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Habermann AC, Timmerman WR, Cohen SM, Burkhardt BW, Amendola MF. Clinical applications of 3D printing in colorectal surgery: A systematic review. Int J Colorectal Dis 2024; 39:127. [PMID: 39107626 PMCID: PMC11303507 DOI: 10.1007/s00384-024-04695-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The utilization of three-dimensional printing has grown rapidly within the field of surgery over recent years. Within the subspecialty of colorectal surgery, the technology has been used to create personalized anatomical models for preoperative planning, models for surgical training, and occasionally customized implantable devices and surgical instruments. We aim to provide a systematic review of the current literature discussing clinical applications of three-dimensional printing in colorectal surgery. METHODS Full-text studies published in English which described the application of 3D printing in pre-surgical planning, advanced surgical planning, and patient education within the field of colorectal surgery were included. Exclusion criteria were duplicate articles, review papers, studies exclusively dealing with surgical training and/or education, studies which used only virtual models, and studies which described colorectal cancer only as it pertained to other organs. RESULTS Eighteen studies were included in this review. There were two randomized controlled trials, one retrospective outcomes study, five case reports/series, one animal model, and nine technical notes/feasibility studies. There were three studies on advanced surgical planning/device manufacturing, six on pre-surgical planning, two on pelvic anatomy modeling, eight on various types of anatomy modeling, and one on patient education. CONCLUSIONS While more studies with a higher level of evidence are needed, the findings of this review suggest many promising applications of three-dimensional printing within the field of colorectal surgery with the potential to improve patient outcomes and experiences.
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Affiliation(s)
- Alyssa C Habermann
- Department of Surgery, Virginia Commonwealth University, Richmond, USA.
- Department of Surgery, Central Virginia Veterans Affairs Healthcare System, Richmond, USA.
| | - William R Timmerman
- Department of Surgery, Central Virginia Veterans Affairs Healthcare System, Richmond, USA
| | - Stephen M Cohen
- Department of Surgery, Central Virginia Veterans Affairs Healthcare System, Richmond, USA
| | - Brian W Burkhardt
- Office of Advanced Manufacturing Site Lead, Department of Physical Medicine and Rehabilitation, Central Virginia Veterans Affairs Healthcare System, Richmond, USA
| | - Michael F Amendola
- Department of Surgery, Virginia Commonwealth University, Richmond, USA
- Division of Vascular Surgery, Central Virginia Veterans Affairs Healthcare System, Richmond, USA
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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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Kahsai EA, O'Connor B, Khoo KJ, Ogunleye TD, Telfer S, Hagen MS. Improving Patient Understanding of Femoroacetabular Impingement Syndrome With Three-Dimensional Models. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202405000-00006. [PMID: 38722846 PMCID: PMC11081616 DOI: 10.5435/jaaosglobal-d-24-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION Three-dimensional (3D) printed models may help patients understand complex anatomic pathologies such as femoroacetabular impingement syndrome (FAIS). We aimed to assess patient understanding and satisfaction when using 3D printed models compared with standard imaging modalities for discussion of FAIS diagnosis and surgical plan. METHODS A consecutive series of 76 new patients with FAIS (37 patients in the 3D model cohort and 39 in the control cohort) from a single surgeon's clinic were educated using imaging and representative 3D printed models of FAI or imaging without models (control). Patients received a voluntary post-visit questionnaire that evaluated their understanding of the diagnosis, surgical plan, and visit satisfaction. RESULTS Patients in the 3D model cohort reported a significantly higher mean understanding of FAIS (90.0 ± 11.5 versus 79.8 ± 14.9 out of 100; P = 0.001) and surgery (89.5 ± 11.6 versus 81.0 ± 14.5; P = 0.01) compared with the control cohort. Both groups reported high levels of satisfaction with the visit. CONCLUSION In this study, the use of 3D printed models in clinic visits with patients with FAIS improved patients' perceived understanding of diagnosis and surgical treatment.
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Affiliation(s)
- Ermyas A. Kahsai
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Bailey O'Connor
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Kevin J. Khoo
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Temi D. Ogunleye
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Scott Telfer
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Mia S. Hagen
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
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4
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Zhang X, Du H, Liu X, Liu L, Zhang T. Knowledge, Attitudes and Practices Towards Psoriasis Among Patients and Their Family Members. Clin Cosmet Investig Dermatol 2024; 17:769-782. [PMID: 38586181 PMCID: PMC10999187 DOI: 10.2147/ccid.s454798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/31/2024] [Indexed: 04/09/2024]
Abstract
Purpose KAP studies serve to enhance health consciousness and furnish foundational data for appraising, strategizing, and enacting disease management and prejudice eradication initiatives. There remains a dearth of published studies elucidating the dimensions of knowledge, attitudes, and practices among psoriasis patients in China. To investigate the knowledge, attitudes and practices (KAP) towards psoriasis among patients and their family members in Northern China. Methods This web-based, cross-sectional study was conducted among psoriasis patients and their family members through a self-administered questionnaire. Results Among patients (n=260), their mean KAP scores were 9.76±5.69 (range: 0-19), 35.64±11.48 (range: 14-70), and 56.73±10.98 (range: 16-80), respectively. Among family members (n=237), their mean KAP scores were 11.93±5.34 (range: 0-19), 35.80±4.34 (range: 8-40), and 37.04±4.38 (range: 8-40), respectively. Structural equation modeling (SEM) analysis for patients indicated significant and negative path relations between knowledge and attitudes (β=-2.271, P<0.001), and between knowledge and practice (β=-0.398, P<0.001). Extended SEM analysis, which divides knowledge into K1, K2, and K3 parts, showed negative path relations between K3 and attitude (β=-1.300, P=0.002), between attitude and practice (β=-0.634, P<0.001). Moreover, SEM for family members showed positive path relations between knowledge and attitude (β=1.536, P<0.001), between attitude and practice (β=0.682, P<0.001). Conclusion Patients in Northern China demonstrated insufficient knowledge, negative attitude, and proactive practice, while their family members had insufficient knowledge, positive attitude, and proactive practice toward psoriasis. It is recommended to implement educational interventions addressing knowledge gaps among patients and families.
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Affiliation(s)
- Xiaolan Zhang
- Department of Dermatology, The First Affiliated Hospital of JinZhou Medical University, Jinzhou, 121001, People’s Republic of China
| | - Hongyang Du
- Department of Dermatology, The First Affiliated Hospital of JinZhou Medical University, Jinzhou, 121001, People’s Republic of China
| | - Xiaoxiao Liu
- Department of Dermatology, The First Affiliated Hospital of JinZhou Medical University, Jinzhou, 121001, People’s Republic of China
| | - Luyao Liu
- Department of Dermatology, The First Affiliated Hospital of JinZhou Medical University, Jinzhou, 121001, People’s Republic of China
| | - Tingwei Zhang
- Department of Dermatology, The First Affiliated Hospital of JinZhou Medical University, Jinzhou, 121001, People’s Republic of China
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Setiawan J, Rizal DM, Sofyantoro F, Priyono DS, Septriani NI, Mafiroh WU, Kotani T, Matozaki T, Putri WA. Bibliometric analysis of organoids in regenerative medicine-related research worldwide over two decades (2002-2022). Regen Med 2024; 19:119-133. [PMID: 38449425 DOI: 10.2217/rme-2023-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
Aim: This study aimed to evaluate the trends in organoid culture research within the field of regenerative medicine from 2002 to 2022. Methods: The worldwide distribution of organoid research in regenerative medicine articles indexed in the Scopus database was analyzed. Result: A total of 840 documents were analyzed, averaging 42 publications annually. The USA (n = 296) led in publications, followed by China (n = 127), Japan (n = 91) and the UK (n = 75). Since 2011, research has surged, particularly in China, which emerged as a prominent center. Conclusion: The findings highlight significant growth in organoid research, promising future organ transplantation. Research trends integrate tissue engineering, gene modification and induced pluripotent stem cell technologies, reflecting a move toward personalized medicine.
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Affiliation(s)
- Jajar Setiawan
- Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dicky Moch Rizal
- Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fajar Sofyantoro
- Department of Tropical Biology, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dwi Sendi Priyono
- Department of Tropical Biology, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nur Indah Septriani
- Department of Tropical Biology, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Wulan Usfi Mafiroh
- Department of Tropical Biology, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Takenori Kotani
- Division of Molecular and Cellular Signaling, Department of Biochemistry & Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takashi Matozaki
- Division of Molecular and Cellular Signaling, Department of Biochemistry & Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Biosignal Regulation, Department of Biochemistry & Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wahyu Aristyaning Putri
- Department of Tropical Biology, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Shi W, Wang J, Gao J, Zou X, Dong Q, Huang Z, Sheng J, Guan C, Xu Y, Cui Y, Zhong X. Utilization of 3D printing technology in hepatopancreatobiliary surgery. J Zhejiang Univ Sci B 2024; 25:123-134. [PMID: 38303496 PMCID: PMC10835207 DOI: 10.1631/jzus.b2300175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/23/2023] [Indexed: 02/03/2024]
Abstract
The technology of three-dimensional (3D) printing emerged in the late 1970s and has since undergone considerable development to find numerous applications in mechanical engineering, industrial design, and biomedicine. In biomedical science, several studies have initially found that 3D printing technology can play an important role in the treatment of diseases in hepatopancreatobiliary surgery. For example, 3D printing technology has been applied to create detailed anatomical models of disease organs for preoperative personalized surgical strategies, surgical simulation, intraoperative navigation, medical training, and patient education. Moreover, cancer models have been created using 3D printing technology for the research and selection of chemotherapy drugs. With the aim to clarify the development and application of 3D printing technology in hepatopancreatobiliary surgery, we introduce seven common types of 3D printing technology and review the status of research and application of 3D printing technology in the field of hepatopancreatobiliary surgery.
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Affiliation(s)
- Wujiang Shi
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Jiangang Wang
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xian 710032, China
| | - Jianjun Gao
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Xinlei Zou
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Qingfu Dong
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Ziyue Huang
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Jialin Sheng
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Canghai Guan
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Yi Xu
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China. ,
- Key Laboratory of Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi 563006, China. ,
- Key Laboratory of Functional and Clinical Translational Medicine, Fujian Province University, Xiamen Medical College, Xiamen 361000, China. ,
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. ,
- Jiangsu Province Engineering Research Center of Tumor Targeted Nano Diagnostic and Therapeutic Materials, Yancheng Teachers University, Yancheng 224007, China. ,
- Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang Province, Hangzhou 310053, China. ,
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350122, China. ,
- Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150086, China. ,
| | - Yunfu Cui
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China. ,
| | - Xiangyu Zhong
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
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Tsai AY, Greene AC. 3D printing in pediatric surgery. Semin Pediatr Surg 2024; 33:151385. [PMID: 38242062 DOI: 10.1016/j.sempedsurg.2024.151385] [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: 01/21/2024]
Abstract
Pediatric surgery presents a unique challenge, requiring a specialized approach due to the intricacies of compact anatomy and the presence of distinct congenital features in young patients. Surgeons are tasked with making decisions that not only address immediate concerns but also consider the evolving needs of children as they grow. The advent of three-dimensional (3D) printing has emerged as a valuable tool to facilitate a personalized medical approach. This paper starts by outlining the basics of 3D modeling and printing. We then delve into the transformative role of 3D printing in pediatric surgery, elucidating its applications, benefits, and challenges. The paper concludes by envisioning the future prospects of 3D printing, foreseeing advancements in personalized treatment approaches, improved patient outcomes, and the continued evolution of this technology as an indispensable asset in the pediatric surgical arena.
