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Giorgi L, Moffa A, Pericone G, Galantai D, De Benedetto L, Jacobowitz O, Vicini C, Lugo R, Baptista PM, Casale M. Barbed Pharyngoplasty simulation using a 3D-printed model: design and validation study. Sleep Breath 2024; 28:2155-2163. [PMID: 38806978 DOI: 10.1007/s11325-024-03067-4] [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: 01/12/2024] [Revised: 03/22/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Learning how to use barbed sutures and perform Barbed Pharyngoplasty (BP) is challenging due to limited surgical training opportunities. This work aims to design, develop, and validate a new 3D surgical simulator to train ENT residents and specialists in performing BP. METHODS The Barbed Pharyngoplasty Simulator (BPS) was designed using diagnostic images of the facial mass and testing different materials to replicate the mucosal and bony tissues. ENT specialists with experience in BP and ENT residents were included in the validation study and were asked to perform the Alianza BP. After the simulation, they compiled the Face and Content Validity Questionnaires. RESULTS The BPS consists of a reusable cranial structure that contains the disposable palatopharyngeal structure, replicating the palatal structures and the tongue. Fifteen experienced ENT specialists and nine residents were included in the study. Findings demonstrated that the BPS faithfully replicated the muscular and fibrous-bony palatopharyngeal structures, with only 11% of residents having a negative opinion of the mucosal tissue. All the participants positively rated the sensation of using surgical instruments on the simulator. Also, ENT residents rated all aspects of the content validity test from normal to excellent, while specialists rated the BPS as a general training tool from normal to excellent; for lateral pharyngoplasty, BP, and Alianza, only 6.7% of participants disagreed with its usefulness, and 13.3% disagreed with it for anterior pharyngoplasty. CONCLUSION The BPS proposed in this preliminary study can potentially be a valuable tool in BP surgical training for residents and young otolaryngologists.
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Affiliation(s)
- Lucrezia Giorgi
- Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico Di Roma, Rome, Italy
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Antonio Moffa
- School of Medicine, Università Campus Bio-Medico Di Roma, Rome, Italy.
| | - Giovanni Pericone
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- School of Medicine, Università Campus Bio-Medico Di Roma, Rome, Italy
| | - Dorina Galantai
- Bajcsy-Zsilinszky Kórház És Rendelőintézet, Fül-Orr-Gégészeti És Fej-Nyaksebészeti Osztály Budapest, Maglódi Út 89-91, 1106, Maglódi Út, Hungary
| | - Luigi De Benedetto
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Claudio Vicini
- Department of Head-Neck Surgery, Oral Surgery Unit, Morgagni Pierantoni Hospital, Head-Neck, OtolaryngologyForli, Italy
- Department ENT & Audiology, University of Ferrara, Ferrara, Italy
| | - Rodolfo Lugo
- Department of Otolaryngology Head and Neck Surgery, Hospital San José, 64718, Monterrey, Mexico
| | - Peter M Baptista
- ENT Department, Al Zahra Private Hospital Dubai, 23614, Dubai, United Arab Emirates
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Manuele Casale
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- School of Medicine, Università Campus Bio-Medico Di Roma, Rome, Italy
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Morón-Conejo B, Berrendero S, Salido MP, Zarauz C, Pradíes G. Accuracy of surgical guides manufactured with four different 3D printers. A comparative in vitro study. J Dent 2024; 148:105226. [PMID: 38971459 DOI: 10.1016/j.jdent.2024.105226] [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: 11/20/2023] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVES The aim of this study was to assess the accuracy of surgical guides manufactured with four different 3D printers.. METHODS Forty-eight surgical guides (BlueSky Plan, BlueSky Bio) were produced using four different 3D printers, with strict adherence to each manufacturer's instructions. The printers used were three digital light processing (DLP) printers (SolFlex170, VC; Nextdent5100, ND, and D30+Rapidshape, RS) and one stereolithographic (SLA) printer (Formlabs3B+, FL). The study evaluated the trueness and precision of the overall surface, the region of interest (RoI) (occlusal and guide zone), the repeatability in several batches, and the guide hole's diameter and xyz axes. The printed guides were digitized and compared with the CAD design control specimen (Control X, Geomagic). Descriptive statistics and Kruskal-Wallis tests with post-hoc Mann-Whitney tests were performed (α=0.05). RESULTS Differences in trueness and precision were found between groups in the overall zone and RoI (p = 0.00). The ND group demonstrated the highest repeatability. Only the RS group exhibited a comparable guide hole diameter to the master specimen (5.27±2.12 mm; p = 0.104). No statistical differences were observed between groups in the x and z axes. However, in the y-axis, the VC group displayed statistically significant differences (p = 0.01). CONCLUSIONS The results showed that the DLP groups had better overall accuracy, while the SLA group had the best results in the RoI. The manufacturer's workflows demonstrated a high reproducibility between batches in the RoI. The RS group had values most similar values to the guide hole diameter of the master specimen, with minimal deviations in guide hole orientation. CLINICAL SIGNIFICANCE Implant position can be affected by the accuracy of the 3D printed surgical guide. Therefore, it is critical to analyze the final dimensions and the direction of the guide hole using available printing technologies.
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Affiliation(s)
- Belén Morón-Conejo
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal S/N., Madrid 28040, Spain
| | - Santiago Berrendero
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal S/N., Madrid 28040, Spain
| | - Maria Paz Salido
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal S/N., Madrid 28040, Spain.
| | - Cristina Zarauz
- Division of Fixed Prosthodontics and Biomaterials, Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Genève 4, Switzerland
| | - Guillermo Pradíes
- Department of Conservative and Prosthetic Dentistry, Faculty of Dentistry, University Complutense of Madrid, Plaza Ramón y Cajal S/N., Madrid 28040, Spain
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Iqbal J, Zafar Z, Skandalakis G, Kuruba V, Madan S, Kazim SF, A Bowers C. Recent advances of 3D-printing in spine surgery. Surg Neurol Int 2024; 15:297. [PMID: 39246777 PMCID: PMC11380890 DOI: 10.25259/sni_460_2024] [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: 06/12/2024] [Accepted: 07/27/2024] [Indexed: 09/10/2024] Open
Abstract
Background The emerging use of three-dimensional printing (3DP) offers improved surgical planning and personalized care. The use of 3DP technology in spinal surgery has several common applications, including models for preoperative planning, biomodels, surgical guides, implants, and teaching tools. Methods A literature review was conducted to examine the current use of 3DP technology in spinal surgery and identify the challenges and limitations associated with its adoption. Results The review reveals that while 3DP technology offers the benefits of enhanced stability, improved surgical outcomes, and the feasibility of patient-specific solutions in spinal surgeries, several challenges remain significant impediments to widespread adoption. The obvious expected limitation is the high cost associated with implementing and maintaining a 3DP facility and creating customized patient-specific implants. Technological limitations, including the variability between medical imaging and en vivo surgical anatomy, along with the reproduction of intricate high-fidelity anatomical detail, pose additional challenges. Finally, the lack of comprehensive clinical monitoring, inadequate sample sizes, and high-quality scientific evidence all limit our understanding of the full scope of 3DP's utility in spinal surgery and preclude widespread adoption and implementation. Conclusion Despite the obvious challenges and limitations, ongoing research and development efforts are expected to address these issues, improving the accessibility and efficacy of 3DP technology in spinal surgeries. With further advancements, 3DP technology has the potential to revolutionize spinal surgery by providing personalized implants and precise surgical planning, ultimately improving patient outcomes and surgical efficiency.
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Affiliation(s)
- Javed Iqbal
- Department of Neurosurgery, King Edward Medical University, Lahore, Pakistan
| | - Zaitoon Zafar
- Department of Biotechnology, University of San Francisco, San Francisco, California, United States
| | - Georgios Skandalakis
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, United States
| | | | - Shreya Madan
- Department of Neurosurgery, Desert Mountain High School, Scottsdale, Arizona, United States
| | - Syed Faraz Kazim
- Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, New Mexico, United States
| | - Christian A Bowers
- Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, New Mexico, United States
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Chabihi Z, Nouidi N, Demnati B, Benhima MA, Abkari I. Fast and accurate distal locking of interlocked intramedullary nails using computer-vision and a 3D printed device. 3D Print Med 2024; 10:28. [PMID: 39110149 PMCID: PMC11304628 DOI: 10.1186/s41205-024-00221-2] [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: 02/10/2024] [Accepted: 05/30/2024] [Indexed: 08/10/2024] Open
Abstract
INTRODUCTION Distal locking is a challenging and time-consuming step in interlocked intramedullary nailing of long bone fractures. Current methods have limitations in terms of simplicity, universality, accuracy, speed, and safety. We propose a novel device and software for distal locking using computer vision. METHODS AND MATERIALS The device consists of an universal ancillary clamp, a telescopic arm, a viewfinder clamp, and a radio-opaque cross. The software uses a camera photo from the C-arm intensifier and adjusts for geometric projection deformities. The software employs edge detection, Hough transform, perspective interpolation, and vector calculation algorithms to locate the distal hole center. The device and software were designed, manufactured, and tested using 3D CAD, FEM, DRR, and performance testing on phantom bones. RESULTS The device and software showed high accuracy and precision of 98.7% and 99.2% respectively in locating the distal hole center and calculating the correctional vector. The device and software also showed high success ratio in drilling the hole and inserting the screw. The device and software reduced the radiation exposure for the surgeon and the patient. The success ratio of the device and software was validated by the physical testing, which simulated the real clinical scenario of distal locking. The radiation exposure was as low as 5 s with a radiation dose of 0.2mSv, drastically reducing radiation exposure during distal locking. DISCUSSION Our device and software have several advantages over other distal locking methods, such as simplicity, universality, accuracy, speed, and safety. Our device and software also have some disadvantages, such as reliability and legislation. Our device and software can be compared with other distal locking methods based on these criteria. Our device and software have some limitations and challenges that need to be addressed in the future, such as clinical validation, and regulatory approval. CONCLUSION The device showed promising results in terms of low-cost, reusability, low radiation exposure, high accuracy, fast distal locking, high stiffness, and adaptability. The device has several advantages over other distal locking techniques, such as free-hand technique, mechanical aiming devices, electromagnetic navigation systems, and computer-assisted systems. We believe that our device and software have the potential to revolutionize the distal locking technique and to improve the outcomes and quality of life of the patients with long bone fractures.
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Affiliation(s)
- Zakaria Chabihi
- Trauma and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.
- Laboratory of clinical and epidemiological research in bone and joint pathology, Cadi Ayyad University, Marrakesh, Morocco.
| | - Nizar Nouidi
- Trauma and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco
| | - Brahim Demnati
- Chemistry-Biochemestry, Environment, Nutrition and Health laboratory, FMPC, Hassan II University Casablanca, Casablanca, Morocco
| | - Mohamed Amine Benhima
- Trauma and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco
- Laboratory of clinical and epidemiological research in bone and joint pathology, Cadi Ayyad University, Marrakesh, Morocco
| | - Imad Abkari
- Trauma and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco
- Laboratory of clinical and epidemiological research in bone and joint pathology, Cadi Ayyad University, Marrakesh, Morocco
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Chen F, Huang C, Ling C, Zhou J, Wang Y, Zhang P, Jiang X, Xu X, Jian J, Li J, Wang L, Yao Q. 3D PRINTING IN COMPLEX TIBIAL FRACTURE CLASSIFICATION & PLANNING. ACTA ORTOPEDICA BRASILEIRA 2024; 32:e269705. [PMID: 39119246 PMCID: PMC11308553 DOI: 10.1590/1413-785220243203e269705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2024] [Indexed: 08/10/2024]
Abstract
Objective Tibial plateau fractures are common intra-articular fractures that pose classification and treatment challenges for orthopedic surgeons. Objective This study examines the value of 3D printing for classifying and planning surgery for complex tibial plateau fractures. Methods We reviewed 54 complex tibial plateau fractures treated at our hospital from January 2017 to January 2019. Patients underwent preoperative spiral CT scans, with DICOM data processed using Mimics software. 3D printing technology created accurate 1:1 scale models of the fractures. These models helped subdivide the fractures into seven types based on the tibial plateau's geometric planes. Surgical approaches and simulated operations, including fracture reduction and plate placement, were planned using these models. Results The 3D models accurately depicted the direction and extent of fracture displacement and plateau collapse. They facilitated the preoperative planning, allowing for precise reconstruction strategies and matching intraoperative details with the pre-printed models. Post-surgery, the anatomical structure of the tibial plateau was significantly improved in all 54 cases. Conclusion 3D printing effectively aids in the classification and preoperative planning of complex tibial plateau fractures, enhancing surgical outcomes and anatomical restoration. Level of Evidence IV, Prospective Study.
