-enhanced multislice computed tomography were used to create 3-dimensional models of the aortic root. Three-dimensional models were used to create soft silicone models of the aortic root made by casting silicone into a negative mould printed with stereolithography. A comparison between the constructed models and the size of the aortic root was performed. We quantified how much time was needed for production of each model. RESULTS Four patient-specific soft models of the aortic root were produced. Data from patients of different ages and body surface areas were used as prototypes. All models had minimum size errors. During development of this technology, production time per model was reduced from 63 to 39 h. CONCLUSIONS We have demonstrated the feasibility of making soft patient-specific 3-dimensional aortic root models using currently available technology. These models can be used both for training physicians in a variety of open surgical and endovascular interventions and for the study of complex aortic root geometry.
Collapse
Affiliation(s)
| | | | | | | | - Sergeiy P Yatsyk
- National Medical Research Center for Children's Health, Moscow, Russia
| |
Collapse
|
42
|
Park SY, An JH, Kwon H, Choi SY, Lim KY, Kwak HH, Hussein KH, Woo HM, Park KM. Custom-made artificial eyes using 3D printing for dogs: A preliminary study. PLoS One 2020; 15:e0242274. [PMID: 33216792 PMCID: PMC7678976 DOI: 10.1371/journal.pone.0242274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/29/2020] [Indexed: 01/02/2023] Open
Abstract
Various incurable eye diseases in companion animals often result in phthisis bulbi and eye removal surgery. Currently, the evisceration method using silicone balls is useful in animals; however, it is not available to those with impaired cornea or severe ocular atrophy. Moreover, ocular implant and prostheses are not widely used because of the diversity in animal size and eye shape, and high manufacturing cost. Here, we produced low-cost and customized artificial eyes, including implant and prosthesis, using computer-aided design and three-dimensional (3D) printing technique. For 3D modeling, the size of the artificial eyes was optimized using B-mode ultrasonography. The design was exported to STL files, and then printed using polycaprolactone (PCL) for prosthesis and mixture of PCL and hydroxyapatite (HA) for ocular implant. The 3D printed artificial eyes could be produced in less than one and half hour. The prosthesis was painted using oil colors and biocompatible resin. Two types of eye removal surgery, including evisceration and enucleation, were performed using two beagle dogs, as a preliminary study. After the surgery, the dogs were clinically evaluated for 6 months and then histopathological evaluation of the implant was done. Ocular implant was biocompatible and host tissue ingrowth was induced after in vivo application. The custom-made prosthesis was cosmetically excellent. Although long-term clinical follow-up might be required, the use of 3D printed-customized artificial eyes may be beneficial for animals that need personalized artificial eye surgery.
Collapse
Affiliation(s)
- So-Young Park
- Department of Ophthalmology and Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Jeong-Hee An
- Department of Ophthalmology and Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Hyun Kwon
- Department of Ophthalmology and Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Seo-Young Choi
- Department of Ophthalmology and Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Ka-Young Lim
- Department of Ophthalmology and Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Ho-Hyun Kwak
- Department of Surgery, College of Veterinary Medicine, Kangwon National University, Chuncheon, Korea
| | - Kamal Hany Hussein
- Department of Surgery, College of Veterinary Medicine, Kangwon National University, Chuncheon, Korea
- Department of Animal Surgery, College of Veterinary Medicine, Assiut University, Assiut, Egypt
| | - Heung-Myong Woo
- Department of Surgery, College of Veterinary Medicine, Kangwon National University, Chuncheon, Korea
| | - Kyung-Mee Park
- Department of Ophthalmology and Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
- * E-mail:
| |
Collapse
|
43
|
Meglioli M, Naveau A, Macaluso GM, Catros S. 3D printed bone models in oral and cranio-maxillofacial surgery: a systematic review. 3D Print Med 2020; 6:30. [PMID: 33079298 PMCID: PMC7574578 DOI: 10.1186/s41205-020-00082-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
AIM This systematic review aimed to evaluate the use of three-dimensional (3D) printed bone models for training, simulating and/or planning interventions in oral and cranio-maxillofacial surgery. MATERIALS AND METHODS A systematic search was conducted using PubMed® and SCOPUS® databases, up to March 10, 2019, by following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) protocol. Study selection, quality assessment (modified Critical Appraisal Skills Program tool) and data extraction were performed by two independent reviewers. All original full papers written in English/French/Italian and dealing with the fabrication of 3D printed models of head bone structures, designed from 3D radiological data were included. Multiple parameters and data were investigated, such as author's purpose, data acquisition systems, printing technologies and materials, accuracy, haptic feedback, variations in treatment time, differences in clinical outcomes, costs, production time and cost-effectiveness. RESULTS Among the 1157 retrieved abstracts, only 69 met the inclusion criteria. 3D printed bone models were mainly used as training or simulation models for tumor removal, or bone reconstruction. Material jetting printers showed best performance but the highest cost. Stereolithographic, laser sintering and binder jetting printers allowed to create accurate models with adequate haptic feedback. The cheap fused deposition modeling printers exhibited satisfactory results for creating training models. CONCLUSION Patient-specific 3D printed models are known to be useful surgical and educational tools. Faced with the large diversity of software, printing technologies and materials, the clinical team should invest in a 3D printer specifically adapted to the final application.