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Affiliation(s)
- Anthony Y Tsai
- Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States.
| | - Alicia C Greene
- Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States
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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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Yang A, Panchendrabose K, Leong C, Raza SS, Joharifard S. The utility of three-dimensional modeling and printing in pediatric surgical patient and family education: a systematic review. 3D Print Med 2024; 10:1. [PMID: 38170262 PMCID: PMC10762981 DOI: 10.1186/s41205-023-00198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Three-dimensional (3D) modeling and printing are increasingly being used in surgical settings. This technology has several applications including pre-operative surgical planning, inter-team communication, and patient education and counseling. The majority of research on 3D technology has focused on adult populations, where it has been found to be a useful tool for educating patients across various surgical specialties. There is a dearth, however, of research on the utility of 3D modeling and printing for patient and family education in pediatric populations. Our objective was to systematically review the current literature on how this modality is being utilized in pediatric surgical settings for patient and family education and counselling. METHODS We conducted a systematic review in accordance with PRISMA and CASP guidelines. The MEDLINE, CINAHL, Embase, and Web of Science databases were searched from inception to October 21, 2023, with no restrictions on language or geographical location. Citation chaining was used to ensure relevant papers were included. Articles were doubly screened and data was extracted independently by two authors. In the case of disagreement, a third author was consulted. Any articles pertaining to 3D modeling and printing in pediatric surgical settings for patient and family education and counseling were included. RESULTS Six articles met inclusion criteria and were used for qualitative analysis. Two involved questionnaires given to parents of children to assess their understanding of relevant anatomy, surgical procedure, and risks after viewing conventional CT images and again after viewing a 3D-printed model. One involved a quasi-experimental study to assess young patients' pre-operative surgical understanding and anxiety after undergoing conventional teaching as compared to after viewing a 3D storybook. One involved questionnaires given to parents of children in control and study groups to assess the usefulness of 3D printed models compared to conventional CT images in their understanding of relevant anatomy and the surgical procedure. Another study looked at the usefulness of 3D printed models compared to 2D and 3D CT images in providing caregiver understanding during the pre-operative consent process. The last article involved studying the impact of using 3D printing to help patients understand their disease and participate in decision-making processes during surgical consultations. In all six studies, utilizing 3D technology improved transfer of information between surgical team members and their patients and families. CONCLUSION Our systematic review suggests that 3D modeling and printing is a useful tool for patient and family education and counselling in pediatric surgical populations. Given the very small number of published studies, further research is needed to better define the utility of this technology in pediatric settings.
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Affiliation(s)
- Angela Yang
- Office of Pediatric Surgical Evaluation and Innovation, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
| | | | - Cameron Leong
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Syed Shuja Raza
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shahrzad Joharifard
- Division of Pediatric Surgery, Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada
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Pu J, Li H, Li S, Wang Y, Li S, Tang S. Current trends and prospects of surgical techniques for hepatoblastoma. Cancer Med 2024; 13:e6795. [PMID: 38180290 PMCID: PMC10807562 DOI: 10.1002/cam4.6795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/25/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Hepatoblastoma, a common extracranial malignant solid tumor in childhood, is often detected at an advanced stage and is difficult to treat surgically. Despite the availability of multiple comprehensive treatments that can be combined with surgery, hepatoblastoma treatment outcomes remain poor. Surgery is the main treatment strategy for hepatoblastoma, but it faces many challenges, including tumor attachment to surrounding tissues, tumor wrapping or invading of vital organs and tissues, the presence of giant or multiple tumors, distant metastasis, the formation of a tumor thrombus, and significant surgical trauma. In this review, we discuss recent research advances and propose potential strategies for overcoming these challenges. Such strategies may improve the rate of hepatoblastoma resection and local control in children, as well as reduce complications and trauma.
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Affiliation(s)
- Jia‐rui Pu
- Department of Pediatric Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Hang Li
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Shuai Li
- Department of Pediatric Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yong Wang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Shi‐wang Li
- Department of Pediatric Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Shao‐tao Tang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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Valls-Esteve A, Tejo-Otero A, Adell-Gómez N, Lustig-Gainza P, Fenollosa-Artés F, Buj-Corral I, Rubio-Palau J, Munuera J, Krauel L. Advanced Strategies for the Fabrication of Multi-Material Anatomical Models of Complex Pediatric Oncologic Cases. Bioengineering (Basel) 2023; 11:31. [PMID: 38247908 PMCID: PMC10813349 DOI: 10.3390/bioengineering11010031] [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: 10/16/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
The printing and manufacturing of anatomical 3D models has gained popularity in complex surgical cases for surgical planning, simulation and training, the evaluation of anatomical relations, medical device testing and patient-professional communication. 3D models provide the haptic feedback that Virtual or Augmented Reality (VR/AR) cannot provide. However, there are many technologies and strategies for the production of 3D models. Therefore, the aim of the present study is to show and compare eight different strategies for the manufacture of surgical planning and training prototypes. The eight strategies for creating complex abdominal oncological anatomical models, based on eight common pediatric oncological cases, were developed using four common technologies (stereolithography (SLA), selectie laser sinterning (SLS), fused filament fabrication (FFF) and material jetting (MJ)) along with indirect and hybrid 3D printing methods. Nine materials were selected for their properties, with the final models assessed for application suitability, production time, viscoelastic mechanical properties (shore hardness and elastic modulus) and cost. The manufacturing and post-processing of each strategy is assessed, with times ranging from 12 h (FFF) to 61 h (hybridization of FFF and SLS), as labor times differ significantly. Cost per model variation is also significant, ranging from EUR 80 (FFF) to EUR 600 (MJ). The main limitation is the mimicry of physiological properties. Viscoelastic properties and the combination of materials, colors and textures are also substantially different according to the strategy and the intended use. It was concluded that MJ is the best overall option, although its use in hospitals is limited due to its cost. Consequently, indirect 3D printing could be a solid and cheaper alternative.
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Affiliation(s)
- Arnau Valls-Esteve
- Innovation Department, SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Medicina i Recerca Translacional, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- 3D Unit (3D4H), SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
| | - Aitor Tejo-Otero
- Centre CIM, Universitat Politècnica de Catalunya (CIM UPC), Carrer de Llorens i Artigas, 12, 08028 Barcelona, Spain
| | - Núria Adell-Gómez
- Innovation Department, SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- 3D Unit (3D4H), SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
| | - Pamela Lustig-Gainza
- Innovation Department, SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- 3D Unit (3D4H), SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
| | - Felip Fenollosa-Artés
- Centre CIM, Universitat Politècnica de Catalunya (CIM UPC), Carrer de Llorens i Artigas, 12, 08028 Barcelona, Spain
- Department of Mechanical Engineering, Barcelona School of Industrial Engineering (ETSEIB), Universitat Politècnica de Catalunya, Av. Diagonal, 647, 08028 Barcelona, Spain
| | - Irene Buj-Corral
- Department of Mechanical Engineering, Barcelona School of Industrial Engineering (ETSEIB), Universitat Politècnica de Catalunya, Av. Diagonal, 647, 08028 Barcelona, Spain
| | - Josep Rubio-Palau
- Medicina i Recerca Translacional, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- 3D Unit (3D4H), SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Pediatric Surgical Oncology, Pediatric Surgery Department, SJD Barcelona Children’s Hospital, Universitat de Barcelona, 08950 Barcelona, Spain
- Maxillofacial Unit, Department of Pediatric Surgery, Pediatric Surgical Oncology, SJD Barcelona Children’s Hospital, Universitat de Barcelona, 08950 Barcelona, Spain
| | - Josep Munuera
- Medicina i Recerca Translacional, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- Diagnostic Imaging Department, Hospital de la Santa Creu i Sant Pau, 08027 Barcelona, Spain
- Advanced Medical Imaging, Artificial Intelligence, and Imaging-Guided Therapy Research Group, Institut de Recerca Sant Pau—Centre CERCA, 08041 Barcelona, Spain
| | - Lucas Krauel
- Medicina i Recerca Translacional, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- 3D Unit (3D4H), SJD Barcelona Children’s Hospital, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Pediatric Surgical Oncology, Pediatric Surgery Department, SJD Barcelona Children’s Hospital, Universitat de Barcelona, 08950 Barcelona, Spain
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12
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Rodriguez Colon R, Nayak VV, Parente PEL, Leucht P, Tovar N, Lin CC, Rezzadeh K, Hacquebord JH, Coelho PG, Witek L. The presence of 3D printing in orthopedics: A clinical and material review. J Orthop Res 2023; 41:601-613. [PMID: 35634867 DOI: 10.1002/jor.25388] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 04/13/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023]
Abstract
The field of additive manufacturing, 3D printing (3DP), has experienced an exponential growth over the past four decades, in part due to increased accessibility. Developments including computer-aided design and manufacturing, incorporation of more versatile materials, and improved printing techniques/equipment have stimulated growth of 3DP technologies within various industries, but most specifically the medical field. Alternatives to metals including ceramics and polymers have been garnering popularity due to their resorbable properties and physiologic similarity to extracellular matrix. 3DP has the capacity to utilize an assortment of materials and printing techniques for a multitude of indications, each with their own associated benefits. Within the field of medicine, advances in medical imaging have facilitated the integration of 3DP. In particular, the field of orthopedics has been one of the earliest medical specialties to implement 3DP. Current indications include education for patients, providers, and trainees, in addition to surgical planning. Moreover, further possibilities within orthopedic surgery continue to be explored, including the development of patient-specific implants. This review aims to highlight the use of current 3DP technology and materials by the orthopedic community, and includes comments on current trends and future direction(s) within the field.