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Affiliation(s)
- Fuyang Chen
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Chenyu Huang
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
- Univerisity of California, Department of Biomedical Engineering, Irvine, USA
| | - Chen Ling
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Jinming Zhou
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Yufeng Wang
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Po Zhang
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Xiao Jiang
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Xiaoming Xu
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Jian Jian
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Jiayi Li
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Liming Wang
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Qingqiang Yao
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
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Bittner-Frank M, Strassl A, Unger E, Hirtler L, Eckhart B, Koenigshofer M, Stoegner A, Nia A, Popp D, Kainberger F, Windhager R, Moscato F, Benca E. Accuracy Analysis of 3D Bone Fracture Models: Effects of Computed Tomography (CT) Imaging and Image Segmentation. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:1889-1901. [PMID: 38483695 PMCID: PMC11300728 DOI: 10.1007/s10278-024-00998-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 08/07/2024]
Abstract
The introduction of three-dimensional (3D) printed anatomical models has garnered interest in pre-operative planning, especially in orthopedic and trauma surgery. Identifying potential error sources and quantifying their effect on the model dimensional accuracy are crucial for the applicability and reliability of such models. In this study, twenty radii were extracted from anatomic forearm specimens and subjected to osteotomy to simulate a defined fracture of the distal radius (Colles' fracture). Various factors, including two different computed tomography (CT) technologies (energy-integrating detector (EID) and photon-counting detector (PCD)), four different CT scanners, two scan protocols (i.e., routine and high dosage), two different scan orientations, as well as two segmentation algorithms were considered to determine their effect on 3D model accuracy. Ground truth was established using 3D reconstructions of surface scans of the physical specimens. Results indicated that all investigated variables significantly impacted the 3D model accuracy (p < 0.001). However, the mean absolute deviation fell within the range of 0.03 ± 0.20 to 0.32 ± 0.23 mm, well below the 0.5 mm threshold necessary for pre-operative planning. Intra- and inter-operator variability demonstrated fair to excellent agreement for 3D model accuracy, with an intra-class correlation (ICC) of 0.43 to 0.92. This systematic investigation displayed dimensional deviations in the magnitude of sub-voxel imaging resolution for all variables. Major pitfalls included missed or overestimated bone regions during the segmentation process, necessitating additional manual editing of 3D models. In conclusion, this study demonstrates that 3D bone fracture models can be obtained with clinical routine scanners and scan protocols, utilizing a simple global segmentation threshold, thereby providing an accurate and reliable tool for pre-operative planning.
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Affiliation(s)
- Martin Bittner-Frank
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Andreas Strassl
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Lena Hirtler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Barbara Eckhart
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Markus Koenigshofer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Alexander Stoegner
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Arastoo Nia
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Domenik Popp
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Franz Kainberger
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Emir Benca
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Scheuermann LM, Lewis DD, Johnson MD, Biedrzycki AH, Kim SE. Virtual surgical planning and use of a 3D-printed, patient-specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study. Vet Surg 2024; 53:1052-1061. [PMID: 39088191 DOI: 10.1111/vsu.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/22/2024] [Accepted: 05/05/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE To compare the efficacy and clinical outcomes of computed tomography (CT)-based virtual surgical planning (VSP) and a three-dimensional (3D)-printed, patient-specific reduction system to conventional indirect reduction techniques for diaphyseal tibial fractures stabilized using minimally invasive plate osteosynthesis (MIPO) in dogs. STUDY DESIGN A prospective clinical study with a historic control cohort. SAMPLE POPULATION Dogs undergoing MIPO stabilization of diaphyseal tibial fractures using a custom 3D-printed reduction system (3D-MIPO; n = 15) or conventional indirect reduction techniques (c-MIPO; n = 14). METHODS Dogs were prospectively enrolled to the 3D-MIPO group and CT scans were used to design and fabricate a custom 3D-printed reduction system to facilitate MIPO. Medical records were searched to identify dogs for the c-MIPO group. Pre-, intra- and postoperative parameters were compared between groups. RESULTS The duration from presentation until surgery was 23 h longer in the 3D-MIPO group (p = .002). Fewer intraoperative fluoroscopic images were acquired (p < .001) and mean surgical duration was 34 min shorter in the 3D-MIPO group (p = .014). Median postoperative tibial length, frontal alignment, and sagittal alignment were within 4 mm, 3° and 3°, respectively, of the contralateral tibia in both groups and did not differ between reduction groups (p > .1). Postoperative complications occurred in 27% and 14% of fractures in the 3D-MIPO and c-MIPO groups, respectively. CONCLUSION Both reduction methods yielded comparable results. Although the preoperative planning and guide preparation was time consuming, surgery times were shorter and fluoroscopy use was less in the 3D-MIPO group. CLINICAL SIGNIFICANCE VSP and the custom 3D-printed reduction system facilitated efficient MIPO.
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Affiliation(s)
- Logan M Scheuermann
- Department of Small Animal Clinical Sciences and the Jeff and Jo Godwin Advanced Small Animal Surgical Training Center and Canine Gait Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Daniel D Lewis
- Department of Small Animal Clinical Sciences and the Jeff and Jo Godwin Advanced Small Animal Surgical Training Center and Canine Gait Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Matthew D Johnson
- Department of Small Animal Clinical Sciences and the Jeff and Jo Godwin Advanced Small Animal Surgical Training Center and Canine Gait Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Adam H Biedrzycki
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Stanley E Kim
- Department of Small Animal Clinical Sciences and the Jeff and Jo Godwin Advanced Small Animal Surgical Training Center and Canine Gait Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Aboalazayem A, Ba'ath ME, Kaddah SN, El-Barbary MM, Marei MM. Teaching hypospadias repair by utilising a novel 3D-printed silicon model: An initial assessment using structured trainee and trainer feedback. J Pediatr Urol 2024; 20:607.e1-607.e11. [PMID: 38824107 DOI: 10.1016/j.jpurol.2024.01.006] [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: 08/04/2023] [Revised: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION Simulated paediatric surgical training is inherently advantageous and flourishing. Moreover, several working conditions resulted in reduced training hours, index and subspecialty cases encountered, and the COVID-19 pandemic affected elective surgery backlogs, hence training opportunities. Hypospadias repair is technically-demanding and requires a spectrum of dissective and reconstructive skills. We therefore aimed to test a 3D-printed silicon model for hypospadias repair, in the context of hands-on surgical training. MATERIAL AND METHODS Twenty-Seven trainees, under the supervision of 15 instructors, completed the activity. They were given a seminar to show the relevant anatomy, and 8 key steps of the exercise: (1)-degloving; (2)-urethral plate marking; (3)-incision; (4)-tubularisation; (5)-glansplasty/glanuloplasty; (6)-dartos layer preparation; (7)-preputioplasty and (8)-skin closure. Each trainee completed a structured feedback assessment. An on-site trainer supervised and evaluated each exercise. Trainees and trainers rated the model through the above steps from unsatisfactory-(1/5) to excellent-(5/5), presented herein via cross-sectional analysis. RESULTS Eleven-(40.7 %) trainees were in years:1-3 of specialist training, 10-(37 %) were in years:4-6, and 6-(22.2 %) were beyond year-6. Two-(7.4 %) trainees had nil-hypospadias experience, 16-(59.2 %) previously assisted in procedures or performed steps, 5-(18.5 %) performed whole procedures supervised and 4-(14.8 %) independently. Twenty-(74 %) trainees and 15-(100 %) instructors judged the model to resemble the anomaly. Seventeen-(63 %) trainees and 13-(86.6 %) instructors rated the material needle-penetrability ≥3/5, compared to human tissue. Sixteen-(59 %) trainees and 13-(86.6 %) instructors rated the material suture holding ≥3/5. Eleven-(73.3 %) trainees and 13-(86.6 %) instructors rated sutures' evenness and edge coaptability ≥3/5. DISCUSSION Hypospadias is an index operation, which requires precision skills. Simulated training in Paediatric Surgery and Urology is gaining importance. 3D-printed models are gaining a key role in simulated training. The study presents a novel 3D-printed high-fidelity silicon-based hypospadias model designed for hands-on training. A structured pathway to divide a standard hypospadias repair into key steps is displayed to ensure skill acquisition and stabilisation. CONCLUSION This 3D-printed silicon-based hypospadias model is proven useful for hands-on training. The fidelity can still improve, especially regarding suture holding of the material. LEVEL OF EVIDENCE LEVEL III.
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Affiliation(s)
- Abeer Aboalazayem
- Cairo University, Faculty of Medicine (Kasr Alainy), Cairo University Hospitals, Paediatric Surgery Section/Units (Departments of General Surgery), Cairo University Specialized Paediatric Hospital [CUSPH] & Cairo University Children's Hospital [Abu El-Reesh El-Mounira], 11562, Cairo, Egypt.
| | - Muhammad Eyad Ba'ath
- American Hospital Dubai, Oud Maitha, Dubai & Gulf Medical University, Ajman, United Arab Emirates; King's College Hospital London, Dubai Branch, United Arab Emirates.
| | - Sherif Nabhan Kaddah
- Cairo University, Faculty of Medicine (Kasr Alainy), Cairo University Hospitals, Paediatric Surgery Section/Units (Departments of General Surgery), Cairo University Specialized Paediatric Hospital [CUSPH] & Cairo University Children's Hospital [Abu El-Reesh El-Mounira], 11562, Cairo, Egypt.
| | - Mohamed Magdy El-Barbary
- Cairo University, Faculty of Medicine (Kasr Alainy), Cairo University Hospitals, Paediatric Surgery Section/Units (Departments of General Surgery), Cairo University Specialized Paediatric Hospital [CUSPH] & Cairo University Children's Hospital [Abu El-Reesh El-Mounira], 11562, Cairo, Egypt.
| | - Mahmoud Marei Marei
- Cairo University, Faculty of Medicine (Kasr Alainy), Cairo University Hospitals, Paediatric Surgery Section/Units (Departments of General Surgery), Cairo University Specialized Paediatric Hospital [CUSPH] & Cairo University Children's Hospital [Abu El-Reesh El-Mounira], 11562, Cairo, Egypt.
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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.
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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
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10
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Khan FW, Chopko TC, Maltais S, Stulak J. Three-dimensional printing for complex cardiac reoperations: optimising Gerbode defect repairs. BMJ Case Rep 2024; 17:e260689. [PMID: 39043460 DOI: 10.1136/bcr-2024-260689] [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] [Indexed: 07/25/2024] Open
Abstract
Cardiac fistulas present diagnostical and therapeutical challenges due to their variability in size, shape and pathway. Three-dimensional printing is increasingly used to provide a tactile representation that aids in preoperative planning and patient education. We present the case of a female in her 60s who developed a fistula between the left ventricle, right atrium and coronary sinus 2 years after bioprosthetic valve replacement. We used three-dimensional modelling to better understand her cardiac anatomy and optimise our surgical approach. She was discharged home without deficit following an uneventful postoperative course. Three-dimensional printing can improve patient care through tangible demonstration, preoperative planning and trainee education.
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Affiliation(s)
- Fazal W Khan
- Cardiac Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - John Stulak
- Cardiac Surgery, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
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Chrz K, Bruthans J, Ptáčník J, Štuka Č. A Cost-Affordable Methodology of 3D Printing of Bone Fractures Using DICOM Files in Traumatology. J Med Syst 2024; 48:66. [PMID: 38976137 PMCID: PMC11231013 DOI: 10.1007/s10916-024-02084-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: 04/07/2024] [Accepted: 06/27/2024] [Indexed: 07/09/2024]
Abstract
Three-dimensional (3D) printing has gained popularity across various domains but remains less integrated into medical surgery due to its complexity. Existing literature primarily discusses specific applications, with limited detailed guidance on the entire process. The methodological details of converting Computed Tomography (CT) images into 3D models are often found in amateur 3D printing forums rather than scientific literature. To address this gap, we present a comprehensive methodology for converting CT images of bone fractures into 3D-printed models. This involves transferring files in Digital Imaging and Communications in Medicine (DICOM) format to stereolithography format, processing the 3D model, and preparing it for printing. Our methodology outlines step-by-step guidelines, time estimates, and software recommendations, prioritizing free open-source tools. We also share our practical experience and outcomes, including the successful creation of 72 models for surgical planning, patient education, and teaching. Although there are challenges associated with utilizing 3D printing in surgery, such as the requirement for specialized expertise and equipment, the advantages in surgical planning, patient education, and improved outcomes are evident. Further studies are warranted to refine and standardize these methodologies for broader adoption in medical practice.
