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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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Burkhardt F, Handermann L, Rothlauf S, Gintaute A, Vach K, Spies BC, Lüchtenborg J. Accuracy of additively manufactured and steam sterilized surgical guides by means of continuous liquid interface production, stereolithography, digital light processing, and fused filament fabrication. J Mech Behav Biomed Mater 2024; 152:106418. [PMID: 38295512 DOI: 10.1016/j.jmbbm.2024.106418] [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: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
Different printing technologies can be used for prosthetically oriented implant placement, however the influence of different printing orientations and steam sterilization remains unclear. In particular, no data is available for the novel technology Continuous Liquid Interface Production. The objective was to evaluate the dimensional accuracy of surgical guides manufactured with different printing techniques in vertical and horizontal printing orientation before and after steam sterilization. A total of 80 surgical guides were manufactured by means of continuous liquid interface production (CLIP; material: Keyguide, Keyprint), digital light processing (DLP; material: Luxaprint Ortho, DMG), stereolithography (SLA; Surgical guide, Formlabs), and fused filament fabrication (FFF; material: Clear Base Support, Arfona) in vertical and horizontal printing orientation (n = 10 per subgroup). Spheres were included in the design to determine the coordinates of 17 reference points. Each specimen was digitized with a laboratory scanner after additive manufacturing (AM) and after steam sterilization (134 °C). To determine the accuracy, root mean square values (RMS) were calculated and coordinates of the reference points were recorded. Based on the measured coordinates, deviations of the reference points and relevant distances were calculated. Paired t-tests and one-way ANOVA were applied for statistical analysis (significance p < 0.05). After AM, all printing technologies showed comparable high accuracy, with an increased deviation in z-axis when printed horizontally. After sterilization, FFF printed surgical guides showed distinct warpage. The other subgroups showed no significant differences regarding the RMS of the corpus after steam sterilization (p > 0.05). Regarding reference points and distances, CLIP showed larger deviations compared to SLA in both printing orientations after steam sterilization, while DLP manufactured guides were the most dimensionally stable. In conclusion, the different printing technologies and orientations had little effect on the manufacturing accuracy of the surgical guides before sterilization. However, after sterilization, FFF surgical guides exhibited significant deformation making their clinical use impossible. CLIP showed larger deformations due to steam sterilization than the other photopolymerizing techniques, however, discrepancies may be considered within the range of clinical acceptance. The influence on the implant position remains to be evaluated.
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Affiliation(s)
- Felix Burkhardt
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Leon Handermann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Severin Rothlauf
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Aiste Gintaute
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Jörg Lüchtenborg
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Gu Y, Zhuang Y. 3D printing-assisted surgery for the treatment of proximal clavicle fracture with ipsilateral acromioclavicular joint dislocation: a case description. Quant Imaging Med Surg 2024; 14:1234-1240. [PMID: 38223100 PMCID: PMC10784062 DOI: 10.21037/qims-23-720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/11/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Yang Gu
- Department of Trauma Orthopedics Surgery, Ningbo No. 6 Hospital, Ningbo, China
| | - Yunqiang Zhuang
- Department of Trauma Orthopedics Surgery, Ningbo No. 6 Hospital, Ningbo, China
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