Collapse
Affiliation(s)
- Matteo Meglioli
- University Center of Dentistry, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Adrien Naveau
- Department of Prosthodontics, Dental Science Faculty, University of Bordeaux, 46 rue Léo-Saignat, 33076, Bordeaux, France.,Dental and Periodontal Rehabilitation Unit, Saint Andre Hospital, Bordeaux University Hospital, 46 rue Léo-Saignat, 33076, Bordeaux, France.,Biotis Laboratory, Inserm U1026, University of Bordeaux, 46 rue Léo-Saignat, 33076, Bordeaux, France
| | - Guido Maria Macaluso
- University Center of Dentistry, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy.,IMEM-CNR, Parco Area delle Scienze 37/A, 43124, Parma, Italy
| | - Sylvain Catros
- Biotis Laboratory, Inserm U1026, University of Bordeaux, 46 rue Léo-Saignat, 33076, Bordeaux, France. .,Department of Oral Surgery, UFR d'Odontologie, University of Bordeaux, 46 rue Léo-Saignat, 33076, Bordeaux, France. .,Service de Chirurgie Orale, CHU de Bordeaux, 46 rue Léo-Saignat, 33076, Bordeaux, France.
| |
Collapse
|
44
|
The utility of three-dimensional models in complex microsurgical reconstruction. Arch Plast Surg 2020; 47:428-434. [PMID: 32971594 PMCID: PMC7520243 DOI: 10.5999/aps.2020.00829] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/29/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes. METHODS A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction. RESULTS Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with use of 3D model (CTA vs. 3D, 117.7±14.2 minutes vs. 109.8±11.6 minutes; P=0.001). In addition, there was no change in preoperative decision on type of flap harvested in all cases in 3D print group (0%), compared with 24.1% change in conventional CTA group. CONCLUSIONS Use of 3D print model improves accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction.
Collapse
|
45
|
Czako L, Simko K, Thurzo A, Galis B, Varga I. The Syndrome of Elongated Styloid Process, the Eagle's Syndrome-From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E458. [PMID: 32916813 PMCID: PMC7558969 DOI: 10.3390/medicina56090458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022]
Abstract
Background and Objectives: The symptoms of Eagle's syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle's syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1-3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle's syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament.