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Affiliation(s)
- Kristián Chrz
- 1st Surgical Department, General Teaching Hospital, Prague, Czech Republic
| | - Jan Bruthans
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
- Department of Anesthesiology and Intensive Care, General Teaching Hospital, Prague, Czech Republic.
| | - Jan Ptáčník
- 1st Surgical Department, General Teaching Hospital, Prague, Czech Republic
| | - Čestmír Štuka
- Institute of Biophysics and Informatics, 1st Medical Faculty, Charles University, Prague, Czech Republic
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12
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Lin J, Li Y, Feng X, Zhang Y, Wang J, Liao W, Li H, Yi X, Gan W, Yuan Z, Liu F, Shi L, Zeng B, Diao D. Impact of three-dimensional-printing technology guidance on surgical outcomes for retroperitoneal sarcoma: A propensity score-matched study. Cancer 2024. [PMID: 38959293 DOI: 10.1002/cncr.35452] [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: 12/21/2023] [Revised: 05/07/2024] [Accepted: 05/15/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The surgical treatment of retroperitoneal sarcoma (RPS) is highly challenging because of its complex anatomy. In this study, the authors compared the surgical outcomes of patients with RPS who underwent surgical resection guided by three-dimensional (3D) printing technology versus traditional imaging. METHODS This retrospective study included 251 patients who underwent RPS resection guided by 3D-printing technology or traditional imaging from January 2019 to December 2022. The main outcome measures were operative time, intraoperative blood loss, postoperative complications, and hospital stay. RESULTS In total, 251 patients were enrolled in the study: 46 received 3D-printed navigation, and 205 underwent traditional surgical methods. Propensity score matching yielded 44 patients in the 3D group and 82 patients in the control group. The patients' demographics and tumor characteristics were comparable in the matched cohorts. The 3D group had significantly shorter operative time (median, 186.5 minutes [interquartile range (IQR), 130.0-251.3 minutes] vs. 210.0 minutes [IQR, 150.8-277.3 minutes]; p = .04), less intraoperative blood loss (median, 300.0 mL [IQR, 100.0-575.0 mL] vs. 375.0 mL [IQR, 200.0-925.0 mL]; p = .02), shorter postoperative hospital stays (median, 11.0 days [IQR, 9.0-13.0 days] vs. 14.0 days [IQR, 10.8-18.3 days]; p = .02), and lower incidence rate of overall postoperative complications than the control group (18.1% vs. 36.6%; p = .03). There were no differences with regard to the intraoperative blood transfusion rate, the R0/R1 resection rate, 30-day mortality, or overall survival. CONCLUSIONS Patients in the 3D group had favorable surgical outcomes compared with those in the control group. These results suggest that 3D-printing technology might overcome challenges in RPS surgical treatment. PLAIN LANGUAGE SUMMARY The surgical treatment of retroperitoneal sarcoma (RPS) is highly challenging because of its complex anatomy. The purpose of this study was to investigate whether three-dimensional (3D) printing technology offers advantages over traditional two-dimensional imaging (such as computed tomography and magnetic resonance imaging) for guiding the surgical treatment of RPS. In a group of patients who had RPS, surgery guided by 3D-printing technology was associated with better surgical outcomes, including shorter operative time, decreased blood loss, shorter hospital stays, and fewer postoperative complications. These findings suggested that 3D-printing technology could help surgeons overcome challenges in the surgical treatment of RPS. 3D-printing technology has important prospects in the surgical treatment of RPS.
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Affiliation(s)
- Jiaxin Lin
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Yingru Li
- Department of General Surgery, Hernia and Abdominal Wall Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaochuang Feng
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yu Zhang
- Department of Pathology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiahao Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Weilin Liao
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Hongming Li
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaojiang Yi
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wenchang Gan
- Department of General Surgery, Hernia and Abdominal Wall Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhilong Yuan
- Department of General Surgery, Hernia and Abdominal Wall Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fuheng Liu
- Department of General Surgery, Hernia and Abdominal Wall Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lishuo Shi
- Clinical Research Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Bing Zeng
- Department of General Surgery, Hernia and Abdominal Wall Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Dechang Diao
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
- Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
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Cunha CMQDA, Campelo APBS, Sales LB, Ary IBLM, Gomes JWF, Campelo MWS. Development and mechanical-functional validation of 3D-printed laparoscopic forceps. Rev Col Bras Cir 2024; 51:e20243619. [PMID: 38896634 PMCID: PMC11185057 DOI: 10.1590/0100-6991e-20243619-en] [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: 07/12/2023] [Accepted: 02/14/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION 3-dimensional printing has enabled the development of unique and affordable additive manufacturing, including the prototyping and production of surgical forceps. Objective: demonstrate the development, 3D printing and mechanical-functional validation of a laparoscopic grasping forceps. METHODS the clamp was designed using a computer program and printed in 3 dimensions with polylactic acid (PLA) filament and added 5 screws for better leverage. Size and weight measurements were carried out, as well as mechanicalfunctional grip and rotation tests in the laboratory with a validated simulator. RESULTS Called "Easylap", the clamp weighed 48 grams, measured 43cm and was printed in 8 pieces, taking an average of 12 hours to produce. It allowed the simulation of the functional characteristics of laparoscopic pressure forceps, in addition to the rotation and rack locking mechanism. However, its strength is reduced due to the material used. CONCLUSION It is possible to develop plastic laparoscopic grasping forceps through 3-dimensional printing.
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Affiliation(s)
| | | | | | | | | | - Márcio Wilker Soares Campelo
- - Centro Universitário Christus, Mestrado de Inovação Tecnológica em Saúde - Fortaleza - CE - Brasil
- - Universidade Federal do Ceará, Departamento de Cirurgia - Fortaleza - CE - Brasil
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14
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Mayer HF, Coloccini A, Viñas JF. Three-Dimensional Printing in Breast Reconstruction: Current and Promising Applications. J Clin Med 2024; 13:3278. [PMID: 38892989 PMCID: PMC11172985 DOI: 10.3390/jcm13113278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Three-dimensional (3D) printing is dramatically improving breast reconstruction by offering customized and precise interventions at various stages of the surgical process. In preoperative planning, 3D imaging techniques, such as computer-aided design, allow the creation of detailed breast models for surgical simulation, optimizing surgical outcomes and reducing complications. During surgery, 3D printing makes it possible to customize implants and precisely shape autologous tissue flaps with customized molds and scaffolds. This not only improves the aesthetic appearance, but also conforms to the patient's natural anatomy. In addition, 3D printed scaffolds facilitate tissue engineering, potentially favoring the development and integration of autologous adipose tissue, thus avoiding implant-related complications. Postoperatively, 3D imaging allows an accurate assessment of breast volume and symmetry, which is crucial in assessing the success of reconstruction. The technology is also a key educational tool, enhancing surgeon training through realistic anatomical models and surgical simulations. As the field evolves, the integration of 3D printing with emerging technologies such as biodegradable materials and advanced imaging promises to further refine breast reconstruction techniques and outcomes. This study aims to explore the various applications of 3D printing in breast reconstruction, addressing current challenges and future opportunities.
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Affiliation(s)
- Horacio F. Mayer
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), Buenos Aires C1053ABH, Argentina; (A.C.); (J.F.V.)
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15
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Zahid MJ, Mavani P, Awuah WA, Alabdulrahman M, Punukollu R, Kundu A, Mago A, Maher K, Adebusoye FT, Khan TN. Sculpting the future: A narrative review of 3D printing in plastic surgery and prosthetic devices. Health Sci Rep 2024; 7:e2205. [PMID: 38915353 PMCID: PMC11194296 DOI: 10.1002/hsr2.2205] [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: 01/17/2024] [Revised: 06/02/2024] [Accepted: 06/08/2024] [Indexed: 06/26/2024] Open
Abstract
Background and Aims The advent of 3D printing has revolutionized plastic surgery and prosthetic devices, providing personalized solutions for patients with traumatic injuries, deformities, and appearance-related conditions. This review offers a comprehensive overview of 3D printing's applications, advantages, limitations, and future prospects in these fields. Methods A literature search was conducted in PubMed, Google Scholar, and Scopus for studies on 3D printing in plastic surgery. Results 3D printing has significantly contributed to personalized medical interventions, with benefits like enhanced design flexibility, reduced production time, and improved patient outcomes. Using computer-aided design (CAD) software, precise models tailored to a patient's anatomy can be created, ensuring better fit, functionality, and comfort. 3D printing allows for intricate geometries, leading to improved aesthetic outcomes and patient-specific prosthetic limbs and orthoses. The historical development of 3D printing, key milestones, and breakthroughs are highlighted. Recent progress in bioprinting and tissue engineering shows promising applications in regenerative medicine and transplantation. The integration of AI and automation with 3D printing enhances surgical planning and outcomes. Emerging trends in patient-specific treatment planning and precision medicine are potential game-changers. However, challenges like technical considerations, economic implications, and ethical issues exist. Addressing these challenges and advancing research in materials, design processes, and long-term outcomes are crucial for widespread adoption. Conclusion The review underscores the increasing adoption of 3D printing in healthcare and its impact on plastic surgery and prosthetic devices. It emphasizes the importance of evaluating the current state and addressing knowledge gaps through future research to foster further advancements.
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Affiliation(s)
| | - Parit Mavani
- B. J. Medical CollegeAhmedabadIndia
- Department of SurgeryEmory University School of MedicineAtlantaGeorgiaUSA
| | | | | | | | - Arnab Kundu
- R.G. Kar Medical College and HospitalKolkataIndia
| | - Arpit Mago
- Jawaharlal Nehru medical CollegeBelgaumIndia
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16
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Le Stum M, Clave A, Adzinyo Agbemanyole K, Stindel E, Le Goff-Pronost M. A pilot study on preferences from surgeons to deal with an innovative customized and connected knee prosthesis - A discret choice experiment. Heliyon 2024; 10:e30041. [PMID: 38784553 PMCID: PMC11112283 DOI: 10.1016/j.heliyon.2024.e30041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
Background To address the increasing global demand for Total Knee Arthroplasty and reduce the need for revisions, several technologies combining 3D planning and artificial intelligence have emerged. These innovations aim to enhance customization, improve component positioning accuracy and precision. The integration of these advancements paves the way for the development of personalized and connected knee implant. Questions/purposes These groundbreaking advancements may necessitate changes in surgical practices. Hence, it is important to comprehend surgeons' intentions in integrating these technologies into their routine procedures. Our study aims to assess how surgeons' preferences will affect the acceptability of using this new implant and associated technologies within the entire care chain. Methods We employed a Discrete Choice Experiment, a predictive technique mirroring real-world healthcare decisions, to assess surgeons' trade-off evaluations and preferences. Results A total of 90 experienced surgeons, performing a significant number of procedures annually (mostly over 51) answered. Analysis indicates an affinity for technology but limited interest in integrating digital advancements like preoperative software and robotics. However, they are receptive to practice improvements and considering the adoption of future sensors. Conclusions In conclusion, surgeons prefer customized prostheses via augmented reality, accepting extra cost. Embedded sensor technology is deemed premature by them.
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Affiliation(s)
- Mathieu Le Stum
- Université de Brest, UBO, LATIM, UMR 1101, 22 rue Camille Desmoulins, 29200, Brest, France
- Institut National de la Santé et de la Recherche Médicale, Inserm, LaTIM, UMR 1101, 22 rue Camille Desmoulins, 29200, Brest, France
| | - Arnaud Clave
- Service d'orthopédie, Clinique Saint George, 2 Avenue de Rimiez, 06100, Nice, France
| | - Koffi Adzinyo Agbemanyole
- Institut Mines-Telecom, IMT Atlantique, LATIM, UMR 1101, M@rsouin, 655 Av. du Technopôle, 29280, Plouzané, France
| | - Eric Stindel
- Université de Brest, UBO, LATIM, UMR 1101, 22 rue Camille Desmoulins, 29200, Brest, France
- Centre Hospitalo-Universitaire de Brest, CHU Brest, LATIM, UMR 1101, 2 Avenue Foch, 29200, Brest, France
| | - Myriam Le Goff-Pronost
- Institut Mines-Telecom, IMT Atlantique, LATIM, UMR 1101, M@rsouin, 655 Av. du Technopôle, 29280, Plouzané, France
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Nola V, Vicente E, Quijano Y, Caruso R. Preoperative and postoperative 3D reconstruction for surgical management of a post-cholecystectomy biliary stricture. BMJ Case Rep 2024; 17:e259006. [PMID: 38802258 DOI: 10.1136/bcr-2023-259006] [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] [Indexed: 05/29/2024] Open
Abstract
Cholecystectomy-related iatrogenic biliary injuries cause intricate postoperative complications that can significantly affect a patient's life, often leading to chronic liver disease and biliary stenosis. These patients require a multidisciplinary approach with intervention from radiologists, endoscopists and surgeons experienced in hepatobiliary reconstruction. Symptoms vary from none to jaundice, pruritus and ascending cholangitis. The best strategy for the management of biliary stricture is based on optimal preoperative planning. Our patient presented 1 year after an iatrogenic lesion was induced during a cholecystectomy, and was managed with a complex common bile duct reconstruction through a Roux-en-Y hepaticojejunostomy. The three-dimensional (3D) model reconstruction of the biliary tract was pivotal in the planning of the patient's surgery, providing additional preoperative and intraoperative assistance throughout the procedure. The 3D model's description of detailed spatial relations between the bile duct and the vascular structure in the liver hilum enabled a correct surgical dissection and safe execution of the anastomosis.
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Affiliation(s)
- Valentina Nola
- Cirugia General, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Emilio Vicente
- Cirugia General, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Yolanda Quijano
- Cirugia General, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Riccardo Caruso
- Cirugia General, Hospital Universitario HM Sanchinarro, Madrid, Spain
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18
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Kelly SS, Suarez CA, Mirsky NA, Slavin BV, Brochu B, Vivekanand Nayak V, El Shatanofy M, Witek L, Thaller SR, Coelho PG. Application of 3D Printing in Cleft Lip and Palate Repair. J Craniofac Surg 2024:00001665-990000000-01572. [PMID: 38738906 DOI: 10.1097/scs.0000000000010294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/03/2024] [Indexed: 05/14/2024] Open
Abstract
This manuscript reviews the transformative impact of 3-dimensional (3D) printing technologies in the treatment and management of cleft lip and palate (CLP), highlighting its application across presurgical planning, surgical training, implantable scaffolds, and postoperative care. By integrating patient-specific data through computer-aided design and manufacturing, 3D printing offers tailored solutions that improve surgical outcomes, reduce operation times, and enhance patient care. The review synthesizes current research findings, technical advancements, and clinical applications, illustrating the potential of 3D printing to revolutionize CLP treatment. Further, it discusses the future directions of combining 3D printing with other innovative technologies like artificial intelligence, 4D printing, and in situ bioprinting for more comprehensive care strategies. This paper underscores the necessity for multidisciplinary collaboration and further research to overcome existing challenges and fully utilize the capabilities of 3D printing in CLP repair.
