Mp34-02 Printed Three-Dimensional Elastic Organ Model to Increase Robot-Assisted Laparoscopic Partial Nephrectomy Performance

Abstract

INTRODUCTION AND OBJECTIVES:The UCiTrainer is a low cost, portable laparoscopic trainer that utilizes an electronic tablet for video and optics; it can be printed with a consumer-level three-dimensional (3D) printer. We report our initial experience on the feasibility of using 3D printing technology as a novel method of manufacturing and distribution for low cost, surgical education tools on a global on demand basis.METHODS: We created computer-aided designs (CAD) using Solidworks Software (Dassault Systemes Solidworks Corp., Velizy-Villacoublay, France) for nine separate components which could then be assembled into a laparoscopic training device including an instrument port mold. These files were provided to two remote institutions to 3D print and assemble the trainer. The CAD files were uploaded to Makerware software (MakerBot Industries, New York City, NY) to be sliced into layers and prepared for printing. All pieces were printed using a Flashforge Creator 3D printer (Flashforge, Jinhua, China) in five separate prints. The following printer settings were used: raft layer, 15% infill, 2 shells, 0.10 mm layer height, 230 ? C extruder, 110 ? C build plate, 90 mm/s extrusion and 150 mm/s travel. In this process, successive layers of a heated, acrylonitrile butadiene styrene filament were extruded and laid on top of one another in both the horizontal and vertical axis. The printed mold was used to create two instrument ports using a liquid silicone rubber. Both remote institutions were provided oral and written instructions for assembly of the components.RESULTS: Initial attempts of 3D printing of the larger pieces (Figure 1b) were not successful due to deformation of the plastic. Additionally, initial calibration and leveling of the 3D printer were challenging to novices. Accordingly, the build plate was increased to 120 ? C and a full enclosure was made for the 3D printer to retain heat during the printing process. With these adjustments, successful printing of the components was accomplished. Both institutions were subsequently able to completely assemble and use the training device using only the oral and written instructions provided.CONCLUSIONS: 3D printing technology can be used successfully to disseminate a training device for use in surgical education. The device is inexpensive and can be made on an as-needed basis.

Three‐dimensional computed tomography‐based resection process map for robot‐assisted partial nephrectomy: propensity score matching of a single‐center retrospective study

“…Further, 3D-printed models applying this technology have shown improved surgical outcomes such as WIT, parenchymal preservation, and negative surgical margins 13 ; moreover, the utility of 3D elastic organ models has been demonstrated. 14 However, preoperative 3D model construction is time consuming and expensive, so it is becoming more specialized for training and discussion of complex cases. 16 The RPM that we have developed is noninvasive to the patient and requires less additional time and is more cost effective than the regular 3D CT configuration.…”

“…These models, which often incorporate 3D imaging and virtual reality (VR), provide surgeons with detailed anatomical insights, facilitating precise and effective surgical interventions. Further, 3D‐printed models applying this technology have shown improved surgical outcomes such as WIT, parenchymal preservation, and negative surgical margins 13 ; moreover, the utility of 3D elastic organ models has been demonstrated 14 . However, preoperative 3D model construction is time consuming and expensive, so it is becoming more specialized for training and discussion of complex cases 16 .…”

“…For skill acquisition and simulation of RAPN, pig training models, 11,12 three‐dimensional (3D) printed models, 13–16 and high‐definition 3D computed tomography (CT) images have been reportedly used 17 …”

“…For skill acquisition and simulation of RAPN, pig training models, 11,12 three-dimensional (3D) printed models, [13][14][15][16] and highdefinition 3D computed tomography (CT) images have been reportedly used. 17 In this study, we introduce the resection process map (RPM), a novel approach in RAPN that utilizes advanced 3D imaging techniques.…”