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Wilkat M, Lommen J, Rana M, Kübler N, Wienemann T, Braß SM, Ziegler RT, Mazrekaj A, Knapsis A, Schelzig H, Wagenhäuser MU, Arnautovic A. Accuracy and Sterilizability of In-House Printed Patient-Specific Aortic Model for Surgeon-Modified Stent Grafts-A Workflow Description for Emergency Aortic Endovascular Procedures. J Clin Med 2024; 13:1309. [PMID: 38592134 PMCID: PMC10931993 DOI: 10.3390/jcm13051309] [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: 01/23/2024] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction: The use of 3D-printed aortic models for the creation of surgeon-modified endoprostheses represents a promising avenue in aortic surgery. By focusing on the potential impact of sterilization on model integrity and geometry, this report sheds light on the suitability of these models for creating customized endoprostheses. The study presented here aimed to investigate the safety and viability of 3D-printed aortic models in the context of sterilization processes and subsequent remodeling. Methods: The study involved the fabrication of 3D-printed aortic models using patient-specific imaging data and established additive manufacturing techniques. Five identical aortic models of the same patient were printed. Two models were subjected to sterilization and two to disinfection using commonly employed methods, and one model remained untreated. The models were checked by in-house quality control for deformation (heat map analyses) after the sterilization and disinfection processes. Three models (sterilized, disinfected, and untreated) were sent for ex-house (Lufthansa Technik, AG, Materials Technologies and Central Laboratory Services, Hamburg, Germany) evaluation and subsequent quantification of possible structural changes using advanced imaging and measurement technologies (macroscopic and SEM/EDX examinations). After sterilization and disinfection, each aortic model underwent sterility checks. Results: Based on macroscopic and SEM/EDX examinations, distinct evidence of material alterations attributed to a treatment process, such as a cleaning procedure, was not identified on the three implants. Comparative material analyses conducted via the EDX technique yield consistent results for all three implants. Disinfected and sterilized models tested negative for common pathogens. Conclusions: The evaluation of 3D-printed aortic models' safety after sterilization as well as their suitability for surgeon-modified endoprostheses is a critical step toward their clinical integration. By comprehensively assessing changes in model integrity and geometry after sterilization, this research has contributed to the broader understanding of the use of 3D-printed models for tailor-made endovascular solutions. As medical technologies continue to evolve, research endeavors such as this one can serve as a foundation for harnessing the full potential of 3D printing to advance patient-centered care in aortic surgery.
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Affiliation(s)
- Max Wilkat
- Department for Oral & Maxillofacial Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Julian Lommen
- Department for Oral & Maxillofacial Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Majeed Rana
- Department for Oral & Maxillofacial Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Norbert Kübler
- Department for Oral & Maxillofacial Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Tobias Wienemann
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Sönke Maximilian Braß
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Reinhold Thomas Ziegler
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Agnesa Mazrekaj
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Artis Knapsis
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Hubert Schelzig
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Markus Udo Wagenhäuser
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
| | - Amir Arnautovic
- Department for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany
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Coles-Black J, Ong S, Teh J, Kearns P, Ischia J, Bolton D, Lawrentschuk N. 3D printed patient-specific prostate cancer models to guide nerve-sparing robot-assisted radical prostatectomy: a systematic review. J Robot Surg 2023; 17:1-10. [PMID: 35349074 PMCID: PMC9939493 DOI: 10.1007/s11701-022-01401-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/11/2022] [Indexed: 01/04/2023]
Abstract
Precise knowledge of each patient's index cancer and surrounding anatomy is required for nerve-sparing robot-assisted radical prostatectomy (NS-RARP). Complementary to this, 3D printing has proven its utility in improving the visualisation of complex anatomy. This is the first systematic review to critically assess the potential of 3D printed patient-specific prostate cancer models in improving visualisation and the practice of NS-RARP. A literature search of PubMed and OVID Medline databases was performed using the terms "3D Printing", "Robot Assisted Radical Prostatectomy" and related index terms as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight articles were included; six were identified via database searches, to which a further two articles were located via a snowballing approach. Eight papers were identified for review. There were five prospective single centre studies, one case series, one technical report and one letter to the editor. Of these articles, five publications (62.5%) reported on the utility of 3D printed models for NS-RARP planning. Two publications (25%) utilised 3D printed prostate models for simulation and training, and two publications (25%) used the models for patient engagement. Despite the nascency of the field, 3D printed models are emerging in the uro-oncological literature as a useful tool in visualising complex anatomy. This has proven useful in NS-RARP for preoperative planning, simulation and patient engagement. However, best practice guidelines, the future regulatory landscape, and health economic considerations need to be addressed before this synergy of new technologies is ready for the mainstream.
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Affiliation(s)
- Jasamine Coles-Black
- Department of Surgery, Austin Health, University of Melbourne, 145 Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia. .,Young Urology Researchers Organisation (YURO), Melbourne, Australia. .,EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Australia.
| | - Sean Ong
- Department of Surgery, Austin Health, University of Melbourne, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia ,Young Urology Researchers Organisation (YURO), Melbourne, Australia ,EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Jiasian Teh
- Department of Surgery, Austin Health, University of Melbourne, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia ,Young Urology Researchers Organisation (YURO), Melbourne, Australia ,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Paul Kearns
- EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Joseph Ischia
- Department of Surgery, Austin Health, University of Melbourne, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia ,Young Urology Researchers Organisation (YURO), Melbourne, Australia ,Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, University of Melbourne, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia ,Young Urology Researchers Organisation (YURO), Melbourne, Australia ,Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Nathan Lawrentschuk
- Young Urology Researchers Organisation (YURO), Melbourne, Australia ,EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Australia ,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia ,Department of Surgery, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
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