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Affiliation(s)
- Sophie S Kelly
- Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL
| | | | | | | | | | | | - Muhammad El Shatanofy
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY
| | - Seth R Thaller
- DeWitt Daughtry Family, Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine
- DeWitt Daughtry Family, Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
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Lopez P, Belgacem A, Sarnacki S, Arnaud A, Houari J, Piguet C, Baudouin M, Fourcade L, Lauvray T, Ballouhey Q. Enhancing surgical planning for abdominal tumors in children through advanced 3D visualization techniques: a systematic review of future prospects. Front Pediatr 2024; 12:1386280. [PMID: 38863523 PMCID: PMC11166126 DOI: 10.3389/fped.2024.1386280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/26/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction Preoperative three-dimensional (3D) reconstruction using sectional imaging is increasingly used in challenging pediatric cases to aid in surgical planning. Many case series have described various teams' experiences, discussing feasibility and realism, while emphasizing the technological potential for children. Nonetheless, general knowledge on this topic remains limited compared to the broader research landscape. The aim of this review was to explore the current devices and new opportunities provided by preoperative Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI). Methods A systematic review was conducted to screen pediatric cases of abdominal and pelvic tumors with preoperative 3D reconstruction published between 2000 and 2023. Discussion Surgical planning was facilitated through virtual reconstruction or 3D printing. Virtual reconstruction of complex tumors enables precise delineation of solid masses, formulation of dissection plans, and suggests dedicated vessel ligation, optimizing tissue preservation. Vascular mapping is particularly relevant for liver surgery, large neuroblastoma with imaging-defined risk factors (IDRFs), and tumors encasing major vessels, such as complex median retroperitoneal malignant masses. 3D printing can facilitate specific tissue preservation, now accessible with minimally invasive procedures like partial nephrectomy. The latest advancements enable neural plexus reconstruction to guide surgical nerve sparing, for example, hypogastric nerve modelling, typically adjacent to large pelvic tumors. New insights will soon incorporate nerve plexus images into anatomical segmentation reconstructions, facilitated by non-irradiating imaging modalities like MRI. Conclusion Although not yet published in pediatric surgical procedures, the next anticipated advancement is augmented reality, enhancing real-time intraoperative guidance: the surgeon will use a robotic console overlaying functional and anatomical data onto a magnified surgical field, enhancing robotic precision in confined spaces.
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Affiliation(s)
- Pauline Lopez
- Service de Chirurgie Viscérale Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Alexis Belgacem
- Service de Chirurgie Viscérale Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Sabine Sarnacki
- Service de Chirurgie Pédiatrique Viscérale, Urologique et Transplantation, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Alexis Arnaud
- Service de Chirurgie Pédiatrique, CHU Rennes, Institut NuMeCan, INRAe, INSERM, Univ Rennes, Rennes, France
| | - Jenna Houari
- Service de Chirurgie Viscérale Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Christophe Piguet
- Service d’Oncologie Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Maxime Baudouin
- Service de Radiologie Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Laurent Fourcade
- Service de Chirurgie Viscérale Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Thomas Lauvray
- Service d’Oncologie Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
| | - Quentin Ballouhey
- Service de Chirurgie Viscérale Pédiatrique, Hôpital des Enfants, Limoges Cedex, France
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Nardi Agmon I, Mor Y, Kornowski R, Perl L. A Personalized 3D-Printed Chest Protector. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2024; 19:324-326. [PMID: 38742452 DOI: 10.1177/15569845241252388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Affiliation(s)
- Inbar Nardi Agmon
- Department of Cardiology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Beilinson Innovation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Yarden Mor
- Beilinson Innovation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Leor Perl
- Department of Cardiology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Beilinson Innovation, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
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21
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Lan D, Luo Y, Qu Y, Man Y. The three-dimensional stability and accuracy of 3D printing surgical templates: An In Vitro study. J Dent 2024; 144:104936. [PMID: 38492806 DOI: 10.1016/j.jdent.2024.104936] [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: 08/15/2023] [Revised: 02/23/2024] [Accepted: 03/10/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE To evaluate the three-dimensional (3D) stability and accuracy of additively manufactured surgical templates fabricated using two different 3D printers and materials. MATERIALS AND METHODS Forty surgical templates were designed and printed using two different 3D printers: the resin group (n = 20) used a digital light processing (DLP) 3D printer with photopolymer resin, and the metal group (n = 20) employed a selective laser melting (SLM) 3D printer with titanium alloy. All surgical templates were scanned immediately after production and re-digitalized after one month of storage. Similarly, the implant simulations were performed twice. Three-dimensional congruency between the original design and the manufactured surgical templates was quantified using the root mean square (RMS), and the definitive and planned implant positions were determined and compared. RESULTS At the postproduction stage, the metal templates exhibited higher accuracy than the resin templates (p < 0.001), and these differences persisted after one month of storage (p < 0.001). The resin templates demonstrated a significant decrease in three-dimensional stability after one month of storage (p < 0.001), whereas the metal templates were not affected (p > 0.05). No significant differences in implant accuracy were found between the two groups. However, the resin templates showed a significant increase in apical and angular deviations after one month of storage (p < 0.001), whereas the metal templates were not affected (p > 0.05). CONCLUSION Printed metal templates showed higher fabrication accuracy than printed resin templates. The three-dimensional stability and implant accuracy of printed metal templates remained unaffected by one month of storage. CLINICAL SIGNIFICANCE With superior three-dimensional stability and acceptable implant accuracy, printed metal templates can be considered a viable alternative technique for guided surgery.
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Affiliation(s)
- Dongping Lan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yilin Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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22
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Maintz M, Tourbier C, de Wild M, Cattin PC, Beyer M, Seiler D, Honigmann P, Sharma N, Thieringer FM. Patient-specific implants made of 3D printed bioresorbable polymers at the point-of-care: material, technology, and scope of surgical application. 3D Print Med 2024; 10:13. [PMID: 38639834 PMCID: PMC11031859 DOI: 10.1186/s41205-024-00207-0] [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: 01/05/2024] [Accepted: 03/04/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Bioresorbable patient-specific additive-manufactured bone grafts, meshes, and plates are emerging as a promising alternative that can overcome the challenges associated with conventional off-the-shelf implants. The fabrication of patient-specific implants (PSIs) directly at the point-of-care (POC), such as hospitals, clinics, and surgical centers, allows for more flexible, faster, and more efficient processes, reducing the need for outsourcing to external manufacturers. We want to emphasize the potential advantages of producing bioresorbable polymer implants for cranio-maxillofacial surgery at the POC by highlighting its surgical applications, benefits, and limitations. METHODS This study describes the workflow of designing and fabricating degradable polymeric PSIs using three-dimensional (3D) printing technology. The cortical bone was segmented from the patient's computed tomography data using Materialise Mimics software, and the PSIs were designed created using Geomagic Freeform and nTopology software. The implants were finally printed via Arburg Plastic Freeforming (APF) of medical-grade poly (L-lactide-co-D, L-lactide) with 30% β-tricalcium phosphate and evaluated for fit. RESULTS 3D printed implants using APF technology showed surfaces with highly uniform and well-connected droplets with minimal gap formation between the printed paths. For the plates and meshes, a wall thickness down to 0.8 mm could be achieved. In this study, we successfully printed plates for osteosynthesis, implants for orbital floor fractures, meshes for alveolar bone regeneration, and bone scaffolds with interconnected channels. CONCLUSIONS This study shows the feasibility of using 3D printing to create degradable polymeric PSIs seamlessly integrated into virtual surgical planning workflows. Implementing POC 3D printing of biodegradable PSI can potentially improve therapeutic outcomes, but regulatory compliance must be addressed.
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Affiliation(s)
- Michaela Maintz
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
- Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences and Arts Northwestern Switzerland FHNW, Hofackerstrasse 30, Muttenz, Switzerland
| | - Céline Tourbier
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland.
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland.
| | - Michael de Wild
- Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences and Arts Northwestern Switzerland FHNW, Hofackerstrasse 30, Muttenz, Switzerland
| | - Philippe C Cattin
- Department of Biomedical Engineering, Center of Medical Image Analysis and Navigation (CIAN), University of Basel, Hegenheimermattweg 167C, Allschwil, Basel, Switzerland
| | - Michel Beyer
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
| | - Daniel Seiler
- Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences and Arts Northwestern Switzerland FHNW, Hofackerstrasse 30, Muttenz, Switzerland
| | - Philipp Honigmann
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
- Department of Orthopaedic Surgery and Traumatology, Hand- and peripheral Nerve Surgery, Kantonsspital Baselland, Bruderholz| Liestal| Laufen, Switzerland
- Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Neha Sharma
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
| | - Florian M Thieringer
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
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Gonzalez-Urquijo M, Hosseinzadeh E, Aguirre-Soto A, Fabiani MA. Stereolithographic (SLA) 3D Printing for Preprocedural Planning in Endovascular Aortic Repair of a Thoracic Aneurysm. Vasc Endovascular Surg 2024; 58:343-349. [PMID: 37944002 DOI: 10.1177/15385744231215560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND When treating aortic aneurysm patients with complex anatomical features, preprocedural planning aided by 3D-printed models offers valuable insights for endovascular intervention. This study highlights the use of stereolithographic (SLA) 3D printing to fabricate a phantom of a challenging aortic arch aneurysm with a complex neck anatomy. CLINICAL CASE A 75-year-old female presented with a 58 mm descending thoracic aortic aneurysm (TAA) extending to the distal arch, involving the left subclavian artery (LSA) and the left common carotid artery (LCCA). The computed tomography (CT) scans underwent scrutiny by radiology and vascular teams. Nevertheless, the precise spatial relationships of the ostial origins proved to be challenging to ascertain. To address this, a patient-specific phantom of the aortic arch was fabricated utilizing an SLA printer and a biomedical resin. The thoracic endovascular aortic repair (TEVAR) procedure was simulated using fluoroscopy on the phantom to enhance procedural preparedness. Subsequently, the patient underwent a right carotid-left carotid bypass and a right carotid-left subclavian bypass. After a 24-hour interval, the patient underwent the TEVAR procedure, during which a 37 mm × 150 mm stent graft (CTAG, WL Gore and Associates, Flagstaff, AZ, USA) and a 40 mm × 200 mm stent graft (CTAG, WL Gore and Associates, Flagstaff, AZ, USA) were deployed, effectively covering the LSA and LCCA. Notably, the aneurysm exhibited complete sealing, with no indications of endoleaks or graft infoldings. At the 12-month follow-up, the patient remains in good health, with no evidence of endoleaks or any other surgery-related complication. CONCLUSION This report showcases the successful use of a 3D-printed endovascular phantom in guiding the decision-making process during the preparation for a TEVAR procedure. The simulation played a pivotal role in selecting the appropriate stent graft, ensuring an intervention protocol optimized based on the patient-specific anatomy.
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Affiliation(s)
| | - Elnaz Hosseinzadeh
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alan Aguirre-Soto
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, Mexico
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Krasovsky A, Hija A, Zeineh N, Capucha T, Haze DA, Emodi O, Rachmiel A, Shilo D. Comparison of patient specific implant reconstruction vs conventional titanium mesh reconstruction of orbital fractures using a novel method. J Craniomaxillofac Surg 2024; 52:491-502. [PMID: 38388230 DOI: 10.1016/j.jcms.2024.02.002] [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: 10/10/2023] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
To compare the reconstruction of orbital fractures using patient-specific implants (PSI) and conventional pre-formed titanium mesh; to develop a method of three-dimensional (3D) superimposition and analysis of the reconstructed orbits; and to present the pitfalls in 3D planning of orbital PSI and how to avoid them. This was a retrospective study of patients with orbital fractures who were treated in our institution between the years 2022 and 2023 using PSI or conservative prefabricated titanium mesh. Three different methods for virtual reconstruction of orbital fractures were used and are detailed with advantages, disadvantages and indications. Data acquired included age, gender, method of reconstruction, functional outcomes and aesthetic outcomes. 3D analysis for accuracy of reconstruction was performed. A total of 23 patients were included; 12 were treated using PSI and 11 using prefabricated titanium meshes. There were 8 male and 4 female patients in the PSI group comparted to 5 and 6 in the prefabricated group. All three virtual methods for reconstruction were used successfully, each with the proper indications. When comparing PSI reconstruction to conventional mesh, a significant difference in accuracy was observed; PSI cases showed an inaccuracy of 0.58 mm compared to 1.54 mm with the conventional method. Complications are presented, and tips for avoiding them are detailed. Three different methods for virtual reconstruction were used successfully; automated computerized reconstruction is used for small defects, repositioning is the superior method for non-comminuted cases while mirroring is the method of choice in comminuted fractures. 3D analysis can be performed using a novel method detailed in this report. PSI reconstruction showed superior results, indicating it should be the method of choice when possible. Pitfalls are presented and approaches to prevent them are discussed. Orbital reconstruction is a very important entity in maxillofacial surgery with crucial functional and esthetical implications, and one should use virtual planning and PSI implants, as they significantly improve outcomes.