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Affiliation(s)
- Ricardo Rodriguez Colon
- Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York, USA
| | - Vasudev Vivekanand Nayak
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
| | - Paulo E L Parente
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.,Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Philipp Leucht
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA.,Department of Cell Biology, NYU Grossman School of Medicine, New York, New York, USA
| | - Nick Tovar
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Charles C Lin
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Kevin Rezzadeh
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Jacques H Hacquebord
- Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York, USA.,Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Paulo G Coelho
- Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York, USA.,Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
| | - Lukasz Witek
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
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13
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Giehl-Brown E, Dennler S, Garcia SA, Seppelt D, Oehme F, Schweipert J, Weitz J, Riediger C. 3D liver model-based surgical education improves preoperative decision-making and patient satisfaction-a randomized pilot trial. Surg Endosc 2023:10.1007/s00464-023-09915-w. [PMID: 36849565 PMCID: PMC9970129 DOI: 10.1007/s00464-023-09915-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/28/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE Hepatobiliary surgery bares obstacles to informed consent for the patients due to its complexity and related risk of postoperative complications. 3D visualization of the liver has been proven to facilitate comprehension of the spatial relationship between anatomical structures and to assist in clinical decision-making. Our objective is to utilize individual 3D-printed liver models to enhance patient satisfaction with surgical education in hepatobiliary surgery. DESIGN, SETTING We conducted a prospective, randomized pilot study comparing 3D liver model-enhanced (3D-LiMo) surgical education against regular patient education during preoperative consultation at the department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany. PARTICIPANTS Of 97 screened patients, undergoing hepatobiliary surgery, 40 patients were enrolled from July 2020 to January 2022. RESULTS The study population (n = 40) was predominantly of male gender (62.5%) with a median age of 65.2 years and a high prevalence of preexisting diseases. Underlying disease, warranting hepatobiliary surgery, was malignancy in the majority of cases (97.5%). Patients in the 3D-LiMo group were more likely to feel very thoroughly educated and exhibited a higher level of satisfaction following surgical education than the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively). Applying 3D models was also associated with enhanced understanding of the underlying disease with regard to amount (100% vs. 70%, p = 0.020) and location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also demonstrated enhanced understanding of the surgical procedure (80 vs. 55%, n.s.), leading to better awareness for the occurrence of postoperative complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were similar. CONCLUSION In conclusion, individual 3D-printed liver models increase patient satisfaction with surgical education and facilitate patients' understanding of the surgical procedure as well as awareness of postoperative complications. Therefore, the study protocol is feasible to apply to an adequately powered, multicenter, randomized clinical trial with minor modifications.
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Affiliation(s)
- Esther Giehl-Brown
- grid.412282.f0000 0001 1091 2917Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.461742.20000 0000 8855 0365National Center for Tumor Diseases (NCT/UCC), Dresden, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412282.f0000 0001 1091 2917Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.40602.300000 0001 2158 0612Helmholtz-Zentrum Dresden—Rossendorf (HZDR), Dresden, Germany
| | - Sandra Dennler
- grid.412282.f0000 0001 1091 2917Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.461742.20000 0000 8855 0365National Center for Tumor Diseases (NCT/UCC), Dresden, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412282.f0000 0001 1091 2917Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.40602.300000 0001 2158 0612Helmholtz-Zentrum Dresden—Rossendorf (HZDR), Dresden, Germany
| | - Sebastián A. Garcia
- grid.412282.f0000 0001 1091 2917Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.461742.20000 0000 8855 0365National Center for Tumor Diseases (NCT/UCC), Dresden, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412282.f0000 0001 1091 2917Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.40602.300000 0001 2158 0612Helmholtz-Zentrum Dresden—Rossendorf (HZDR), Dresden, Germany
| | - Danilo Seppelt
- grid.4488.00000 0001 2111 7257Department of Radiology, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Florian Oehme
- grid.412282.f0000 0001 1091 2917Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.461742.20000 0000 8855 0365National Center for Tumor Diseases (NCT/UCC), Dresden, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412282.f0000 0001 1091 2917Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.40602.300000 0001 2158 0612Helmholtz-Zentrum Dresden—Rossendorf (HZDR), Dresden, Germany
| | - Johannes Schweipert
- grid.412282.f0000 0001 1091 2917Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.461742.20000 0000 8855 0365National Center for Tumor Diseases (NCT/UCC), Dresden, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412282.f0000 0001 1091 2917Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.40602.300000 0001 2158 0612Helmholtz-Zentrum Dresden—Rossendorf (HZDR), Dresden, Germany
| | - Jürgen Weitz
- grid.412282.f0000 0001 1091 2917Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.461742.20000 0000 8855 0365National Center for Tumor Diseases (NCT/UCC), Dresden, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412282.f0000 0001 1091 2917Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany ,grid.40602.300000 0001 2158 0612Helmholtz-Zentrum Dresden—Rossendorf (HZDR), Dresden, Germany
| | - Carina Riediger
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. .,National Center for Tumor Diseases (NCT/UCC), Dresden, Germany. .,German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. .,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.
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14
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Proposed Implementation of a Patient-Centered Self-Assessment Tool for Patients with Neuroendocrine Tumors among Academic and Community Practice Sites: The City of Hope Model. J Clin Med 2023; 12:jcm12031229. [PMID: 36769875 PMCID: PMC9917881 DOI: 10.3390/jcm12031229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Neuroendocrine tumors are a rare type of cancer found in hormone-producing cells throughout the body. Research on disease-specific patient education assessments in this population is lacking. We previously demonstrated the feasibility and validity of NET VITALS, a patient-centered self-assessment designed to improve patients' knowledge of their neuroendocrine tumor diagnosis/treatment and facilitate communication with their physician. In this report, we provide a brief overview of patient assessments that have been used for patients with neuroendocrine tumors. We summarize NET VITALS and present a proposed infrastructure for its implementation into standard clinical care in both academic and community practice settings at City of Hope. Incorporating NET VITALS into standard of care treatment for patients with neuroendocrine tumors may improve patients' overall clinical care experience.
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15
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Honda M, Uchida K, Irie T, Hirukawa K, Kadohisa M, Shimata K, Isono K, Shimojima N, Sugawara Y, Hibi T. Recent advances in surgical strategies and liver transplantation for hepatoblastoma. Cancer Med 2023; 12:3909-3918. [PMID: 36394165 PMCID: PMC9972171 DOI: 10.1002/cam4.5300] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
Hepatoblastoma (HB) is the most common malignant liver tumor in children. Although the development of treatment strategies with advances in chemotherapy has greatly improved the prognosis of HB, surgical resection and liver transplantation still play a vital role in the treatment of HB. In recent years, technological innovations have led to the development of new surgical approaches for HB. In this review, we describe the latest research on the surgical management of HB, including new imaging technologies, minimally invasive approaches, and the application of associating liver partition portal vein ligation for staged hepatectomy. We also discuss the current role of liver transplantation, use of ante-situm or ex-situ liver resection with auto-transplantation, and management of metastatic HB.
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Affiliation(s)
- Masaki Honda
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Koushi Uchida
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Tomoaki Irie
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kazuya Hirukawa
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masashi Kadohisa
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Keita Shimata
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kaori Isono
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Naoki Shimojima
- Department of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Yasuhiko Sugawara
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Taizo Hibi
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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16
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Application of 3D printing technology for pre-operative evaluation, education and informed consent in pediatric retroperitoneal tumors. Sci Rep 2023; 13:1671. [PMID: 36717595 PMCID: PMC9886922 DOI: 10.1038/s41598-023-28423-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
To investigate usefulness of 3D printing for preoperative evaluations, student and resident education, and communication with parents or guardians of patients with pediatric retroperitoneal tumors. Ten patients planning retroperitoneal tumor resection between March and November 2019 were included. Preoperative computed tomography (CT) images were used for 3D reconstruction and printing. Surveyed items were understanding of preoperative lesions with 3 different modules (CT, 3D reconstruction, and 3D printing) by students, residents, and specialists; satisfaction of specialists; and comprehension by guardians after preoperative explanations with each module. The median age at operation was 4.2 years (range, 1.8-18.1), and 8 patients were diagnosed with neuroblastoma. The 3D printing was the most understandable module for all groups (for students, residents, and specialists, P = 0.002, 0.027, 0.013, respectively). No significant intraoperative adverse events or immediate postoperative complications occurred. All specialists stated that 3D printing enhanced their understanding of cases. Guardians answered that 3D printing were the easiest to comprehend among the 3 modules (P = 0.007). Use of 3D printing in treatment of pediatric patients with retroperitoneal tumors was useful for preoperative planning, education, and parental explaining with obtaining informed consents.
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17
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Selvarajan A, Arulanandam B, Guadagno E, Poenaru D. Family risk communication preferences in pediatric surgery: A scoping review. J Pediatr Surg 2023; 58:891-901. [PMID: 36822973 DOI: 10.1016/j.jpedsurg.2023.01.027] [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] [Received: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Effective patient-surgeon communication is vital in pediatric surgical practice. However, family (including child) preferences for the format and content of risk communication information are largely unknown. In order to optimize the shared-decision making process, this scoping review explored the family-preferred methods for risk communication in pediatric surgery. METHODS A search was conducted in 7 databases from inception until June 2020 to identify family risk communication preferences in pediatric surgical patients, with language restricted to English and French. Two independent reviewers completed the screening in Rayyan software following PRISMA protocol. Included publications were reviewed for data extraction, analyzed, and assessed for risk of bias using standardized instruments. RESULTS A total of 6370 publications were retrieved, out of which 70 were included. Studies were predominantly from ENT (30.0%), general surgery (15.7%), and urology (11.4%). Family-preferred risk communication methods were classified as visual, verbal, technology-based, written, decision aids or other. Technological (32.4%) and written tools (29.7%) were most commonly chosen by families as their preferred risk communication methods. Written tools were frequently used in general surgery and urology, while technology-based tools were widely used in ENT. Most studies were cross-sectional and had a significant risk of bias. CONCLUSION Eliciting families' preferences for risk communication methods is critical for the implementation of shared decision-making. Different risk communication media appear to be preferred within specific surgical domains. To further improve shared-decision making in pediatric surgery, the development and usage of robust, validated risk communication tools are necessary. LEVEL OF EVIDENCE Level IV (Scoping Review).