Collapse
Affiliation(s)
- Ladislav Czako
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Kristian Simko
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Andrej Thurzo
- Department of Simulation and Virtual Medical Education, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
| | - Branislav Galis
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Ivan Varga
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
| |
Collapse
|
46
|
Elshafei M, Binder J, Baecker J, Brunner M, Uder M, Weber GF, Grützmann R, Krautz C. Comparison of Cinematic Rendering and Computed Tomography for Speed and Comprehension of Surgical Anatomy. JAMA Surg 2020; 154:738-744. [PMID: 31141115 PMCID: PMC6705138 DOI: 10.1001/jamasurg.2019.1168] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Question Does the use of cinematic rendering improve the comprehension of the surgical anatomy? Findings In this German preclinical randomized crossover study, visualization with cinematic rendering allowed a more correct and faster comprehension of the surgical anatomy compared with conventional computed tomography independent of the level of surgical experience. Meaning Cinematic rendering is a tool that may assist general surgeons with preoperative preparation and intraoperative guidance through an improved interpretation of computed tomography imaging data. Importance Three-dimensional (3-D) volume rendering has been shown to improve visualization in general surgery. Cinematic rendering (CR), a novel 3-D visualization technology for postprocessing of computed tomographaphy (CT) images, provides photorealistic images with the potential to improve visualization of anatomic details. Objective To determine the value of CR for the comprehension of the surgical anatomy. Design, Setting, and Participants This preclinical, randomized, 2-sequence crossover study was conducted from February to November 1, 2018, at University Hospital of Erlangen, Germany. The 40 patient cases were evaluated by 18 resident and attending surgeons using a prepared set of CT and CR images. The patient cases were randomized to 2 assessment sequences (CR-CT and CT-CR). During each assessment period, participants answered 1 question per case that addressed crucial issues of anatomic understanding, preoperative planning, and intraoperative strategies. After a washout period of 2 weeks, case evaluations were crossed over to the respective second image modality. Main Outcomes and Measures The primary outcome measure was the correctness of answers. Secondary outcome was the time needed to answer. Results The mean (SD) interperiod differences for the percentage of correct answers in the CR-CT sequence (8.5% [7.0%]) differed significantly from those in the CT-CR sequence (−13.1% [6.3%]) (P < .001). The mean (SD) interperiod differences for the time spent to answer the questions in the CR-CT sequence (−18.3 [76.9] seconds) also differed significantly from those in the CT-CR sequence (52.4 [88.5] seconds) (P < .001). Subgroup analysis revealed that residents as well as attending physicians benefitted from CR visualization. Analysis of the case assessment questionnaire showed that CR added significant value to the comprehension of the surgical anatomy (overall mean [SD] score, 4.53 [0.75]). No carryover or period effects were observed. Conclusions and Relevance The visualization with CR allowed a more correct and faster comprehension of the surgical anatomy compared with conventional CT imaging, independent of level of surgeon experience. Therefore, CR may assist general surgeons with preoperative preparation and intraoperative guidance.
Collapse
Affiliation(s)
- Moustafa Elshafei
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Johannes Binder
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Justus Baecker
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Maximilian Brunner
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Georg F Weber
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Robert Grützmann
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Christian Krautz
- Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| |
Collapse
|
47
|
Yamaki VN, Cancelliere NM, Nicholson P, Rodrigues M, Radovanovic I, Sungur JM, Krings T, Pereira VM. Biomodex patient-specific brain aneurysm models: the value of simulation for first in-human experiences using new devices and robotics. J Neurointerv Surg 2020; 13:272-277. [PMID: 32601259 PMCID: PMC7892376 DOI: 10.1136/neurintsurg-2020-015990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 12/29/2022]
Abstract
Background With the recent advent of advanced technologies in the field, treatment of neurovascular diseases using endovascular techniques is rapidly evolving. Here we describe our experience with pre-surgical simulation using the Biomodex EVIAS patient-specific 3D-printed models to plan aneurysm treatment using endovascular robotics and novel flow diverter devices. Methods Pre-procedural rehearsals with 3D-printed patient-specific models of eight cases harboring brain aneurysms were performed before the first in-human experiences. To assess the reliability of the experimental model, the characteristics of the aneurysms were compared between the patient and 3D models. The rehearsals were used to define the patient treatment plan, including technique, device sizing, and operative working projections. Results The study included eight patients with their respective EVIAS 3D aneurysm models. Pre-operative simulation was performed for the first in-human robotic-assisted neurovascular interventions (n=2) and new generation flow-diverter stents (n=6). Aneurysms were located in both the anterior (n=5) and posterior (n=3) circulation and were on average 11.0±6.5 mm in size. We found reliable reproduction of the aneurysm features and similar dimensions of the parent vessel anatomy between the 3D models and patient anatomy. Information learned from pre-surgical in vitro simulation are described in detail, including an improved patient treatment plan, which contributed to successful first in-world procedures with no intraprocedural complications. Conclusions Pre-procedural rehearsal using patient-specific 3D models provides precise procedure planning, which can potentially lead to greater operator confidence, decreased radiation dose and improvements in patient safety, particularly in first in-human experiences.