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Affiliation(s)
- Andrei Krasovsky
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ahmad Hija
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Nidal Zeineh
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Tal Capucha
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Dr Amir Haze
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Omri Emodi
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Adi Rachmiel
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dekel Shilo
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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25
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Wang X, Shujaat S, Shaheen E, Jacobs R. Quality and haptic feedback of three-dimensionally printed models for simulating dental implant surgery. J Prosthet Dent 2024; 131:660-667. [PMID: 35513918 DOI: 10.1016/j.prosdent.2022.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM A model offering anatomic replication and haptic feedback similar to that of real bone is essential for hands-on surgical dental implant training. Patient-specific skeletal models can be produced with 3-dimensional (3D) printing, but whether these models can offer optimal haptic feedback for simulating implant surgery is unknown. PURPOSE The purpose of this trial was to compare the haptic feedback of different 3D printed models for simulating dental implant surgery. MATERIAL AND METHODS A cone beam computed tomography image of a 60-year-old man with a partially edentulous mandible was manipulated to segment the mandible and isolated from the rest of the scan. Three-dimensional models were printed with 6 different printers and materials: material jetting-based printer (MJ, acrylic-based resin); digital light processing-based printer (DLP, acrylic-based resin); fused filament fabrication-based printer (FFF1, polycarbonate filament; FFF2, polylactic acid filament); stereolithography-based printer (SLA, acrylic-based resin); and selective laser sintering-based printer (SLS, polyamide filament). Five experienced maxillofacial surgeons performed a simulated implant surgery on the models. A 5-point Likert scale questionnaire was established to assess the haptic feedback. The Friedman test and cumulative logit models were applied to evaluate differences among the models (α=.05). RESULTS The median score for drilling perception and implant insertion was highest for the MJ-based model and lowest for the SLS-based model. In relation to the drill chips, a median score of ≥3 was observed for all models. The score for corticotrabecular transition was highest for the MJ-based model and lowest for the FFF2-based model. Overall, the MJ-based model offered the highest score compared with the other models. CONCLUSIONS The 3D printed model with MJ technology and acrylic-based resin provided the best haptic feedback for performing implant surgery. However, none of the models were able to completely replicate the haptic perception of real bone.
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Affiliation(s)
- Xiaotong Wang
- Doctoral Candidate, OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Clinical Surgeon, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Sohaib Shujaat
- Postdoctoral Researcher, OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Eman Shaheen
- Clinical Engineer, OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Professor, OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Professor, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.
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Cho HJ, Lloyd T, Zammit A, Pattavilakom Sadasivan A, Wagels M, Sutherland A. Radiologically derived 3D virtual models for neurosurgical planning. J Clin Neurosci 2024; 123:23-29. [PMID: 38518385 DOI: 10.1016/j.jocn.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 03/24/2024]
Abstract
Three dimensional (3D) virtual models for neurosurgery have demonstrated substantial clinical utility, especially for neuro-oncological cases. Computer-aided design (CAD) modelling of radiological images can provide realistic and high-quality 3D models which neurosurgeons may use pre-operatively for surgical planning. 3D virtual models are useful as they are the basis for other models that build off this design. 3D virtual models are quick to segment but can also be easily added to normal neurosurgical and radiological workflow without disruption. Three anatomically complex neuro-oncology cases that were referred from a single institution by three different neurosurgeons were segmented and 3D virtual models were created for pre-operative surgical planning. A face-to-face interview was performed with the surgeons after the models were delivered to gauge the usefulness of the model in pre-surgical planning. All three neurosurgeons found that the 3D virtual model was useful for presurgical planning. Specifically, the virtual model helped in planning operative positioning, understanding spatial relationship between lesion and surrounding critical anatomy and identifying anatomy that will be encountered intra-operatively in a sequential manner. It provided benefit in Multidisciplinary team (MDT) meetings and patient education for shared decision making.3D virtual models are beneficial for pre-surgical planning and patient education for shared decision making for neurosurgical neuro-oncology cases. We believe this could be further expanded to other surgical specialties. The integration of 3D virtual models into normal workflow as the initial step will provide an easier transition into modalities that build off the virtual models such as printed, virtual, augmented and mixed reality models.
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Affiliation(s)
- Hyun-Jae Cho
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia.
| | - Thomas Lloyd
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; Department of Radiology, The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Adrian Zammit
- The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; Department of Neurosurgery, The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Ananthababu Pattavilakom Sadasivan
- The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; Department of Neurosurgery, The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Michael Wagels
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Allison Sutherland
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
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27
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Bouchalakis A, Somani BK, Lima E, Rassweiler-Seyfried MC, Mamoulakis C, Tokas T. Navigation systems and 3D imaging in percutaneous nephrolithotripsy: improving outcomes and safety. Curr Opin Urol 2024; 34:105-109. [PMID: 37889519 DOI: 10.1097/mou.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Percutaneous nephrolithotripsy (PCNL) is the first-line management option for large kidney stones (>2 cm). It remains, however, a demanding procedure with considerable morbidity. The present narrative review summarizes recent knowledge from original research studies investigating navigation systems/three-dimensional (3D) imaging in PCNL, particularly on publications during the past 12-18 months. RECENT FINDINGS Navigation systems and 3D imaging are primarily used for preoperative planning, with few intra-operative applications. Patient management and residents' training could benefit from their use. SUMMARY Navigation systems and 3D imaging technology have emerged as a potential game-changer in PCNL. Even though available evidence is currently scarce/inconclusive, the safety/efficacy of navigation systems and 3D dimensional imaging use in PCNL appears promising. This advanced technology offers precise anatomical mapping, improved visualization, and surgical accuracy. Enabling a comprehensive preoperative evaluation and improving guidance, navigation systems, and 3D imaging technology may improve the safety and efficacy of PCNL. With continuous technological evolution, it is expected that improvements/innovations will offer further aid in such demanding procedures. Familiarization and cost reduction are necessary for widespread application, while larger-scale prospective studies and well designed randomized controlled trials are still needed.
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Affiliation(s)
- Athanasios Bouchalakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece
| | - Bhaskar Kumar Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Estevao Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho
- ICVS/3B's-PT, Government Associate Laboratory, Braga/Guimarães
- Deparment of Urology, Hospital of Braga, Braga, Portugal
| | | | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece
| | - Theodoros Tokas
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece
- Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria
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Lagerburg V, van den Boorn M, Vorrink S, Amajjar I, Witbreuk MMEH. The clinical value of preoperative 3D planning and 3D surgical guides for Imhäuser osteotomy in slipped capital femoral epipysis: a retrospective study. 3D Print Med 2024; 10:8. [PMID: 38427154 PMCID: PMC10908070 DOI: 10.1186/s41205-024-00205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Accurate repositioning of the femoral head in patients with Slipped Capital Femoral Epiphysis (SCFE) undergoing Imhäuser osteotomy is very challenging. The objective of this study is to determine if preoperative 3D planning and a 3D-printed surgical guide improve the accuracy of the placement of the femoral head. METHODS This retrospective study compared outcome parameters of patients who underwent a classic Imhäuser osteotomy from 2009 to 2013 with those who underwent an Imhäuser osteotomy using 3D preoperative planning and 3D-printed surgical guides from 2014 to 2021. The primary endpoint was improvement in Range of Motion (ROM) of the hip. Secondary outcomes were radiographic improvement (Southwick angle), patient-reported clinical outcomes regarding hip and psychosocial complaints assessed with two questionnaires and duration of surgery. RESULTS In the 14 patients of the 3D group radiographic improvement was slightly greater and duration of surgery was slightly shorter than in the 7 patients of the classis Imhäuser group. No difference was found in the ROM, and patient reported clinical outcomes were slightly less favourable. CONCLUSIONS Surprisingly we didn't find a significant difference between the two groups. Further research on the use of 3D planning an 3D-printed surgical guides is needed. TRIAL REGISTRATION Approval for this study was obtained of the local ethics committees of both hospitals.
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Affiliation(s)
| | | | - Sigrid Vorrink
- Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Ihsane Amajjar
- Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands
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Benca E, Eckhart B, Stoegner A, Unger E, Bittner-Frank M, Strassl A, Gahleitner C, Hirtler L, Windhager R, Hobusch GM, Moscato F. Dimensional accuracy and precision and surgeon perception of additively manufactured bone models: effect of manufacturing technology and part orientation. 3D Print Med 2024; 10:5. [PMID: 38376810 PMCID: PMC10877873 DOI: 10.1186/s41205-024-00203-4] [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: 11/03/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Additively manufactured (AM) anatomical bone models are primarily utilized for training and preoperative planning purposes. As such, they must meet stringent requirements, with dimensional accuracy being of utmost importance. This study aimed to evaluate the precision and accuracy of anatomical bone models manufactured using three different AM technologies: digital light processing (DLP), fused deposition modeling (FDM), and PolyJetting (PJ), built in three different part orientations. Additionally, the study sought to assess surgeons' perceptions of how well these models mimic real bones in simulated osteosynthesis. METHODS Computer-aided design (CAD) models of six human radii were generated from computed tomography (CT) imaging data. Anatomical models were then manufactured using the three aforementioned technologies and in three different part orientations. The surfaces of all models were 3D-scanned and compared with the original CAD models. Furthermore, an anatomical model of a proximal femur including a metastatic lesion was manufactured using the three technologies, followed by (mock) osteosynthesis performed by six surgeons on each type of model. The surgeons' perceptions of the quality and haptic properties of each model were assessed using a questionnaire. RESULTS The mean dimensional deviations from the original CAD model ranged between 0.00 and 0.13 mm with maximal inaccuracies < 1 mm for all models. In surgical simulation, PJ models achieved the highest total score on a 5-point Likert scale ranging from 1 to 5 (with 1 and 5 representing the lowest and highest level of agreement, respectively), (3.74 ± 0.99) in the surgeons' perception assessment, followed by DLP (3.41 ± 0.99) and FDM (2.43 ± 1.02). Notably, FDM was perceived as unsuitable for surgical simulation, as the material melted during drilling and sawing. CONCLUSIONS In conclusion, the choice of technology and part orientation significantly influenced the accuracy and precision of additively manufactured bone models. However, all anatomical models showed satisfying accuracies and precisions, independent of the AM technology or part orientation. The anatomical and functional performance of FDM models was rated by surgeons as poor.
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Affiliation(s)
- Emir Benca
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
| | - Barbara Eckhart
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Alexander Stoegner
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Martin Bittner-Frank
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Andreas Strassl
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Claudia Gahleitner
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Lena Hirtler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Gerhard M Hobusch
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Ørbæk Andersen M, Smerup MH, Munk K, Mortensen UM, Nørgaard BL, Helvind M, Andersen HØ, Linde JJ. Computed tomographic-based three-dimensional printing of giant coronary artery fistulas to guide surgical strategy: a case series. Eur Heart J Case Rep 2024; 8:ytad413. [PMID: 38374985 PMCID: PMC10875921 DOI: 10.1093/ehjcr/ytad413] [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: 12/19/2022] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 02/21/2024]
Abstract
Background Coronary artery fistulas (CAFs) are abnormal communications between the coronary arteries and the heart chambers, arteries, or veins, potentially leading to significant shunting, myocardial ischaemia and heart failure. Computed tomographic (CT) angiography or conventional invasive angiography is the reference standard for the diagnosis of coronary fistulas. The fistula anatomy can become very complex, which makes surgical or interventional planning challenging. Case summary We report two cases of hugely dilated and tortuous coronary circumflex artery fistulas draining into the coronary sinus. Both patients were followed up for more than 10 years because of very complex coronary fistula anatomy and mild symptoms. From two-dimensional (2D) sliced CT images alone it, was uncertain whether surgery was feasible. However, since both patients had symptom progression (Patient 1 developed heart failure, and Patient 2 had recurrent pericardial effusions), three-dimensional (3D) heart models were printed for better understanding of the complex fistula anatomy and improved surgical planning. Both patients had successful surgery and symptomatic relief at follow-up. Discussion The delay in surgery, until clinical deterioration, may partly be a consequence of a general reluctance in performing complex surgery in patients with CAFs. As of now, CT-based 3D printing has primarily been used in isolated cases. However, 3D printing is evolving rapidly and supplementing 2D sliced CT images with a physical 3D heart model may improve the anatomical understanding and pre-surgical planning that could lead to better surgical outcome.