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Affiliation(s)
- Arthega Selvarajan
- McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada
| | - Brandon Arulanandam
- McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dan Poenaru
- McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
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18
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Grab M, Hundertmark F, Thierfelder N, Fairchild M, Mela P, Hagl C, Grefen L. New perspectives in patient education for cardiac surgery using 3D-printing and virtual reality. Front Cardiovasc Med 2023; 10:1092007. [PMID: 36937915 PMCID: PMC10020687 DOI: 10.3389/fcvm.2023.1092007] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Background Preoperative anxiety in cardiac surgery can lead to prolonged hospital stays and negative postoperative outcomes. An improved patient education using 3D models may reduce preoperative anxiety and risks associated with it. Methods Patient education was performed with standardized paper-based methods (n = 34), 3D-printed models (n = 34) or virtual reality models (n = 31). Anxiety and procedural understanding were evaluated using questionnaires prior to and after the patient education. Additionally, time spent for the education and overall quality were evaluated among further basic characteristics (age, gender, medical expertise, previous non-cardiac surgery and previously informed patients). Included surgeries were coronary artery bypass graft, surgical aortic valve replacement and thoracic aortic aneurysm surgery. Results A significant reduction in anxiety measured by Visual Analog Scale was achieved after patient education with virtual reality models (5.00 to 4.32, Δ-0.68, p < 0.001). Procedural knowledge significantly increased for every group after the patient education while the visualization and satisfaction were best rated for patient education with virtual reality. Patients rated the quality of the patient education using both visualization methods individually [3D and virtual reality (VR) models] higher compared to the control group of conventional paper-sheets (control paper-sheets: 86.32 ± 11.89%, 3D: 94.12 ± 9.25%, p < 0.0095, VR: 92.90 ± 11.01%, p < 0.0412). Conclusion Routine patient education with additional 3D models can significantly improve the patients' satisfaction and reduce subjective preoperative anxiety effectively.
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Affiliation(s)
- Maximilian Grab
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
- Correspondence: Maximilian Grab
| | - Fabian Hundertmark
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | - Nikolaus Thierfelder
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | | | - Petra Mela
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | - Linda Grefen
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
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Guy BJ, Morris A, Mirjalili SA. Toward Emulating Human Movement: Adopting a Data-Driven Bitmap-Based "Voxel" Multimaterial Workflow to Create a Flexible 3D Printed Neonatal Lower Limb. 3D PRINTING AND ADDITIVE MANUFACTURING 2022; 9:349-364. [PMID: 36660289 PMCID: PMC9831563 DOI: 10.1089/3dp.2021.0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
It is increasingly common to produce physical anatomical medical models using high-fidelity multiproperty 3D printing to assist doctor-patient communication, presurgical planning, and surgical simulation. Currently, most medical models are created using image thresholding and traditional mesh-based segmentation techniques to produce mono-material boundaries (STL file formats) of anatomical features. Existing medical modeling manufacturing methods restrict shape specification to one material or density, which result in anatomically simple 3D printed medical models with no gradated material qualities. Currently, available high-resolution functionally graded multimaterial 3D printed medical models are rigid and do not represent biomechanical movement. To bypass the identified limitations of current 3D printing medical modeling workflows, we present a bitmap-based "voxel" multimaterial additive manufacturing workflow for the production of highly realistic and flexible anatomical models of the neonatal lower limb using computed tomographic ("CT") data. By interpolating and re-slicing a biomedical volumetric data set at the native 3D printer z resolution of 27 μm and using CT scan attenuation properties (Hounsfield units) to guide material mixing ratios, producing highly realistic models of the neonatal lower limb at a significantly faster rate than other manufacturing methods. The presented medical modeling workflow has considerable potential to improve medical modeling manufacturing methods by translating medical data directly into 3D printing files aiding in anatomical education and surgical simulation practices, especially in neonatal research and clinical training.
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Affiliation(s)
- Bernard Joseph Guy
- Industrial Design Department, School of Design Innovation, Victoria University of Wellington, Wellington, New Zealand
| | - Ana Morris
- Industrial Design Department, School of Design Innovation, Victoria University of Wellington, Wellington, New Zealand
| | - Seyed Ali Mirjalili
- Anatomy and Medical Imaging Department, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Tejo-Otero A, Valls-Esteve A, Fenollosa-Artés F, Siles-Hinojosa A, Nafria B, Ayats M, Buj-Corral I, Otero MC, Rubio-Palau J, Munuera J, Krauel L. Patient comprehension of oncologic surgical procedures using 3D printed surgical planning prototypes. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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21
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Three-dimensional modeling in complex liver surgery and liver transplantation. Hepatobiliary Pancreat Dis Int 2022; 21:318-324. [PMID: 35701284 DOI: 10.1016/j.hbpd.2022.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/24/2022] [Indexed: 02/05/2023]
Abstract
Liver resection and transplantation are the most effective therapies for many hepatobiliary tumors and diseases. However, these surgical procedures are challenging due to the anatomic complexity and many anatomical variations of the vascular and biliary structures. Three-dimensional (3D) printing models can clearly locate and describe blood vessels, bile ducts and tumors, calculate both liver and residual liver volumes, and finally predict the functional status of the liver after resection surgery. The 3D printing models may be particularly helpful in the preoperative evaluation and surgical planning of especially complex liver resection and transplantation, allowing to possibly increase resectability rates and reduce postoperative complications. With the continuous developments of imaging techniques, such models are expected to become widely applied in clinical practice.
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22
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Shine KM, Schlegel L, Ho M, Boyd K, Pugliese R. From the ground up: understanding the developing infrastructure and resources of 3D printing facilities in hospital-based settings. 3D Print Med 2022; 8:21. [PMID: 35821456 PMCID: PMC9275538 DOI: 10.1186/s41205-022-00147-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/09/2022] [Indexed: 12/02/2022] Open
Abstract
Background 3D printing is a popular technology in many industries secondary to its ability to rapidly produce inexpensive, high fidelity models/products, mainly through layer-by-layer fusion of various substrate materials. In healthcare, 3D printing has garnered interest for its applications in surgery, simulation, education, and medical device development, and 3D printing facilities are now being integrated into hospital-based settings. Yet, little is known regarding the leadership, resources, outputs, and role of these new onsite entities. Methods The purpose of this research was to survey features of North American hospital-based 3D printing facilities to understand their design and utility in anticipation of future expansion. Hospital-based 3D printing labs were recruited through online special interest groups to participate via survey response. Anonymous, voluntary data were collected from 21 facilities over 9 weeks and reported/analyzed in aggregate. Results Of the respondents, > 50% were founded in the past 5 years and 80% in the past decade, indicating recent and rapid growth of such facilities. Labs were most commonly found within large, university-affiliated hospitals/health systems with administration frequently, but not exclusively, through radiology departments, which was shown to enhance collaboration. All groups reported collaborating with other medical specialties/departments and image segmentation as part of the workflow, showing widespread interest in high fidelity, personalized medicine applications. Lab leadership was most often multidisciplinary, with physicians present on nearly all leadership teams. Budgets, personnel, and outputs varied among groups, however, all groups reported engagement in multiple 3D printing applications. Conclusion This preliminary study provides a foundation for understanding the unique nature of hospital-based 3D printing labs. While there is much to learn about such in-house facilities, the data obtained reveal important baseline characteristics. Further research is indicated to validate these early findings and create a detailed picture of the developing infrastructure of 3D printing in healthcare settings. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-022-00147-7.
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Affiliation(s)
- Kristy M Shine
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA. .,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA. .,Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, USA.
| | - Lauren Schlegel
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA
| | - Michelle Ho
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,Department of Medicine, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, USA
| | - Kaitlyn Boyd
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,College of Engineering, Drexel University, Philadelphia, USA
| | - Robert Pugliese
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,Innovation Pillar, Thomas Jefferson University, Philadelphia, USA
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23
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Christou CD, Tsoulfas G. Role of three-dimensional printing and artificial intelligence in the management of hepatocellular carcinoma: Challenges and opportunities. World J Gastrointest Oncol 2022; 14:765-793. [PMID: 35582107 PMCID: PMC9048537 DOI: 10.4251/wjgo.v14.i4.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/24/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) constitutes the fifth most frequent malignancy worldwide and the third most frequent cause of cancer-related deaths. Currently, treatment selection is based on the stage of the disease. Emerging fields such as three-dimensional (3D) printing, 3D bioprinting, artificial intelligence (AI), and machine learning (ML) could lead to evidence-based, individualized management of HCC. In this review, we comprehensively report the current applications of 3D printing, 3D bioprinting, and AI/ML-based models in HCC management; we outline the significant challenges to the broad use of these novel technologies in the clinical setting with the goal of identifying means to overcome them, and finally, we discuss the opportunities that arise from these applications. Notably, regarding 3D printing and bioprinting-related challenges, we elaborate on cost and cost-effectiveness, cell sourcing, cell viability, safety, accessibility, regulation, and legal and ethical concerns. Similarly, regarding AI/ML-related challenges, we elaborate on intellectual property, liability, intrinsic biases, data protection, cybersecurity, ethical challenges, and transparency. Our findings show that AI and 3D printing applications in HCC management and healthcare, in general, are steadily expanding; thus, these technologies will be integrated into the clinical setting sooner or later. Therefore, we believe that physicians need to become familiar with these technologies and prepare to engage with them constructively.
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Affiliation(s)
- Chrysanthos D Christou
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
| | - Georgios Tsoulfas
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
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24
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Li D, Imbesi GJ, Yen L, Kim H, Sun CL, Crook CJ, Ballena R, Zhang YH, Allen R, Sedrak M, Singh G. Feasibility and Satisfaction of Using NET VITALS Self-assessment Tool Among Patients With Neuroendocrine Tumors. Pancreas 2022; 51:319-324. [PMID: 35775639 DOI: 10.1097/mpa.0000000000002034] [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] [Indexed: 12/10/2022]
Abstract
OBJECTIVES There is a lack of effective patient education regarding diagnosis/treatment of neuroendocrine tumors (NETs), possibly related to their rare incidence. METHODS In this cross-sectional survey study, NET patients attending the 2019 Annual Los Angeles NET Education Conference were approached to complete NET VITALS, a self-assessment tool gauging patients' perception/awareness of their NET diagnosis/treatment, and a satisfaction survey. Feasibility of NET VITALS, patient satisfaction with NET VITALS, and patients' perception/awareness of their NET diagnosis/treatment were evaluated. RESULTS This analysis included 68 patients (median age, 63 years; 47.1% gastrointestinal NETs; 88.2% metastatic disease). Participation was 88.3% (68/77), with a median of 85.7% of items completed (range, 61.9%-100.0%). More than 30% of the patients answered "Don't know/Not familiar"/left blank questions related to tumor characteristics, years of symptoms, and liver-directed therapies. In addition, 69.5% of the patients did not feel sufficient information about NETs was provided at diagnosis. Overall, 67.8% of the patients felt that NET VITALS provides topics to discuss with providers and 76.3% would recommend NET VITALS to others. CONCLUSIONS NET VITALS is a feasible and acceptable self-assessment tool to potentially help patients improve communication about their NET diagnosis/treatment with their physician. Further studies will examine NET VITALS' generalizability and discuss its incorporation into clinical care.