Collapse
Affiliation(s)
- Vitor Nagai Yamaki
- Division of Neurosurgery, Department of Neurology, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
| | | | - Patrick Nicholson
- Department of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Marta Rodrigues
- Imagiology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Porto, Portugal
| | - Ivan Radovanovic
- Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada
| | | | - Timo Krings
- Department of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, Canada.,Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Vitor M Pereira
- Department of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, Canada.,Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada
| |
Collapse
|
48
|
Ballard DH, Wake N, Witowski J, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions. 3D Print Med 2020; 6:13. [PMID: 32514795 PMCID: PMC7278118 DOI: 10.1186/s41205-020-00065-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications. Methods A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines. Results Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, pancreatitis, splenic disease, gastric pathology, small bowel pathology, colorectal cancer, perianal fistula, visceral trauma, hernia, abdominal sarcoma, abdominal wall masses, and intra-abdominal fluid collections. Conclusion This document provides initial appropriate use criteria for medical 3D printing in abdominal, hepatobiliary, and gastrointestinal conditions.
Collapse
Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO, 63110, USA.
| | - Nicole Wake
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jan Witowski
- 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Krakow, Poland
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | |
Collapse
|
49
|
Hojo D, Murono K, Nozawa H, Kawai K, Hata K, Tanaka T, Ishihara S. Utility of a three-dimensional printed pelvic model for lateral pelvic lymph node dissection. Int J Colorectal Dis 2020; 35:905-910. [PMID: 32124050 DOI: 10.1007/s00384-020-03534-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE In patients with advanced lower rectal cancer, the complex pelvic anatomy renders lateral pelvic lymph node dissection to be challenging. Therefore, we evaluated the utility of printing a three-dimensional (3D) pelvic model for lateral pelvic lymph node dissection. METHODS We included 22 patients who underwent lateral pelvic lymph node dissection for rectal cancer between June 2017 and February 2019. Using CT scans, 3D pelvic images and models were constructed and printed, respectively. Thirty colorectal surgeons subjectively evaluated the utility of 3D pelvic models based on a 5-point Likert scale questionnaire (1 = strongly disagree, 5 = strongly agree). RESULTS The average Likert score for the question "Would a 3D model be useful for understanding pelvic anatomy?" was 4.68. Cases with clinically diagnosed metastatic lymph nodes (4.79 ± 0.44) scored higher than those without them (4.38 ± 0.77, p = 0.02). For spatial comprehension of pelvic anatomy, 3D models scored higher (4.83) than 3D images (4.36, p < 0.001). The ease of use of 3D models and images was scored 4.60 and 4.20, respectively (p = 0.015). With experience, the 3D image reconstruction time decreased from 900 to 150 min. CONCLUSION The 3D pelvic models may be helpful for experienced surgeons to understand the pelvic anatomy in lateral pelvic lymph node dissection.
Collapse
Affiliation(s)
- Daisuke Hojo
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Koji Murono
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Keisuke Hata
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| |
Collapse
|
50
|
Marone EM, Peri A, Argenti F, Pugliese L, Rinaldi LF, Pietrabissa A. Robotic Treatment of Complex Splenic Artery Aneurysms with Deep Hilar Location: Technical Insights and Midterm Results. Ann Vasc Surg 2020; 68:50-56. [PMID: 32283302 DOI: 10.1016/j.avsg.2020.03.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Splenic artery aneurysms are rare, but their occurrence is burdened by considerable mortality and morbidity rates. Although the indications to treatment are quite clear-cut, there is still debate on the first-choice technique of treatment (endovascular, open, or laparoscopic surgery). Recently, robotic surgery has been proposed as an alternative option in patients at high surgical risk. The present case series aims to assess the value of robotic treatment of splenic artery aneurysms in patients unfit for surgery. METHODS All cases of splenic artery aneurysms treated by robotic surgery at our center between 2014 and 2018 were retrospectively reviewed. Primary endpoints were clinical and technical success and disease-free survival. RESULTS Robotic surgery was used to treat four patients affected by splenic artery aneurysms, with the guidance of 3D printed patient-specific models. All patients, after aneurysm excision, received reconstruction of the splenic artery by direct anastomosis. All cases were treated successfully without mortality. Reintervention-free survival at 24-month mean follow-up is 100%, and no systemic complication of clinical relevance was reported. The mean time of organ ischemia was 45 min. CONCLUSIONS Robotic surgery is a safe and effective option in treating visceral aneurysms, providing the possibility to reconstruct the splenic artery after aneurysm excision.
Collapse
Affiliation(s)
- Enrico Maria Marone
- Vascular Surgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Andrea Peri
- General Surgery, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Argenti
- General Surgery, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luigi Pugliese
- General Surgery, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luigi Federico Rinaldi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Pietrabissa
- General Surgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|