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Affiliation(s)
- Mads Ørbæk Andersen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Morten H Smerup
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kim Munk
- Department of Cardiology, Aarhus University Hospital, 8200 Århus, Denmark
| | | | | | - Morten Helvind
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Henrik Ørbæk Andersen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jesper James Linde
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
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He H, Fan L, Lü G, Li X, Li Y, Zhang O, Chen Z, Yuan H, Pan C, Wang X, Kuang L. Myth or fact: 3D-printed off-the-shelf prosthesis is superior to titanium mesh cage in anterior cervical corpectomy and fusion? BMC Musculoskelet Disord 2024; 25:96. [PMID: 38279132 PMCID: PMC10811816 DOI: 10.1186/s12891-024-07213-7] [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: 08/13/2023] [Accepted: 01/17/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND To find out if three-dimensional printing (3DP) off-the-shelf (OTS) prosthesis is superior to titanium mesh cages in anterior cervical corpectomy and fusion (ACCF) when treating single-segment degenerative cervical spondylotic myelopathy (DCSM). METHODS DCSM patients underwent ACCF from January 2016 to January 2019 in a single center were included. Patients were divided into the 3DP group (28) and the TMC group (23). The hospital stays, operation time, intraoperative blood loss, and the cost of hospitalization were compared. The Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI) were recorded pre-operatively, 1 day, 3, 6, 12, and 24 months post-operatively. Radiological data was measured to evaluate fusion, subsidence, and cervical lordosis. Patients were sent with SF-36 to assess their health-related quality of life (HRQoL). RESULTS The differences in operative time, intraoperative blood loss, and hospital stay were not statistically significant between groups (p > 0.05). Postoperative dysphagia occurred in 2 cases in the 3DP group and 3 cases in the TMC group, which all relieved one week later. The difference in improvement of JOA and NDI between the two groups was not statistically significant (p > 0.05). No hardware failure was found and bony fusion was achieved in all cases except one in the 3DP group. The difference in cervical lordosis (CL), fused segmental angle (FSA), mean vertebral height (MVH), and subsidence rates between groups at each follow-up time point was not statistically significant and the results of the SF-36 were similar (p > 0.05). The total cost was higher in the 3DP group with its higher graft cost (p < 0.05). CONCLUSION In treating single-segment DCSM with ACCF, both 3DP OTS prosthesis and TMC achieved satisfactory outcomes. However, the more costly 3DP OTS prosthesis was not able to reduce subsidence as it claimed.
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Affiliation(s)
- Haoyu He
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Lei Fan
- Department of Spinal Surgery, Third Hospital of Changsha, Changsha, Hunan Province, China
| | - Guohua Lü
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Xinyi Li
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Yunchao Li
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Ou Zhang
- Department of Medical Education, California University of Science and Medicine, Colton, CA, USA
| | - Zejun Chen
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Hui Yuan
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Changyu Pan
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Xiaoxiao Wang
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Lei Kuang
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
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Moreno Florez AI, Malagon S, Ocampo S, Leal-Marin S, Gil González JH, Diaz-Cano A, Lopera A, Paucar C, Ossa A, Glasmacher B, Peláez-Vargas A, Garcia C. Antibacterial and osteoinductive properties of wollastonite scaffolds impregnated with propolis produced by additive manufacturing. Heliyon 2024; 10:e23955. [PMID: 38205336 PMCID: PMC10777370 DOI: 10.1016/j.heliyon.2023.e23955] [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: 08/18/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Biocompatible ceramic scaffolds offer a promising approach to address the challenges in bone reconstruction. Wollastonite, well-known for its exceptional biocompatibility, has attracted significant attention in orthopedics and craniofacial fields. However, the antimicrobial properties of wollastonite have contradictory findings, necessitating further research to enhance its antibacterial characteristics. This study aimed to explore a new approach to improve in vitro biological response in terms of antimicrobial activity and cell proliferation by taking advantage of additive manufacturing for the development of scaffolds with complex geometries by 3D printing using propolis-modified wollastonite. The scaffolds were designed with a TPMS (Triply Periodic Minimal Surface) gyroid geometric shape and 3D printed prior to impregnation with propolis extract. The paste formulation was characterized by rheometric measurements, and the presence of propolis was confirmed by FTIR spectroscopy. The scaffolds were comprehensively assessed for their mechanical strength. The biological characterization involved evaluating the antimicrobial effects against Staphylococcus aureus and Staphylococcus epidermidis, employing Minimum Inhibitory Concentration (MIC), Zone of Inhibition (ZOI), and biofilm formation assays. Additionally, SaOs-2 cultures were used to study cell proliferation (Alamar blue assay), and potential osteogenic was tested (von Kossa, Alizarin Red, and ALP stainings) at different time points. Propolis impregnation did not compromise the mechanical properties of the scaffolds, which exhibited values comparable to human trabecular bone. Propolis incorporation conferred antibacterial activity against both Staphylococcus aureus and Staphylococcus epidermidis. The implementation of TPMS gyroid geometry in the scaffold design demonstrated favorable cell proliferation with increased metabolic activity and osteogenic potential after 21 days of cell cultures.
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Affiliation(s)
- Ana Isabel Moreno Florez
- Grupo de Cerámicos y Vítreos, Universidad Nacional de Colombia sede Medellín, Medellín 050034, Colombia
| | - Sarita Malagon
- Faculty of Dentistry, Universidad Cooperativa de Colombia sede Medellín, Medellín 055422, Colombia
| | - Sebastian Ocampo
- Grupo de Cerámicos y Vítreos, Universidad Nacional de Colombia sede Medellín, Medellín 050034, Colombia
| | - Sara Leal-Marin
- Institute for Multiphase Processes (IMP), Leibniz University Hannover, Garbsen, Germany, Lower Saxony Center for Biomedical Engineering, Implant Research and Development, Hannover, Germany
| | - Jesús Humberto Gil González
- Departamento de ingeniería agrícola y alimentos. Facultad de ciencias agrarias. Universidad Nacional de Colombia sede Medellín, Colombia
| | - Andres Diaz-Cano
- Grupo de Cerámicos y Vítreos, Universidad Nacional de Colombia sede Medellín, Medellín 050034, Colombia
| | - Alex Lopera
- Grupo de Nanoestructuras y Física Aplicada (NANOUPAR), Universidad Nacional de Colombia, La Paz 202017, Colombia
| | - Carlos Paucar
- Grupo de Cerámicos y Vítreos, Universidad Nacional de Colombia sede Medellín, Medellín 050034, Colombia
| | - Alex Ossa
- School of Applied Sciences and Engineering, Universidad Eafit, Medellín 050022, Colombia
| | - Birgit Glasmacher
- Institute for Multiphase Processes (IMP), Leibniz University Hannover, Garbsen, Germany, Lower Saxony Center for Biomedical Engineering, Implant Research and Development, Hannover, Germany
| | - Alejandro Peláez-Vargas
- Faculty of Dentistry, Universidad Cooperativa de Colombia sede Medellín, Medellín 055422, Colombia
| | - Claudia Garcia
- Grupo de Cerámicos y Vítreos, Universidad Nacional de Colombia sede Medellín, Medellín 050034, Colombia
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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.
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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
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Iannotta M, d'Aiello FA, Van De Bruaene A, Caruso R, Conte G, Ferrero P, Bassareo PP, Pasqualin G, Chiarello C, Militaru C, Giamberti A, Bognoni L, Chessa M. Modern tools in congenital heart disease imaging and procedure planning: a European survey. J Cardiovasc Med (Hagerstown) 2024; 25:76-87. [PMID: 38079284 PMCID: PMC10754484 DOI: 10.2459/jcm.0000000000001569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/04/2023] [Accepted: 10/07/2023] [Indexed: 12/18/2023]
Abstract
AIMS Congenital heart diseases (CHDs) often show a complex 3D anatomy that must be well understood to assess the pathophysiological consequences and to guide therapy. Three-dimensional imaging technologies have the potential to enhance the physician's comprehension of such spatially complex anatomies. Unfortunately, due to the new introduction in clinical practice, there is no evidence on the current applications. We conducted a survey to examine how 3D technologies are currently used among CHD European centres. METHODS Data were collected using an online self-administered survey via SurveyMonkey. The questionnaire was sent via e-mail and the responses were collected between January and June 2022. RESULTS Ninety-eight centres correctly completed the survey. Of these, 22 regularly perform 3D rotational angiography, 43 have the availability to print in-silico models, and 22 have the possibility to visualize holographic imaging/virtual reality. The costs were mostly covered by the hospital or the department of financial resources. CONCLUSION From our survey, it emerges that these technologies are quite spread across Europe, despite not being part of a routine practice. In addition, there are still not enough data supporting the improvement of clinical management for CHD patients. For this reason, further studies are needed to develop clinical recommendations for the use of 3D imaging technologies in medical practice.
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Affiliation(s)
- Marvin Iannotta
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Fabio Angelo d'Aiello
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | | | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Paolo Ferrero
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Pier Paolo Bassareo
- University College of Dublin, School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Giulia Pasqualin
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Carmelina Chiarello
- Congenital Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Constantin Militaru
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Alessandro Giamberti
- Congenital Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Massimo Chessa
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
- Vita Salute San Raffaele University
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Park H, Kim YC, Choi JW, Kim DH. Efficacy and feasibility of a forehead flap surgical guide for nasal reconstruction. J Craniomaxillofac Surg 2024; 52:14-22. [PMID: 37880042 DOI: 10.1016/j.jcms.2023.09.012] [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: 02/26/2023] [Accepted: 09/30/2023] [Indexed: 10/27/2023] Open
Abstract
For successful nasal reconstruction using a forehead flap, three-dimensional (3D) nasal defects need to be translated into a two-dimensional (2D) forehead surface. For this study, a patient-specific 3D-printed forehead flap guide that could precisely translate a virtually simulated nasal shape into a 2D flap template was developed. The study aimed to evaluate the feasibility and efficacy of a 3D-printed forehead flap guide for nasal reconstructions. The 3D nasal surface was scanned using a 3D camera, and a 'digital clay' process was performed to correct the nasal deformity. The 3D morphology was flattened into a 2D forehead flap guide. The guide was 3D-printed and used for the forehead flap design. Photographic records were used to conduct anthropometric and aesthetic evaluations. Between October 2016 and August 2020, forehead flaps were performed using the forehead flap guide (guide group) and traditional templating method (control group) in 16 and 15 patients, respectively. The alar shape was more symmetric in the guide group than in the control group, with smaller right-to-left differences in alar width (p = 0.01) and height (p = 0.05). Regarding aesthetic evaluations, nose contour (p = 0.02) and nasal symmetry (p = 0.033) were better in the guide group than in the control group. The mean operative time was significantly shorter (91.9 ± 10.7 min) in the guide group than in the control group (116.4 ± 13.6 min) (p = 0.001). Our findings suggest that a 3D-printed forehead flap surgical guide can be effectively used in nasal reconstruction to reduce operative time and improve aesthetic outcomes.
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Affiliation(s)
- Hojin Park
- Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Young Chul Kim
- Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jong Woo Choi
- Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
| | - Don Han Kim
- Department of Digital Contents, College of Architecture and Design, University of Ulsan, Seoul, South Korea
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Mavrodontis II, Trikoupis IG, Kontogeorgakos VA, Savvidou OD, Papagelopoulos PJ. Point-of-Care Orthopedic Oncology Device Development. Curr Oncol 2023; 31:211-228. [PMID: 38248099 PMCID: PMC10814108 DOI: 10.3390/curroncol31010014] [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: 11/14/2023] [Revised: 12/08/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The triad of 3D design, 3D printing, and xReality technologies is explored and exploited to collaboratively realize patient-specific products in a timely manner with an emphasis on designs with meta-(bio)materials. METHODS A case study on pelvic reconstruction after oncological resection (osteosarcoma) was selected and conducted to evaluate the applicability and performance of an inter-epistemic workflow and the feasibility and potential of 3D technologies for modeling, optimizing, and materializing individualized orthopedic devices at the point of care (PoC). RESULTS Image-based diagnosis and treatment at the PoC can be readily deployed to develop orthopedic devices for pre-operative planning, training, intra-operative navigation, and bone substitution. CONCLUSIONS Inter-epistemic symbiosis between orthopedic surgeons and (bio)mechanical engineers at the PoC, fostered by appropriate quality management systems and end-to-end workflows under suitable scientifically amalgamated synergies, could maximize the potential benefits. However, increased awareness is recommended to explore and exploit the full potential of 3D technologies at the PoC to deliver medical devices with greater customization, innovation in design, cost-effectiveness, and high quality.
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Affiliation(s)
- Ioannis I. Mavrodontis
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.T.); (V.A.K.); (O.D.S.); (P.J.P.)
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Zhang Y, Chen W, Cao S, He S, Wei H. Surgical Treatments and Long-Term Outcomes for Pediatric Patients With Lumbar Spinal Tumors. Global Spine J 2023:21925682231212863. [PMID: 38060695 DOI: 10.1177/21925682231212863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
STUDY DESIGN Retrospective case‒control study. OBJECTIVES This study aimed to report the effects of surgical intervention on spinal stability recovery and to assess the long-term outcomes of children and adolescents with lumbar tumors. METHODS From January 2016 to June 2021, 42 pediatric patients with lumbar tumors were selected and separated into different groups based on the surgical method used (total en bloc resection (TER) group, n = 21; piecemeal resection (PR) group, n = 21; titanium mesh (TM) group n = 23; artificial vertebrae (AV) group n = 19). The clinicopathological characteristics, treatments and related outcomes were described in detail and compared between groups, with P value ≤.05 indicating statistically significant differences. RESULTS The average follow-up duration was 24.89 months, and the mean age was 14.89 ± 2.41 years. There were no significant differences in the mean operation time, average blood loss, complication rate, or length of hospital stay between the groups. The ODI, VAS and JOA scores at the final follow-up (FF) were elevated after surgery in all groups. The FF local angular drift (LOD) and lumbar angular drift (LUD) were greater in the TM group than in the AV group (P = .03, P = .001). CONCLUSIONS After surgery, pediatric patients with lumbar tumors can obtain satisfactory spinal stability, effective relief of pain symptoms and substantial improvements in neurological function. There was no significant difference in the invasiveness, safety or timeliness between the 2 surgical methods, so TER is recommended due to its low postoperative recurrence rate and good local control. Spinal fusion in the AV group resulted in better spinal stability.