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Affiliation(s)
- Daneng Li
- From the Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte
| | | | - Lisa Yen
- Los Angeles Carcinoid Neuroendocrine Tumor Society, Del Mar
| | - Heeyoung Kim
- Departments of Supportive Care Medicine, Center for Cancer and Aging
| | - Can-Lan Sun
- Departments of Supportive Care Medicine, Center for Cancer and Aging
| | - Christiana J Crook
- From the Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte
| | - Richard Ballena
- From the Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte
| | - Ya-Han Zhang
- From the Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte
| | - Rebecca Allen
- From the Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte
| | - Mina Sedrak
- From the Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte
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Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
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Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
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Robb H, Scrimgeour G, Boshier P, Przedlacka A, Balyasnikova S, Brown G, Bello F, Kontovounisios C. The current and possible future role of 3D modelling within oesophagogastric surgery: a scoping review. Surg Endosc 2022; 36:5907-5920. [PMID: 35277766 PMCID: PMC9283150 DOI: 10.1007/s00464-022-09176-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/24/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND 3D reconstruction technology could revolutionise medicine. Within surgery, 3D reconstruction has a growing role in operative planning and procedures, surgical education and training as well as patient engagement. Whilst virtual and 3D printed models are already used in many surgical specialities, oesophagogastric surgery has been slow in their adoption. Therefore, the authors undertook a scoping review to clarify the current and future roles of 3D modelling in oesophagogastric surgery, highlighting gaps in the literature and implications for future research. METHODS A scoping review protocol was developed using a comprehensive search strategy based on internationally accepted guidelines and tailored for key databases (MEDLINE, Embase, Elsevier Scopus and ISI Web of Science). This is available through the Open Science Framework (osf.io/ta789) and was published in a peer-reviewed journal. Included studies underwent screening and full text review before inclusion. A thematic analysis was performed using pre-determined overarching themes: (i) surgical training and education, (ii) patient education and engagement, and (iii) operative planning and surgical practice. Where applicable, subthemes were generated. RESULTS A total of 56 papers were included. Most research was low-grade with 88% (n = 49) of publications at or below level III evidence. No randomised control trials or systematic reviews were found. Most literature (86%, n = 48) explored 3D reconstruction within operative planning. These were divided into subthemes of pre-operative (77%, n = 43) and intra-operative guidance (9%, n = 5). Few papers reported on surgical training and education (14%, n = 8), and were evenly subcategorised into virtual reality simulation (7%, n = 4) and anatomical teaching (7%, n = 4). No studies utilising 3D modelling for patient engagement and education were found. CONCLUSION The use of 3D reconstruction is in its infancy in oesophagogastric surgery. The quality of evidence is low and key themes, such as patient engagement and education, remain unexplored. Without high quality research evaluating the application and benefits of 3D modelling, oesophagogastric surgery may be left behind.
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Affiliation(s)
- Henry Robb
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | | | - Piers Boshier
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | - Anna Przedlacka
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | | | - Gina Brown
- Imperial College London, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Christos Kontovounisios
- Imperial College London, London, UK.
- The Royal Marsden NHS Foundation Trust, London, UK.
- Chelsea Westminster NHS Foundation Trust, London, UK.
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27
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3D Printing Surgical Phantoms and their Role in the Visualization of Medical Procedures. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Pereira HR, Barzegar M, Hamadelseed O, Esteve AV, Munuera J. 3D surgical planning of pediatric tumors: a review. Int J Comput Assist Radiol Surg 2022; 17:805-816. [PMID: 35043366 DOI: 10.1007/s11548-022-02557-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/31/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND 3D surgical planning for the treatment of tumors in pediatrics using different neuroimaging methods is witnessing an accelerating and dynamic development. Until now, there have been many reports on the use of 3D printing techniques in different aspects of medical practice. Pediatric tumors mainly in the abdomen are among the most medical specialties that benefit from using this technique. The purpose of the current study is to review published literature regarding 3D surgical planning and its applications in the treatment of pediatric tumors and present challenges facing these techniques. MATERIALS AND METHODS A completed review of the available literature was performed, effect sizes from published studies were investigated, and results are presented concerning the use of 3D surgical planning in the management of pediatric tumors, most of which are abdominal. RESULTS According to the reviewed literature, our study comes to the point that 3D printing is a valuable technique for planning surgery for pediatric tumors in heart, brain, abdomen and bone. MRI and CT are the most common used techniques for preparing 3D printing models, as indicated by the reviewed reports. The reported studies have indicated that 3D printing allows the understanding of the anatomy of complex tumor cases, the simulation using surgical instruments, and medical and family education. The materials, 3D printing techniques and costs to be used depend on the application. CONCLUSION This technology can be applied in clinical practice with a wide spectrum, using various tools and a range of available 3D printing methods. Incorporating 3D printing into an effective application can be a gratifying process with the use of a multidisciplinary team and rapid advances, so more experience would be needed with this technique to show a clinical gain.
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Affiliation(s)
- Helena Rico Pereira
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da, Universidade de Lisboa, Campo Grande, C1 Building, 3rd Floor, 1749-016, Lisboa, Portugal. .,Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-517, Caparica, Portugal.
| | - Mojtaba Barzegar
- Intelligent Quantitative Biomedical Imaging (Iqbmi), 1955748171, Tehran, Iran.,School of Medical Physics and Medical Engineering, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, 71348-14336, Shiraz, Iran.,Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, 90272, USA
| | - Osama Hamadelseed
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany
| | - Arnau Valls Esteve
- 3D4H Unit, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.,Innovation Department, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Josep Munuera
- Imatge Diagnòstica i Terapéutica, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.,Servei de Diagnòstic per la Imatge, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain.,3D4H unit, Institut de Recerca Sant Joan de Déu, PasseigSant Joan deDéu 2, 08950, Esplugues deLlobregat, Spain
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Pokojna H, Erolin C, Henstridge C. The transparent minds: methods of creation of 3D digital models from patient specific data. J Vis Commun Med 2022; 45:17-31. [PMID: 35019795 DOI: 10.1080/17453054.2021.2008230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This paper focuses on the method for creating 3-dimensional (3D) digital models extracted from patient- specific scans of the brain. The described approach consists of several cross-platform stages: raw data segmentation, data correction in 3D-modelling software, post-processing of the 3D digital models and their presentation on an interactive web-based platform. This method of data presentation offers a cost and time effective option to present medical data accurately. An important aspect of the process is using real patient data and enriching the traditional slice-based representation of the scans with 3D models that can provide better understanding of the organs' structures. The resulting 3D digital models also form the basis for further processing into different modalities, for example models in Virtual Reality or 3D physical model printouts. The option to make medical data less abstract and more understandable can extend their use beyond diagnosis and into a potential aid in anatomy and patient education. The methods presented in this paper were originally based on the master thesis 'Transparent Minds: Testing for Efficiency of Transparency in 3D Physical and 3D Digital Models', which focussed on creating and comparing the efficiency of transparent 3D physical and 3D digital models from real-patient data.
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Affiliation(s)
- Hana Pokojna
- Department of Computer Science, Fakulta informatiky, Masarykova Univerzita, Brno, Czech Republic
| | - Caroline Erolin
- Centre for Anatomy and Human Identification, University of Dundee, Dundee, United Kingdom of Great Britain and Northern Ireland
| | - Christopher Henstridge
- Department of Systems Medicine, University of Dundee, Dundee, United Kingdom of Great Britain and Northern Ireland
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Utility of Three-Dimensional Printing for Preoperative Assessment of Children with Extra-Cranial Solid Tumors: A Systematic Review. Pediatr Rep 2022; 14:32-39. [PMID: 35076594 PMCID: PMC8788437 DOI: 10.3390/pediatric14010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In cases with solid tumors, preoperative radiological investigations provide valuable information on the anatomy of the tumor and the adjoining structures, thus helping in operative planning. However, due to a two-dimensional view in these investigations, a detailed spatial relationship is difficult to decipher. In contrast, three-dimensional (3D) printing technology provides a precise topographic view to perform safe surgical resections of these tumors. This systematic review aimed to summarize and analyze current evidence on the utility of 3D printing in pediatric extra-cranial solid tumors. METHODS The present study was registered on PROSPERO-international prospective register of systematic reviews (registration number: CRD42020206022). PubMed, Embase, SCOPUS, and Google Scholar databases were explored with appropriate search criteria to select the relevant studies. Data were extracted to study the bibliographic information of each article, the number of patients in each study, age of the patient(s), type of tumor, organ of involvement, application of 3D printing (surgical planning, training, and/or parental education). The details of 3D printing, such as type of imaging used, software details, printing technique, printing material, and cost were also synthesized. RESULTS Eight studies were finally included in the systematic review. Three-dimensional printing technology was used in thirty children with Wilms tumor (n = 13), neuroblastoma (n = 7), hepatic tumors (n = 8), retroperitoneal tumor (n = 1), and synovial sarcoma (n = 1). Among the included studies, the technology was utilized for preoperative surgical planning (five studies), improved understanding of the surgical anatomy of solid organs (two studies), and improving the parental understanding of the tumor and its management (one study). Computed tomography and magnetic resonance imaging were either performed alone or in combination for radiological evaluation in these children. Different types of printers and printing materials were used in the included studies. The cost of the 3D printed models and time involved (range 10 h to 4-5 days) were reported by two studies each. CONCLUSIONS 3D printed models can be of great assistance to pediatric surgeons in understanding the spatial relationships of tumors with the adjacent anatomic structures. They also facilitate the understanding of families, improving doctor-patient communication.
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Methods and Applications of 3D Patient-Specific Virtual Reconstructions in Surgery. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1356:53-71. [PMID: 35146617 DOI: 10.1007/978-3-030-87779-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
3D modelling has been highlighted as one of the key digital technologies likely to impact surgical practice in the next decade. 3D virtual models are reconstructed using traditional 2D imaging data through either direct volume or indirect surface rendering. One of the principal benefits of 3D visualisation in surgery relates to improved anatomical understanding-particularly in cases involving highly variable complex structures or where precision is required.Workflows begin with imaging segmentation which is a key step in 3D reconstruction and is defined as the process of identifying and delineating structures of interest. Fully automated segmentation will be essential if 3D visualisation is to be feasibly incorporated into routine clinical workflows; however, most algorithmic solutions remain incomplete. 3D models must undergo a range of processing steps prior to visualisation, which typically include smoothing, decimation and colourization. Models used for illustrative purposes may undergo more advanced processing such as UV unwrapping, retopology and PBR texture mapping.Clinical applications are wide ranging and vary significantly between specialities. Beyond pure anatomical visualisation, 3D modelling offers new methods of interacting with imaging data; enabling patient-specific simulations/rehearsal, Computer-Aided Design (CAD) of custom implants/cutting guides and serves as the substrate for augmented reality (AR) enhanced navigation.3D may enable faster, safer surgery with reduced errors and complications, ultimately resulting in improved patient outcomes. However, the relative effectiveness of 3D visualisation remains poorly understood. Future research is needed to not only define the ideal application, specific user and optimal interface/platform for interacting with models but also identify means by which we can systematically evaluate the efficacy of 3D modelling in surgery.