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Affiliation(s)
- Yue Zhang
- Department of Orthopedics, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Wenjun Chen
- Department of orthopedic oncology, Changzheng Hospital, Second Military Medical University, Huangpu, Shanghai, China
| | - Shuang Cao
- Department of orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaohui He
- Department of orthopedic oncology, Changzheng Hospital, Second Military Medical University, Huangpu, Shanghai, China
| | - Haifeng Wei
- Department of orthopedic oncology, Changzheng Hospital, Second Military Medical University, Huangpu, Shanghai, China
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Subei MO, Kumar I, Kapuria A, Ayvaz B, Vestal M, Bobbert C, Zafar MS. A feasibility study of several 3D printing methods for applications in epilepsy surgery. Epileptic Disord 2023; 25:845-855. [PMID: 37698298 DOI: 10.1002/epd2.20159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To describe the process of three-dimensional printing in epilepsy surgery using three different methods: low-force stereolithography (SLA), filament deposition modeling (FDM), and Polyjet Stratasys, while comparing them in terms of printing efficiency, cost, and clinical utility. MRI and CT images of patient anatomy have been limited to review in the two-dimensional plane, which provides only partial representation of intricate intracranial structures. There has been growing interest in 3D printing of physical models of this complex anatomy to be used as an educational tool and for surgical visualization. One specific application is in epilepsy surgery where there are challenges in visualizing complex intracranial anatomy in relation to implanted surgical tools. METHODS MRI and CT data from patients with refractory epilepsy from a single center that underwent surgery are converted into 3D volumes, or stereolithography files. These were then printed using three popular 3D printing methods: SLA, FDM, and Polyjet. Faculty were surveyed on the impact of 3D modeling on the surgical planning process. RESULTS All three methods generated physical models with an increasing degree of resolution, transparency, and clinical utility directly related to cost of production and accurate representation of anatomy. Polyjet models were the most transparent and clearly represented intricate implanted electrodes but had the highest associated cost. FDM produced relatively inexpensive models that, however, were nearly completely opaque, limiting clinical utility. SLA produced economical and highly transparent models but was limited by single material capacity. SIGNIFICANCE Three-dimensional printing of patient-specific anatomy is feasible with a variety of printing methods. The clinical utility of lower-cost methods is limited by model transparency and lack of multi-material overlay respectively. Polyjet successfully generated transparent models with high resolution of internal structures but is cost-prohibitive. Further research needs to be done to explore cost-saving methods of modeling.
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Affiliation(s)
- Mhd Omar Subei
- Neurology/Epilepsy, Duke University Medical Center Ringgold Standard Institution, Durham, North Carolina, USA
| | - Ishaan Kumar
- Neurology, Duke University Department of Psychology and Neuroscience Ringgold Standard Institution, Durham, North Carolina, USA
| | - Abhi Kapuria
- Neurology, Duke University Department of Psychology and Neuroscience Ringgold Standard Institution, Durham, North Carolina, USA
| | - Bilal Ayvaz
- Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Matthew Vestal
- Neurosurgery, Duke University School of Medicine Ringgold Standard Institution, Durham, North Carolina, USA
| | - Chip Bobbert
- Neurology, Duke University Department of Psychology and Neuroscience Ringgold Standard Institution, Durham, North Carolina, USA
| | - Muhammad Shahzad Zafar
- Department of Pediatrics, Duke University School of Medicine Ringgold Standard Institution, Durham, North Carolina, USA
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Zeller AN, Goetze E, Thiem DGE, Bartella AK, Seifert L, Beiglboeck FM, Kröplin J, Hoffmann J, Pabst A. A survey regarding the organizational aspects and quality systems of in-house 3D printing in oral and maxillofacial surgery in Germany. Oral Maxillofac Surg 2023; 27:661-673. [PMID: 35989406 DOI: 10.1007/s10006-022-01109-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/02/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The aim of the study was to get a cross-sectional overview of the current status of specific organizational procedures, quality control systems, and standard operating procedures for the use of three-dimensional (3D) printing to assist in-house workflow using additive manufacturing in oral and maxillofacial surgery (OMFS) in Germany. METHODS An online questionnaire including dynamic components containing 16-29 questions regarding specific organizational aspects, process workflows, quality controls, documentation, and the respective backgrounds in 3D printing was sent to OMF surgeons in university and non-university hospitals as well as private practices with and without inpatient treatment facilities. Participants were recruited from a former study population regarding 3D printing; all participants owned a 3D printer and were registered with the German Association of Oral and Maxillofacial Surgery. RESULTS Sixty-seven participants answered the questionnaires. Of those, 20 participants ran a 3D printer in-unit. Quality assurance measures were performed by 13 participants and underlying processes by 8 participants, respectively. Standard operating procedures regarding computer-aided design and manufacturing, post-processing, use, or storage of printed goods were non-existent in most printing units. Data segmentation as well as computer-aided design and manufacturing were conducted by a medical doctor in most cases (n = 19, n = 18, n = 8, respectively). Most participants (n = 8) stated that "medical device regulations did not have any influence yet, but an adaptation of the processes is planned for the future." CONCLUSION The findings demonstrated significant differences in 3D printing management in OMFS, especially concerning process workflows, quality control, and documentation. Considering the ever-increasing regulations for medical devices, there might be a necessity for standardized 3D printing recommendations and regulations in OMFS.
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Affiliation(s)
- Alexander-N Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Elisabeth Goetze
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstr. 11, 91054, Erlangen, Germany
| | - Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Lukas Seifert
- Department of Oral, Cranio Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60528, Frankfurt am Main, Germany
| | - Fabian M Beiglboeck
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Munster, Germany
- MAM Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestr. 16, 4123, Allschwil, Switzerland
| | - Juliane Kröplin
- Department of Oral and Maxillofacial Surgery, Helios Hospital Schwerin, Wismarsche Str. 393-397, 19049, Schwerin, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
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Tarca A, Woo N, Bain S, Crouchley D, McNulty E, Yim D. 3D Printed Cardiac Models as an Adjunct to Traditional Teaching of Anatomy in Congenital Heart Disease-A Randomised Controlled Study. Heart Lung Circ 2023; 32:1443-1450. [PMID: 38007317 DOI: 10.1016/j.hlc.2023.09.021] [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: 01/11/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION Three-dimensional (3D) printed cardiac models are increasingly being used for medical education, simulation and training, communication, surgical planning and research. Given the complexities of congenital cardiac anatomy, 3D printing is well suited as an adjunct to traditional teaching methods. This study aims to explore the influence of 3D printed cardiac models as a teaching aid for nurses and paediatric trainees. We hypothesise that using 3D models as an adjunct to didactic teaching methods improves knowledge and confidence levels of participants, regardless of their cardiology experience. METHOD A prospective randomised study was performed recruiting paediatric nurses and doctors at a tertiary paediatric hospital. All participants undertook traditional congenital cardiac teaching describing normal cardiac anatomy and seven congenital lesions of increasing complexity (atrial septal defect, ventricular septal defect, vascular ring, partial anomalous pulmonary venous return, tetralogy of Fallot, transposition of the great arteries, and double outlet right ventricle). The intervention group received an additional recorded demonstration while handling 3D printed models of a normal heart and the same lesions. Pre- and post-intervention assessments were completed using a subjective Likert-scale questionnaire and objective multiple-choice examination. RESULTS A total of 73 health practitioners (30 cardiac nurses and 43 paediatric trainees) were included. Subjective knowledge and confidence levels substantially improved in the intervention group (both p<0.001), with no differences observed in the control group. Greater improvement in both subjective and objective post-test scores was observed in the intervention group. A pronounced difference between pre- and post-teaching objective examination scores was found in both groups (p=0.002), with larger improvements observed in the intervention group. The mean score in the intervention group after teaching increased by 4.27 (21.4% improvement), as opposed to 2.28 (11.4% improvement) in the control group. There was no difference in pre-test score or post-test improvement based on previous cardiology experience. DISCUSSION Three-dimensional (3D) printed cardiac models, when used as an adjunct to traditional teaching methods, substantially improve knowledge and confidence levels of health professionals on a range of congenital cardiac lesions. These models enhance the learners' educational experience and understanding of cardiac anatomy by overcoming the limitation of two-dimensional representations of 3D structures.
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Affiliation(s)
- Adrian Tarca
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Ngai Woo
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Shahira Bain
- Nursing Education, Perth Children's Hospital, Perth, WA, Australia
| | - David Crouchley
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Eamonn McNulty
- Medical Illustrations, Perth Children's Hospital, Perth, WA, Australia
| | - Deane Yim
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia.
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Soliński DG, Celer M, Dyś K, Witkiewicz W, Wiewióra M. 3D printing in the endovascular treatment of visceral artery aneurysms. Medicine (Baltimore) 2023; 102:e35844. [PMID: 37960732 PMCID: PMC10637494 DOI: 10.1097/md.0000000000035844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023] Open
Abstract
Visceral artery aneurysms (VAAs) are vascular pathologies that are difficult to treat. The variable geometry of the vessels and the location of aneurysms render difficult their evaluation in radiological imaging studies. Less invasive endovascular procedures are increasingly used in common practice. Our aim was to test the feasibility of using 3D printing technology in the preparation of preoperative spatial models of visceral artery aneurysms and their impact on interventional treatment. In our observational study, we examined a group of patients with true aneurysms of the visceral arteries who were followed and who underwent endovascular procedures with the use of 3D prints for better imaging of vascular lesions. We analyzed the fused filament fabrication method of 3D printing and printable materials in the preparation of spatial vascular models. We confirmed that more accurate visualization and analysis of vascular anatomy could assist operators in attempting minimally invasive treatment with good results. Extending imaging studies using 3D printing models that allow for the assessment of the position, morphology and geometry of the aneurysm sac, particularly of vessel branches, could encourage surgeons to perform endovascular procedures.
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Affiliation(s)
| | - Marcin Celer
- Regional Specialist Hospital in Wroclaw, Research and Development Center, Wroclaw, Poland
| | - Krzysztof Dyś
- Regional Specialist Hospital in Wroclaw, Research and Development Center, Wroclaw, Poland
| | - Wojciech Witkiewicz
- Regional Specialist Hospital in Wroclaw, Research and Development Center, Wroclaw, Poland
| | - Maciej Wiewióra
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Borowska M, Jasiński T, Gierasimiuk S, Pauk J, Turek B, Górski K, Domino M. Three-Dimensional Segmentation Assisted with Clustering Analysis for Surface and Volume Measurements of Equine Incisor in Multidetector Computed Tomography Data Sets. SENSORS (BASEL, SWITZERLAND) 2023; 23:8940. [PMID: 37960639 PMCID: PMC10650163 DOI: 10.3390/s23218940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023]
Abstract
Dental diagnostic imaging has progressed towards the use of advanced technologies such as 3D image processing. Since multidetector computed tomography (CT) is widely available in equine clinics, CT-based anatomical 3D models, segmentations, and measurements have become clinically applicable. This study aimed to use a 3D segmentation of CT images and volumetric measurements to investigate differences in the surface area and volume of equine incisors. The 3D Slicer was used to segment single incisors of 50 horses' heads and to extract volumetric features. Axial vertical symmetry, but not horizontal, of the incisors was evidenced. The surface area and volume differed significantly between temporary and permanent incisors, allowing for easy eruption-related clustering of the CT-based 3D images with an accuracy of >0.75. The volumetric features differed partially between center, intermediate, and corner incisors, allowing for moderate location-related clustering with an accuracy of >0.69. The volumetric features of mandibular incisors' equine odontoclastic tooth resorption and hypercementosis (EOTRH) degrees were more than those for maxillary incisors; thus, the accuracy of EOTRH degree-related clustering was >0.72 for the mandibula and >0.33 for the maxilla. The CT-based 3D images of equine incisors can be successfully segmented using the routinely achieved multidetector CT data sets and the proposed data-processing approaches.
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Affiliation(s)
- Marta Borowska
- Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, 15-351 Bialystok, Poland; (M.B.); (S.G.); (J.P.)
| | - Tomasz Jasiński
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (T.J.); (B.T.); (K.G.)
| | - Sylwia Gierasimiuk
- Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, 15-351 Bialystok, Poland; (M.B.); (S.G.); (J.P.)
| | - Jolanta Pauk
- Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, 15-351 Bialystok, Poland; (M.B.); (S.G.); (J.P.)
| | - Bernard Turek
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (T.J.); (B.T.); (K.G.)
| | - Kamil Górski
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (T.J.); (B.T.); (K.G.)
| | - Małgorzata Domino
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (T.J.); (B.T.); (K.G.)