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Caregiver Preferences for Three-Dimensional Printed or Augmented Reality Craniosynostosis Skull Models: A Cross-Sectional Survey. J Craniofac Surg 2021; 33:151-155. [PMID: 34967521 DOI: 10.1097/scs.0000000000008134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Recent advances in three-dimensional (3D) printing and augmented reality (AR) have expanded anatomical modeling possibilities for caregiver craniosynostosis education. The purpose of this study is to characterize caregiver preferences regarding these visual models and determine the impact of these models on caregiver understanding of craniosynostosis. METHODS The authors constructed 3D-printed and AR craniosynostosis models, which were randomly presented in a cross-sectional survey. Caregivers rated each model's utility in learning about craniosynostosis, learning about skull anatomy, viewing an abnormal head shape, easing anxiety, and increasing trust in the surgeon in comparison to a two-dimensional (2D) diagram. Furthermore, caregivers were asked to identify the fused suture on each model and indicate their preference for generic versus patient-specific models. RESULTS A total of 412 craniosynostosis caregivers completed the survey (mean age 33 years, 56% Caucasian, 51% male). Caregivers preferred interactive, patient-specific 3D-printed or AR models over 2D diagrams (mean score difference 3D-printed to 2D: 0.16, P < 0.05; mean score difference AR to 2D: 0.17, P < 0.01) for learning about craniosynostosis, with no significant difference in preference between 3D-printed and AR models. Caregiver detection accuracy of the fused suture on the sagittal model was 19% higher with the 3D-printed model than with the AR model (P < 0.05) and 17% higher with the 3D-printed model than with the 2D diagram (P < 0.05). CONCLUSIONS Our findings indicate that craniosynostosis caregivers prefer 3D-printed or AR models over 2D diagrams in learning about craniosynostosis. Future craniosynostosis skull models with increased user interactivity and patient-specific components can better suit caregiver preferences.
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Chopra S, Boro AK, Sinha VD. 3D Printing-Assisted Skull Base Tumor Surgeries: An Institutional Experience. J Neurosci Rural Pract 2021; 12:630-634. [PMID: 34737495 PMCID: PMC8559068 DOI: 10.1055/s-0041-1734001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Three-dimensional (3D) printing technology in neurosurgery has gained popularity nowadays. Skull base contains many major neurovascular structures in a confined space, along with anatomical variations making surgical approaches to this region challenging. 3D-printed model of skull base tumors consists of the patient's bony skull base, actual tumor dimensions, and surrounding major neurovascular structures. We included a total number of five patients with skull base tumors (one case of planum sphenoidale meningioma, two cases of sellar tumor with suprasellar extension, and two cases of cerebellopontine angle tumor) and 3D-printed tumor model of each of them. These models were used for preoperative simulation and served as very true to life training tool. These help in increasing the efficacy of the surgeon, improves surgical safety and ergonomics. They were also used for patient counselling, educating about the disease, the surgical procedure, and associated risks.
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Affiliation(s)
- Sanjeev Chopra
- Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, India
| | - Ashim Kumar Boro
- Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, India
| | - Virendra Deo Sinha
- Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, India
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Jin Z, Li Y, Yu K, Liu L, Fu J, Yao X, Zhang A, He Y. 3D Printing of Physical Organ Models: Recent Developments and Challenges. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2101394. [PMID: 34240580 PMCID: PMC8425903 DOI: 10.1002/advs.202101394] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Indexed: 05/05/2023]
Abstract
Physical organ models are the objects that replicate the patient-specific anatomy and have played important roles in modern medical diagnosis and disease treatment. 3D printing, as a powerful multi-function manufacturing technology, breaks the limitations of traditional methods and provides a great potential for manufacturing organ models. However, the clinical application of organ model is still in small scale, facing the challenges including high cost, poor mimicking performance and insufficient accuracy. In this review, the mainstream 3D printing technologies are introduced, and the existing manufacturing methods are divided into "directly printing" and "indirectly printing", with an emphasis on choosing suitable techniques and materials. This review also summarizes the ideas to address these challenges and focuses on three points: 1) what are the characteristics and requirements of organ models in different application scenarios, 2) how to choose the suitable 3D printing methods and materials according to different application categories, and 3) how to reduce the cost of organ models and make the process simple and convenient. Moreover, the state-of-the-art in organ models are summarized and the contribution of 3D printed organ models to various surgical procedures is highlighted. Finally, current limitations, evaluation criteria and future perspectives for this emerging area are discussed.
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Affiliation(s)
- Zhongboyu Jin
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Yuanrong Li
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Kang Yu
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Linxiang Liu
- Zhejiang University HospitalZhejiang UniversityHangzhouZhejiang310027China
| | - Jianzhong Fu
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Xinhua Yao
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Aiguo Zhang
- Department of OrthopedicsWuxi Children's Hospital affiliated to Nanjing Medical UniversityWuxiJiangsu214023China
| | - Yong He
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of Materials Processing and MoldZhengzhou UniversityZhengzhou450002China
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Spangler HD, Simancas-Pallares MA, Ginnis J, Ferreira Zandoná AG, Roach J, Divaris K. A Web-Based Rendering Application for Communicating Dental Conditions. Healthcare (Basel) 2021; 9:healthcare9080960. [PMID: 34442097 PMCID: PMC8393219 DOI: 10.3390/healthcare9080960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/19/2021] [Accepted: 07/24/2021] [Indexed: 11/16/2022] Open
Abstract
The importance of visual aids in communicating clinical examination findings or proposed treatments in dentistry cannot be overstated. Similarly, communicating dental research results with tooth surface-level precision is impractical without visual representations. Here, we present the development, deployment, and two real-life applications of a web-based data visualization informatics pipeline that converts tooth surface-level information to colorized, three-dimensional renderings. The core of the informatics pipeline focuses on texture (UV) mapping of a pre-existing model of the human primary dentition. The 88 individually segmented tooth surfaces receive independent inputs that are represented in colors and textures according to customizable user specifications. The web implementation SculptorHD, deployed on the Google Cloud Platform, can accommodate manually entered or spreadsheet-formatted tooth surface data and allows the customization of color palettes and thresholds, as well as surface textures (e.g., condition-free, caries lesions, stainless steel, or ceramic crowns). Its current implementation enabled the visualization and interpretation of clinical early childhood caries (ECC) subtypes using latent class analysis-derived caries experience summary data. As a demonstration of its potential clinical utility, the tool was also used to simulate the restorative treatment presentation of a severe ECC case, including the use of stainless steel and ceramic crowns. We expect that this publicly available web-based tool can aid clinicians and investigators deliver precise, visual presentations of dental conditions and proposed treatments. The creation of rapidly adjustable lifelike dental models, integrated to existing electronic health records and responsive to new clinical findings or planned for future work, is likely to boost two-way communication between clinicians and their patients.
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Affiliation(s)
- Hudson D. Spangler
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA; (M.A.S.-P.); (J.G.); (K.D.)
- Correspondence:
| | - Miguel A. Simancas-Pallares
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA; (M.A.S.-P.); (J.G.); (K.D.)
| | - Jeannie Ginnis
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA; (M.A.S.-P.); (J.G.); (K.D.)
| | | | - Jeff Roach
- Department of Research Computing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7032, USA;
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA; (M.A.S.-P.); (J.G.); (K.D.)
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7400, USA
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Raichurkar KK, Lochan R, Jacob M, Asthana S. The Use of a 3D Printing Model in Planning a Donor Hepatectomy for Living Donor Liver Transplantation: First in India. J Clin Exp Hepatol 2021; 11:515-517. [PMID: 34276158 PMCID: PMC8267362 DOI: 10.1016/j.jceh.2020.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Three-dimensional (3D) anatomical relationships between the hepatic veins and portal structures can serve as a guide to plan resections in donor hepatectomy during living donor liver transplantation. We present the first case report from India on the use of a 3D printed liver model, as an assist to living donor liver transplantation. METHODS A 3D model of the donor liver with hepatic venous structures printed within it was prepared using image acquisition data. The model was used for a simulated cut preoperatively, to mimic the donor hepatectomy based on the venous structures seen through the transparent material used for making the liver model. The volume of the graft measured by volume displacement in the actual surgery was compared with the volume of the model after the simulated cut. RESULTS The calculated volume of the graft was 359 ml as per the preoperative simulation, and the observed weight/volume was 380 gm/310 ml. CONCLUSION Three-dimensional printing of liver models using imaging data can help predict the actual size of the graft after donor hepatectomy, in patients undergoing living donor liver transplantation.
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Affiliation(s)
| | | | | | - Sonal Asthana
- Address for correspondence. Sonal Asthana, 43/2, New Airport road, NH-7, Sahakarnagar, Bengaluru, Karnataka, 560092, India.
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Chedid VG, Kamath AA, M Knudsen J, Frimannsdottir K, Yost KJ, R Geske J, Morris JM, Taner T, Matsumoto JM, Kamath PS. Three-Dimensional-Printed Liver Model Helps Learners Identify Hepatic Subsegments: A Randomized-Controlled Cross-Over Trial. Am J Gastroenterol 2020; 115:1906-1910. [PMID: 33156110 DOI: 10.14309/ajg.0000000000000958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The purpose of this study was to find out whether 3-dimensional (3D)-printed models improved the learners' ability to identify liver segments. METHODS A total of 116 physicians from 3 disciplines were tested in a cross-over trial at baseline and after teaching with 3D models and 2-dimensional (2D) images. Adjusted multilevel-mixed models were used to compare scores at baseline and after 3D and 2D. RESULTS Accuracy in identifying hepatic segments was higher with 3D first than 2D (77% vs 69%; P = 0.05) and not significantly improved by a combination of 3D and 2D. Increased confidence in segment identification was highest in trainees after 3D (P = 0.04). DISCUSSION 3D-printed models facilitate learning hepatic segmental anatomy.