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Jinga MR, Lee RBY, Chan KL, Marway PS, Nandapalan K, Rhode K, Kui C, Lee M. Assessing the impact of 3D image segmentation workshops on anatomical education and image interpretation: A prospective pilot study. ANATOMICAL SCIENCES EDUCATION 2023; 16:1024-1032. [PMID: 37381649 DOI: 10.1002/ase.2314] [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: 02/01/2023] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Abstract
Three-dimensional (3D) segmentation, a process involving digitally marking anatomical structures on cross-sectional images such as computed tomography (CT), and 3D printing (3DP) are being increasingly utilized in medical education. Exposure to this technology within medical schools and hospitals remains limited in the United Kingdom. M3dicube UK, a national medical student, and junior doctor-led 3DP interest group piloted a 3D image segmentation workshop to gauge the impact of incorporating 3D segmentation technology on anatomical education. The workshop, piloted with medical students and doctors within the United Kingdom between September 2020 and 2021, introduced participants to 3D segmentation and offered practical experience segmenting anatomical models. Thirty-three participants were recruited, with 33 pre-workshop and 24 post-workshop surveys completed. Two-tailed t-tests were used to compare mean scores. From pre- to post-workshop, increases were noted in participants' confidence in interpreting CT scans (2.36 to 3.13, p = 0.010) and interacting with 3D printing technology (2.15 to 3.33, p = 0.00053), perceived utility of creating 3D models to aid image interpretation (4.18 to 4.45, p = 0.0027), improved anatomical understanding (4.2 to 4.7, p = 0.0018), and utility in medical education (4.45 to 4.79, p = 0.077). This pilot study provides early evidence of the utility of exposing medical students and healthcare professionals in the United Kingdom to 3D segmentation as part of their anatomical education, with additional benefit in imaging interpretation ability.
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Affiliation(s)
| | - Rachel B Y Lee
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kai Lok Chan
- The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Prabhvir S Marway
- Southend Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, UK
| | | | - Kawal Rhode
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Christopher Kui
- Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, Newcastle-Upon-Tyne, UK
| | - Matthew Lee
- Transformation Directorate, NHS England, London, UK
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Rao SR, Pereira GF, Richard MJ. The Use of Patient-Specific Implants for the Treatment of Upper Extremity Fractures. Hand Clin 2023; 39:489-503. [PMID: 37827602 DOI: 10.1016/j.hcl.2023.05.002] [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] [Indexed: 10/14/2023]
Abstract
In this article, we discuss the use of three-dimensional (3-D) printed patient-specific implants in the management of upper extremity fractures. Traditional fracture fixation methods involve the use of standard-sized implants, which may not adequately address the needs of every patient, particularly those who have complications related to fracture nonunion or malunion and those who have significant bone loss. The benefits and limitations of this technology are also discussed, along with considerations for implementation in clinical practice. Overall, the use of 3-D printed patient-specific implants holds promise for improving the accuracy and efficacy of upper extremity fracture management.
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Affiliation(s)
- Sneha R Rao
- Department of Orthopaedics, Duke University Medical Center, Box 3000, Durham, NC 27710, USA.
| | - Gregory F Pereira
- Department of Orthopaedics, Duke University Medical Center, Box 3000, Durham, NC 27710, USA
| | - Marc J Richard
- Department of Orthopaedics, Duke University Medical Center, Box 3000, Durham, NC 27710, USA
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Gao H, Shen G, Hu H, Lin Z, Yuan H, Lin D, Zhu X, Jiang H, Liu A. Sutures positioning technique enhances the predictability and concordance between preoperative simulation and actual outcomes in rhinoplasty. J Plast Reconstr Aesthet Surg 2023; 86:72-78. [PMID: 37716252 DOI: 10.1016/j.bjps.2023.08.019] [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: 02/13/2023] [Revised: 07/09/2023] [Accepted: 08/13/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND The predictability and concordance between simulated and actual outcomes in rhinoplasty are uncertain. Here, we introduce a suture positioning technique (SPT), a simple and low-cost method to minimize the gap between the simulated and actual outcomes of rhinoplasty. METHODS Seventy patients were enrolled in this study between January 2018 and January 2021. Preoperative simulations were performed using Adobe Photoshop. The control group underwent surgery using simulation and intuition. In the SPT group, sutures were used to assist in the preoperative identification of the ideal nasal tip position. The SPT effectiveness was tested by measuring the nasal parameters and using the patient's subjective satisfaction questionnaire at T1 (Time 1, immediately postoperatively) and T2 (Time 2, at least 1 year postoperatively). RESULTS The intraclass correlation coefficient test showed a satisfactory correlation between simulation and postoperative outcomes in both groups. However, the SPT group had a higher correlation than the control group, especially for the nasal length (16% higher at T1 and 15% higher at T2). The mean absolute difference (MAD) between the outcomes and simulation indicated that the MAD of nasal tip projection between T2 and simulation and MAD of nasal length between T1 (or T2) and simulation were statistically significant between groups. Additionally, the SPT group was more satisfied with the postoperative outcomes and were consistent with the preoperative simulation. CONCLUSION This study demonstrated the effectiveness of SPT in intraoperative quality control. This technique may be adopted by surgeons to achieve good concordance between simulated and actual surgical outcomes.
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Affiliation(s)
- Hong Gao
- Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Gan Shen
- Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Hao Hu
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Zhangxiang Lin
- Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Hanli Yuan
- Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Defeng Lin
- Department of Plastic and Reconstructive Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohai Zhu
- Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China.
| | - Hua Jiang
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
| | - Antang Liu
- Department of Plastic and Reconstructive Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Richard RD, Heare A, Mauffrey C, McGinley B, Lencioni A, Chandra A, Nasib V, Chaiken BL, Trompeter A. Use of 3D Printing Technology in Fracture Management: A Review and Case Series. J Orthop Trauma 2023; 37:S40-S48. [PMID: 37828701 DOI: 10.1097/bot.0000000000002693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 10/14/2023]
Abstract
SUMMARY Three-dimensional (3D) offers exciting opportunities in medicine, particularly in orthopaedics. The boundaries of 3D printing are continuously being re-established and have paved the way for further innovations, including 3D bioprinting, custom printing refined methods, 4D bioprinting, and 5D printing potential. The quality of these applications have been steadily improving, increasing their widespread use among clinicians. This article provides a review of the current literature with a brief introduction to the process of additive manufacturing, 3D printing, and its applications in fracture care. We illustrate this technology with a case series of 3D printing used for correction of complex fractures/nonunion. Factors limiting the use of this technology, including cost, and potential solutions are discussed. Finally, we discuss 4D bioprinting and 5D printing and their potential role in fracture surgery.
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Affiliation(s)
- Raveesh D Richard
- Department of Orthopedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and
| | - Austin Heare
- Department of Orthopedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and
| | - Cyril Mauffrey
- Department of Orthopedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and
| | - Beau McGinley
- Department of Orthopedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and
| | - Alex Lencioni
- Department of Orthopedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and
| | - Arjun Chandra
- Trauma and Orthopaedic Department, St. Georges University Hospital, London, England
| | - Vareesha Nasib
- Trauma and Orthopaedic Department, St. Georges University Hospital, London, England
| | - Brian L Chaiken
- Department of Orthopedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO; and
| | - Alex Trompeter
- Trauma and Orthopaedic Department, St. Georges University Hospital, London, England
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Ivanovski S, Breik O, Carluccio D, Alayan J, Staples R, Vaquette C. 3D printing for bone regeneration: challenges and opportunities for achieving predictability. Periodontol 2000 2023; 93:358-384. [PMID: 37823472 DOI: 10.1111/prd.12525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/18/2023] [Accepted: 08/26/2023] [Indexed: 10/13/2023]
Abstract
3D printing offers attractive opportunities for large-volume bone regeneration in the oro-dental and craniofacial regions. This is enabled by the development of CAD-CAM technologies that support the design and manufacturing of anatomically accurate meshes and scaffolds. This review describes the main 3D-printing technologies utilized for the fabrication of these patient-matched devices, and reports on their pre-clinical and clinical performance including the occurrence of complications for vertical bone augmentation and craniofacial applications. Furthermore, the regulatory pathway for approval of these devices is discussed, highlighting the main hurdles and obstacles. Finally, the review elaborates on a variety of strategies for increasing bone regeneration capacity and explores the future of 4D bioprinting and biodegradable metal 3D printing.
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Affiliation(s)
- Saso Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Omar Breik
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Danilo Carluccio
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jamil Alayan
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Ruben Staples
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Cedryck Vaquette
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
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48
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Gernandt S, Tomasella O, Scolozzi P, Fenelon M. Contribution of 3D printing for the surgical management of jaws cysts and benign tumors: A systematic review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101433. [PMID: 36914002 DOI: 10.1016/j.jormas.2023.101433] [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: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing is now a widely recognized surgical tool in oral and maxillofacial surgery. However, little is known about its benefits for the surgical management of benign maxillary and mandibular tumors and cysts. PURPOSE The objective of this systematic review was to assess the contribution of 3D printing in the management of benign jaw lesions. METHODS A systematic review, registered in PROSPERO, was conducted using PubMed and Scopus databases, up to December 2022, by following PRISMA guidelines. Studies reporting 3D printing applications for the surgical management of benign jaw lesions were considered. RESULTS This review included thirteen studies involving 74 patients. The principal use of 3D printing was to produce anatomical models, intraoperative surgical guides, or both, allowing for the successful removal of maxillary and mandibular lesions. The greatest reported benefits of printed models were the visualization of the lesion and its anatomical relationships to anticipate intraoperative risks. Surgical guides were designed as drilling locating guides or osteotomy cutting guides and contributed to decreasing operating time and improving the accuracy of the surgery. CONCLUSION Using 3D printing technologies to manage benign jaw lesions results in less invasive procedures by facilitating precise osteotomies, reducing operating times, and complications. More studies with higher levels of evidence are needed to confirm our results.
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Affiliation(s)
- Steven Gernandt
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Tomasella
- UFR des Sciences Odontologiques, Univ. Bordeaux, 33000 Bordeaux, France
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
| | - Mathilde Fenelon
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland; UFR des Sciences Odontologiques, Univ. Bordeaux, 33000 Bordeaux, France; Service de chirurgie orale, CHU de Bordeaux, France
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Oleksy M, Dynarowicz K, Aebisher D. Rapid Prototyping Technologies: 3D Printing Applied in Medicine. Pharmaceutics 2023; 15:2169. [PMID: 37631383 PMCID: PMC10458921 DOI: 10.3390/pharmaceutics15082169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Three-dimensional printing technology has been used for more than three decades in many industries, including the automotive and aerospace industries. So far, the use of this technology in medicine has been limited only to 3D printing of anatomical models for educational and training purposes, which is due to the insufficient functional properties of the materials used in the process. Only recent advances in the development of innovative materials have resulted in the flourishing of the use of 3D printing in medicine and pharmacy. Currently, additive manufacturing technology is widely used in clinical fields. Rapid development can be observed in the design of implants and prostheses, the creation of biomedical models tailored to the needs of the patient and the bioprinting of tissues and living scaffolds for regenerative medicine. The purpose of this review is to characterize the most popular 3D printing techniques.
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Affiliation(s)
- Małgorzata Oleksy
- Students English Division Science Club, Medical College of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Klaudia Dynarowicz
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the University of Rzeszów, University of Rzeszów, 35-310 Rzeszów, Poland;
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland
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Cevik J, Seth I, Hunter-Smith DJ, Rozen WM. A History of Innovation: Tracing the Evolution of Imaging Modalities for the Preoperative Planning of Microsurgical Breast Reconstruction. J Clin Med 2023; 12:5246. [PMID: 37629288 PMCID: PMC10455834 DOI: 10.3390/jcm12165246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Breast reconstruction is an essential component in the multidisciplinary management of breast cancer patients. Over the years, preoperative planning has played a pivotal role in assisting surgeons in planning operative decisions prior to the day of surgery. The evolution of preoperative planning can be traced back to the introduction of modalities such as ultrasound and colour duplex ultrasonography, enabling surgeons to evaluate the donor site's vasculature and thereby plan operations more accurately. However, the limitations of these techniques paved the way for the implementation of modern three-dimensional imaging technologies. With the advancements in 3D imaging, including computed tomography and magnetic resonance imaging, surgeons gained the ability to obtain detailed anatomical information. Moreover, numerous adjuncts have been developed to aid in the planning process. The integration of 3D-printing technologies has made significant contributions, enabling surgeons to create complex haptic models of the underlying anatomy. Direct infrared thermography provides a non-invasive, visual assessment of abdominal wall vascular physiology. Additionally, augmented reality technologies are poised to reshape surgical planning by providing an immersive and interactive environment for surgeons to visualize and manipulate 3D reconstructions. Still, the future of preoperative planning in breast reconstruction holds immense promise. Most recently, artificial intelligence algorithms, utilising machine learning and deep learning techniques, have the potential to automate and enhance preoperative planning processes. This review provides a comprehensive assessment of the history of innovation in preoperative planning for breast reconstruction, while also outlining key future directions, and the impact of artificial intelligence in this field.
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Affiliation(s)
- Jevan Cevik
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, VIC 3199, Australia
| | - Ishith Seth
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, VIC 3199, Australia
| | - David J. Hunter-Smith
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, VIC 3199, Australia
| | - Warren M. Rozen
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, VIC 3199, Australia
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