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Affiliation(s)
- Victor G Chedid
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Amika A Kamath
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - John M Knudsen
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Katrin Frimannsdottir
- Mayo Clinic Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathleen J Yost
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer R Geske
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Timucin Taner
- Division of Transplantation Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Patrick S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Power RJ, Hearn J, Gillis CJ, Harvey D, French C, Organ M. Development of a 3D-printed testicular cancer model for testicular examination education. Can Urol Assoc J 2020; 15:E221-E226. [PMID: 33007179 DOI: 10.5489/cuaj.6675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Testicular cancer is the most commonly diagnosed malignancy in young males. Testicular examination is a non-invasive and inexpensive means of detecting testicular cancer at an early stage. In this project, a set of 3D-printed models was developed to facilitate teaching testicular examination and improving understanding of testicular malignancies among patients and medical learners. METHODS Five scrotum models were designed: a control model with healthy testes, and four models containing a healthy testicle and a testicle with an endophytic mass of varying size. The anatomy, texture, and composition of the 3D-printed models were refined using an iterative process between the design team and urologists. The completed models were assessed by six urologists, two urology nurse practitioners, and 32 medical learners. Participants were asked to inspect and palpate each model, and to provide feedback using a five-point Likert scale. RESULTS Clinicians reported that the models enabled accurate simulation of a testicular examination involving both healthy and pathologic testes (χ̄=4.3±1.0). They agreed that the models would be useful teaching tools for both medical learners (χ̄=4.8±0.5) and patients (χ̄=4.8±0.7). Following an educational session with the models, medical learners reported improvements in confidence and skill in performing a testicular examination. CONCLUSIONS 3D-printed models can effectively simulate palpation of both healthy and pathologic testes. The developed models have the potential to be a useful adjunct in teaching testicular examination and in demonstrating abnormal findings that require further investigation.
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Affiliation(s)
- Rebecca J Power
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jason Hearn
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Charlie J Gillis
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - David Harvey
- Department of Urology, Discipline of Surgery, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Christopher French
- Department of Urology, Discipline of Surgery, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michael Organ
- Department of Urology, Discipline of Surgery, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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Ballard DH, Wake N, Witowski J, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions. 3D Print Med 2020; 6:13. [PMID: 32514795 PMCID: PMC7278118 DOI: 10.1186/s41205-020-00065-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications. Methods A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines. Results Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, pancreatitis, splenic disease, gastric pathology, small bowel pathology, colorectal cancer, perianal fistula, visceral trauma, hernia, abdominal sarcoma, abdominal wall masses, and intra-abdominal fluid collections. Conclusion This document provides initial appropriate use criteria for medical 3D printing in abdominal, hepatobiliary, and gastrointestinal conditions.
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Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO, 63110, USA.
| | - Nicole Wake
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jan Witowski
- 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Krakow, Poland
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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Rooney MK, Rosenberg DM, Braunstein S, Cunha A, Damato AL, Ehler E, Pawlicki T, Robar J, Tatebe K, Golden DW. Three-dimensional printing in radiation oncology: A systematic review of the literature. J Appl Clin Med Phys 2020; 21:15-26. [PMID: 32459059 PMCID: PMC7484837 DOI: 10.1002/acm2.12907] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/16/2020] [Accepted: 04/23/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose/objectives Three‐dimensional (3D) printing is recognized as an effective clinical and educational tool in procedurally intensive specialties. However, it has a nascent role in radiation oncology. The goal of this investigation is to clarify the extent to which 3D printing applications are currently being used in radiation oncology through a systematic review of the literature. Materials/methods A search protocol was defined according to preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Included articles were evaluated using parameters of interest including: year and country of publication, experimental design, sample size for clinical studies, radiation oncology topic, reported outcomes, and implementation barriers or safety concerns. Results One hundred and three publications from 2012 to 2019 met inclusion criteria. The most commonly described 3D printing applications included quality assurance phantoms (26%), brachytherapy applicators (20%), bolus (17%), preclinical animal irradiation (10%), compensators (7%), and immobilization devices (5%). Most studies were preclinical feasibility studies (63%), with few clinical investigations such as case reports or series (13%) or cohort studies (11%). The most common applications evaluated within clinical settings included brachytherapy applicators (44%) and bolus (28%). Sample sizes for clinical investigations were small (median 10, range 1–42). A minority of articles described basic or translational research (11%) and workflow or cost evaluation studies (3%). The number of articles increased over time (P < 0.0001). While outcomes were heterogeneous, most studies reported successful implementation of accurate and cost‐effective 3D printing methods. Conclusions Three‐dimensional printing is rapidly growing in radiation oncology and has been implemented effectively in a diverse array of applications. Although the number of 3D printing publications has steadily risen, the majority of current reports are preclinical in nature and the few clinical studies that do exist report on small sample sizes. Further dissemination of ongoing investigations describing the clinical application of developed 3D printing technologies in larger cohorts is warranted.
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Affiliation(s)
- Michael K Rooney
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - David M Rosenberg
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Steve Braunstein
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Adam Cunha
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Antonio L Damato
- Department Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eric Ehler
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Todd Pawlicki
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, CA, USA
| | - James Robar
- Department of Radiation Oncology, Dalhousie University, Halifax, Canada.,Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Canada.,Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Ken Tatebe
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
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Ishii T, Fukumitsu K, Ogawa E, Okamoto T, Uemoto S. Living donor liver transplantation in situs inversus totalis with a patient-specific three-dimensional printed liver model. Pediatr Transplant 2020; 24:e13675. [PMID: 32068328 DOI: 10.1111/petr.13675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/31/2019] [Accepted: 01/26/2020] [Indexed: 01/03/2023]
Abstract
We utilized patient-specific 3D liver models based on preoperative computed tomography images as intraoperative navigation and describe our experience. A 1-year and 10-month-old girl with situs inversus totalis underwent living donor liver transplantation for biliary atresia. Information on the hepatic artery, portal vein, inferior vena cava, and liver parenchyma was extracted and segmented from computed tomography images using liver analysis software. Laser lithography produced each 3D part of the liver from these data. The 3D models of each part of the liver were molded from polyurethane resin using different colors for each part and combined together, resulting in a patient-specific liver model. The industrial computed tomography scan of the patient-specific 3D liver model revealed that the gaps between the liver model and the original data were <0.4 mm in the 90% area, <0.8 mm in the 98% area, and 1.53 mm at the maximum. The 3D liver model was brought into the operative field and used as intraoperative navigation for total liver resection. The procedure was finished successfully without any major intraoperative complications. In conclusion, the 3D model facilitates the identification of vessels during operations; it is possible to promptly share patients' anatomy with the operative team.
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Affiliation(s)
- Takamichi Ishii
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Fukumitsu
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eri Ogawa
- Division of Pediatric Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuya Okamoto
- Division of Pediatric Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Division of Pediatric Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Montgomery SJ, Kooner SS, Ludwig TE, Schneider PS. Impact of 3D Printed Calcaneal Models on Fracture Understanding and Confidence in Orthopedic Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2020; 77:472-478. [PMID: 32033916 DOI: 10.1016/j.jsurg.2019.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/23/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine if three-dimensionally printed (3Dp) fracture models can improve orthopedic trainee education. DESIGN A prospective comparison study of orthopedic trainees and attending surgeons was performed, where a range of calcaneal fractures were used for creating anonymized 3Dp models. Study participants rotated through workstations viewing computed tomography images and either a digital 3D volume rendering or 3Dp model of the fractured calcaneus. Diagnosis, time for evaluation, confidence of fracture understanding, perceived model accuracy, and proposed treatment were compared using a standardized questionnaire. PARTICIPANTS Sixteen resident trainees and 5 attending surgeons participated in this study. Attending surgeons were required to have fellowship training in trauma or foot and ankle surgery and manage calcaneal fractures as part of their current practice. RESULTS Junior residents had the slowest time of assessment (mean = 121 ± 54 seconds) and lowest percentage of correct diagnoses (69%), although these findings did not reach significance compared to the other residency years. Residents displayed higher levels of confidence in fracture understanding with increasing residency year of training (p < 0.0001), and this confidence was greater for cases that included a 3Dp model (p < 0.03). Perceived accuracy of cases with 3Dp models was significantly higher than cases without 3Dp models (7.0 vs 5.5 p < 0.001). CONCLUSIONS This study found that 3Dp models increase the perceived accuracy of fracture assessment, though no statistically significant improvement in diagnostic accuracy was observed. The 3Dp models did improve trainee confidence, although this effect diminished with increasing residency year. In orthopedic residency training programs, 3Dp models of complex fractures can be a valuable educational tool, especially for junior trainees.
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Guo XY, He ZQ, Duan H, Lin FH, Zhang GH, Zhang XH, Chen ZH, Sai K, Jiang XB, Wang ZN, Xie T, Chen ZP, Mou YG. The utility of 3-dimensional-printed models for skull base meningioma surgery. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:370. [PMID: 32355814 PMCID: PMC7186736 DOI: 10.21037/atm.2020.02.28] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Skull base meningioma surgery is often difficult and complicated to perform. Therefore, this study aims to investigate the effectiveness of 3-dimensional (3D)-printed models of skull base meningioma in the representation of anatomical structures, the simulation of surgical plans, and patient education on surgical outcomes. Methods A retrospective study of 35 patients (3D group: 19 patients and non-3D group: 16 patients) with skull base meningioma was conducted. Mimics software was used to create 3D reconstructions (with the skull, blood vessels, nerves, and tumors set to different colors), and 3D solid models were printed to determine the surgical protocols and communication pathways with the patient. Results The 3D-printed model can visually display the relationship of different structures, including the skull, blood vessels, cranial nerves, and tumors. The surgeon should select the proper surgical approaches before surgery through the model and pay attention to protecting the important structures during the operation. According to the models, the surgeon should cut off the blood supply to the tumor to reduce intraoperative bleeding. For patients with skull base bone destruction, the skull base repair should be prepared in advance. Patients and their families should have a thorough understanding of the disease through the model, and there should be effective communication between doctors and patients. Conclusions The 3D-printed model of a skull base meningioma can present the structures in a detailed manner and facilitate in helping the surgeon to develop a surgical plan. At the same time, it helps patients and their families to understand the condition and the surgical plan, which is conducive to better patient education.
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Affiliation(s)
- Xiao-Yu Guo
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhen-Qiang He
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Hao Duan
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Fu-Hua Lin
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Guan-Hua Zhang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Xiang-Heng Zhang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zheng-He Chen
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Ke Sai
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Xiao-Bing Jiang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhen-Ning Wang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Tian Xie
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhong-Ping Chen
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Yong-Gao Mou
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
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Decision-making based on 3D printed models in laparoscopic liver resections with intraoperative ultrasound: a prospective observational study. Eur Radiol 2019; 30:1306-1312. [PMID: 31773294 PMCID: PMC7033053 DOI: 10.1007/s00330-019-06511-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/28/2019] [Accepted: 10/11/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate impact of 3D printed models on decision-making in context of laparoscopic liver resections (LLR) performed with intraoperative ultrasound (IOUS) guidance. METHODS Nineteen patients with liver malignances (74% were colorectal cancer metastases) were prospectively qualified for LLR or radiofrequency ablation in a single center from April 2017 to December 2018. Models were 3DP in all cases based on CT and facilitated optical visualization of tumors' relationships with portal and hepatic veins. Planned surgical extent and its changes were tracked after CT analysis and 3D model inspection, as well as intraoperatively using IOUS. RESULTS Nineteen patients were included in the analysis. Information from either 3DP or IOUS led to changes in the planned surgical approach in 13/19 (68%) patients. In 5/19 (26%) patients, the 3DP model altered the plan of the surgery preoperatively. In 4/19 (21%) patients, 3DP independently changed the approach. In one patient, IOUS modified the plan post-3DP. In 8/19 (42%) patients, 3DP model did not change the approach, whereas IOUS did. In total, IOUS altered surgical plans in 9 (47%) cases. Most of those changes (6/9; 67%) were caused by detection of additional lesions not visible on CT and 3DP. CONCLUSIONS 3DP can be helpful in planning complex and major LLRs and led to changes in surgical approach in 26.3% (5/19 patients) in our series. 3DP may serve as a useful adjunct to IOUS. KEY POINTS • 3D printing can help in decision-making before major and complex resections in patients with liver cancer. • In 5/19 patients, 3D printed model altered surgical plan preoperatively. • Most surgical plan changes based on intraoperative ultrasonography were caused by detection of additional lesions not visible on CT and 3D model.
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An overview on 3D printing for abdominal surgery. Surg Endosc 2019; 34:1-13. [PMID: 31605218 DOI: 10.1007/s00464-019-07155-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 09/24/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing is a disruptive technology that is quickly spreading to many fields, including healthcare. In this context, it allows the creation of graspable, patient-specific, anatomical models generated from medical images. The ability to hold and show a physical object speeds up and facilitates the understanding of anatomical details, eases patient counseling and contributes to the education and training of students and residents. Several medical specialties are currently exploring the potential of this technology, including general surgery. METHODS In this review, we provide an overview on the available 3D printing technologies, together with a systematic analysis of the medical literature dedicated to its application for abdominal surgery. Our experience with the first clinical laboratory for 3D printing in Italy is also reported. RESULTS There was a tenfold increase in the number of publications per year over the last decade. About 70% of these papers focused on kidney and liver models, produced primarily for pre-interventional planning, as well as for educational and training purposes. The most used printing technologies are material jetting and material extrusion. Seventy-three percent of publications reported on fewer than ten clinical cases. CONCLUSION The increasing application of 3D printing in abdominal surgery reflects the dawn of a new technology, although it is still in its infancy. The potential benefit of this technology is clear, however, and it may soon lead to the development of new hospital facilities to improve surgical training, research, and patient care.
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Zhuang YD, Zhou MC, Liu SC, Wu JF, Wang R, Chen CM. Effectiveness of personalized 3D printed models for patient education in degenerative lumbar disease. PATIENT EDUCATION AND COUNSELING 2019; 102:1875-1881. [PMID: 31113688 DOI: 10.1016/j.pec.2019.05.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/09/2019] [Accepted: 05/04/2019] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Three-dimensional printing may play an important role in patients' education. The objective of this study was to assess the effectiveness of personalized 3D printed models for increasing patient understanding of their medical condition and surgical plan. METHODS Forty-five patients with degenerative lumbar diseases were randomized by block design into three groups: educational program presented by CT & MRI imaging (care-as-usual), 3D reconstructions, or personalized 3D printed models. Patients' level of understanding and satisfaction were evaluated by two questionnaires one day after education. RESULTS Patients educated with personalized 3D printed models demonstrated an expanded level of understanding than patients educated with CT & MRI imaging (care-as-usual) (P < 0.05) and 3D reconstructions (P < 0.05). Personalized 3D printed models also resulted in a higher degree of patient satisfaction (P < 0.05). CONCLUSIONS Personalized 3D printed models and 3D reconstructions can simplify and enhance understanding of lumbar anatomy, physiology, and patients' disease and surgical plan. Personalized 3D printed models also enhance patients' subjective satisfaction. PRACTICE IMPLICATIONS Personalized 3D printed models for patient education are feasible and could be generalized for degenerative lumbar diseases.
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Affiliation(s)
- Yuan-Dong Zhuang
- Department of Neurosurgery, Union Hospital, Fujian Medical University, Fujian Institute of Neurosurgery, Fuzhou 350001, China
| | - Mao-Chao Zhou
- Department of Neurosurgery, Union Hospital, Fujian Medical University, Fujian Institute of Neurosurgery, Fuzhou 350001, China
| | - Shi-Chao Liu
- Department of Neurosurgery, Union Hospital, Fujian Medical University, Fujian Institute of Neurosurgery, Fuzhou 350001, China
| | - Jian-Feng Wu
- Department of Neurosurgery, Union Hospital, Fujian Medical University, Fujian Institute of Neurosurgery, Fuzhou 350001, China
| | - Rui Wang
- Department of Neurosurgery, Union Hospital, Fujian Medical University, Fujian Institute of Neurosurgery, Fuzhou 350001, China
| | - Chun-Mei Chen
- Department of Neurosurgery, Union Hospital, Fujian Medical University, Fujian Institute of Neurosurgery, Fuzhou 350001, China.
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Bangeas P, Tsioukas V, Papadopoulos VN, Tsoulfas G. Role of innovative 3D printing models in the management of hepatobiliary malignancies. World J Hepatol 2019; 11:574-585. [PMID: 31388399 PMCID: PMC6669192 DOI: 10.4254/wjh.v11.i7.574] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/12/2019] [Accepted: 06/27/2019] [Indexed: 02/06/2023] Open
Abstract
Three-dimensional (3D) printing has recently emerged as a new technique in various liver-related surgical fields. There are currently only a few systematic reviews that summarize the evidence of its impact. In order to construct a systematic literature review of the applications and effects of 3D printing in liver surgery, we searched the PubMed, Embase and ScienceDirect databases for relevant titles, according to the PRISMA statement guidelines. We retrieved 162 titles, of which 32 met the inclusion criteria and are reported. The leading application of 3D printing in liver surgery is for preoperative planning. 3D printing techniques seem to be beneficial for preoperative planning and educational tools, despite their cost and time requirements, but this conclusion must be confirmed by additional randomized controlled trials.
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Affiliation(s)
- Peter Bangeas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Vassilios Tsioukas
- Department of School of Rural and Surveying Engineering, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | | | - Georgios Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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Kim PS, Choi CH, Han IH, Lee JH, Choi HJ, Lee JI. Obtaining Informed Consent Using Patient Specific 3D Printing Cerebral Aneurysm Model. J Korean Neurosurg Soc 2019; 62:398-404. [PMID: 31290295 PMCID: PMC6616983 DOI: 10.3340/jkns.2019.0092] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 04/22/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose. METHODS Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-offlight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery. RESULTS The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0). CONCLUSION The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.
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Affiliation(s)
- Pil Soo Kim
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hwa Choi
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - In Ho Han
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jung Hwan Lee
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyuk Jin Choi
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jae Il Lee
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
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Wake N, Rosenkrantz AB, Huang R, Park KU, Wysock JS, Taneja SS, Huang WC, Sodickson DK, Chandarana H. Patient-specific 3D printed and augmented reality kidney and prostate cancer models: impact on patient education. 3D Print Med 2019; 5:4. [PMID: 30783869 PMCID: PMC6743040 DOI: 10.1186/s41205-019-0041-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/17/2019] [Indexed: 11/21/2022] Open
Abstract
Background Patient-specific 3D models are being used increasingly in medicine for many applications including surgical planning, procedure rehearsal, trainee education, and patient education. To date, experiences on the use of 3D models to facilitate patient understanding of their disease and surgical plan are limited. The purpose of this study was to investigate in the context of renal and prostate cancer the impact of using 3D printed and augmented reality models for patient education. Methods Patients with MRI-visible prostate cancer undergoing either robotic assisted radical prostatectomy or focal ablative therapy or patients with renal masses undergoing partial nephrectomy were prospectively enrolled in this IRB approved study (n = 200). Patients underwent routine clinical imaging protocols and were randomized to receive pre-operative planning with imaging alone or imaging plus a patient-specific 3D model which was either 3D printed, visualized in AR, or viewed in 3D on a 2D computer monitor. 3D uro-oncologic models were created from the medical imaging data. A 5-point Likert scale survey was administered to patients prior to the surgical procedure to determine understanding of the cancer and treatment plan. If randomized to receive a pre-operative 3D model, the survey was completed twice, before and after viewing the 3D model. In addition, the cohort that received 3D models completed additional questions to compare usefulness of the different forms of visualization of the 3D models. Survey responses for each of the 3D model groups were compared using the Mann-Whitney and Wilcoxan rank-sum tests. Results All 200 patients completed the survey after reviewing their cases with their surgeons using imaging only. 127 patients completed the 5-point Likert scale survey regarding understanding of disease and surgical procedure twice, once with imaging and again after reviewing imaging plus a 3D model. Patients had a greater understanding using 3D printed models versus imaging for all measures including comprehension of disease, cancer size, cancer location, treatment plan, and the comfort level regarding the treatment plan (range 4.60–4.78/5 vs. 4.06–4.49/5, p < 0.05). Conclusions All types of patient-specific 3D models were reported to be valuable for patient education. Out of the three advanced imaging methods, the 3D printed models helped patients to have the greatest understanding of their anatomy, disease, tumor characteristics, and surgical procedure.
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Affiliation(s)
- Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU School of Medicine, 660 First Avenue, Fourth Floor, New York, NY, 10016, USA.
| | - Andrew B Rosenkrantz
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU School of Medicine, 660 First Avenue, Fourth Floor, New York, NY, 10016, USA
| | - Richard Huang
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, NYU School of Medicine, New York, NY, USA
| | - Katalina U Park
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU School of Medicine, 660 First Avenue, Fourth Floor, New York, NY, 10016, USA
| | - James S Wysock
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, NYU School of Medicine, New York, NY, USA
| | - Samir S Taneja
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, NYU School of Medicine, New York, NY, USA
| | - William C Huang
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, NYU School of Medicine, New York, NY, USA
| | - Daniel K Sodickson
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU School of Medicine, 660 First Avenue, Fourth Floor, New York, NY, 10016, USA
| | - Hersh Chandarana
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU School of Medicine, 660 First Avenue, Fourth Floor, New York, NY, 10016, USA
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Mardis NJ. Emerging Technology and Applications of 3D Printing in the Medical Field. MISSOURI MEDICINE 2018; 115:368-373. [PMID: 30228770 PMCID: PMC6140256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
3D printing technology evolved in the 1980s, but has made great strides in the last decade from both a cost and accessibility standpoint. While most printers are employed for commercial uses, medical 3D printing is a growing application which serves to aid physicians in the diagnosis, therapeutic planning, and potentially the treatment of patients with complex diseases. In this article we will delineate the types of printers available to the consumer, the various materials which can be utilized, and potential applications of 3D models in the healthcare field.
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Affiliation(s)
- Neil J Mardis
- Neil J Mardis, DO, is an Assistant Professor Pediatric Radiology, Children's Mercy, University of Missouri, Kansas City Kansas City, Mo
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