The clinical use of 3D printing in surgery

Pugliese, Luigi; Marconi, Stefania; Negrello, Erika; Mauri, Valeria; Peri, Andrea; Gallo, Virginia; Auricchio, Ferdinando; Pietrabissa, Andrea

doi:10.1007/s13304-018-0586-5

Cited by 154 publications

(98 citation statements)

References 24 publications

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“…Specifically, 3D-printed surgical navigation templates are widely used in orthopedics owing to simple operation and practicality [20][21][22][23][24]. Individualized navigation templates based on reverse engineering and 3D-printing technology can completely match the solid skeleton of a specific case and allow accurate control of the plane and angle of the osteotomy, which is safe and accurate [32]. As children have large individual differences, their orthopedic surgery requires the assistance of surgical navigation templates to improve surgical accuracy and results and reduce complications and sequelae.…”

Section: Discussionmentioning

confidence: 99%

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

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Background: Cubitus varus deformity is a common sequela of elbow fractures in children. Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. This study aims to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity. Methods: Thirty-five patients were treated for cubitus varus deformity from June 2015 to April 2017, including 21 boys and 14 girls, aged 4.6-13.2 years (average, 7.5 years). Of these cases, 17 deformities were on the left side and 18 were on the right side. All were treated with wedge osteotomy of the lateral distal humerus. 3D-printed navigation templates were used in 16 cases, while traditional surgery was used in 19 cases. All patients underwent computed tomography scans before surgery. Computer software was used to analyze the measurements and design and print individualized navigation templates. The navigation templates were matched, and surgery was initially simulated. Intraoperative individualized navigation templates were used to assist with accurate osteotomy and Kirschner wire fixation. Operation times were recorded in all cases, the carrying angles before and after surgery were assessed by computer, and postoperative elbow joint function was evaluated using Bellemore criteria. All measurement data were presented as means ± SD, and Student's t test was used to examine differences between groups. All count data between both groups were compared using the chi-square test or Fisher's exact test analysis. Results: All individualized navigation templates matched well with the corresponding anatomical markers and were consistent with preoperative planning, simulated surgery, and intraoperative procedures. Average operation times from clear exposure to fixed Kirschner wire were 11.69 min (9.6-13.5 min) for the individualized navigation template group and 22.89 min (17.7-26.8 min) for the traditional operation group (p < 0.001). Average differences in postoperation carrying angles between affected and healthy sides were 1.13°(0-2.0°) and 4.21°(0-7.5°), respectively (p < 0.001). Follow-up 6-12 months postoperation showed that elbow function did not differ significantly between groups using the Bellemore criteria (p > 0.05). Conclusions: Individualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.

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Section: Discussionmentioning

confidence: 99%

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…Currently, successful applications of 3D printing have been reported in the field of surgery, and the greatest advantage of 3D printing is that artificial implants can be customized accurately and effectively (Pugliese et al, 2018). Our study attempted to address the problem of LRV stenosis using 3D-printed extravascular stents because custom-made implants better match target structures in the body.…”

Section: Discussionmentioning

confidence: 99%

3D-Printed PEEK Extravascular Stent in the Treatment of Nutcracker Syndrome: Imaging Evaluation and Short-Term Clinical Outcome

Da-li

Liang

Wang

et al. 2020

Front. Bioeng. Biotechnol.

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Minimally invasive options are safe and reliable alternatives for the treatment of nutcracker syndrome (NCS). After continued efforts, our team successfully devised a new and effective therapeutic method: 3D-printed extravascular stenting of the left renal vein. From December 2017 to May 2019, 28 patients (25 men and 3 women) from different parts of China between 18 and 37 years old (mean, 23.6 years) diagnosed with NCS were admitted for laparoscopic 3D-printed extravascular stenting treatment. The post-operative follow-up duration was 6-24 months (median, 16.3 months). Technical success of the operation was achieved in all patients. After treatment, the NCS symptoms all patients resolved or improved during the follow-up period, without relapse. Most symptoms, including macro-/microhematuria, proteinuria, and flank/abdominal pain, tended to resolve within 3-6 months after the surgery; other symptoms, such as left-sided varicocele, also showed varying degrees of improvement at different times post-operatively. Perioperative complications were noted in two patients, including transient and mild lymphatic leakage, without any adverse effects. All extravascular stents were visualized on computed tomography and Doppler ultrasound scans, and no migration or any side effects occurred during the entire follow-up period. Compared to endovascular stenting or polytetrafluoroethylene artificial vessel procedures, 3Dprinted polyetheretherketone extravascular stenting has more advantages in terms of stent design and rigidity and approach rationality while successfully preventing stent migration and thrombosis. Therefore, this method may serve as an accurate and effective treatment for NCS patients.

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“…They discussed that the walk down of vascular roots before laparoscopic right hemicolectomy could reduce the risk of venous injury and intra-operative hemorrhage. The advantage of technological development to create 3D model and tool for surgical use from CT image elaboration is represented by the recognition, in a real size mode, of the interspatial relationship between anatomical structures of the target area [19]. Furthermore, the availability of the model several days prior to surgery represents the mainstay of 3D printing technology: all surgical team members can discuss the surgical strategy evaluating all possible approaches and solutions to perform the operation as well as defining critical maneuvers in a calmer condition than surgical theatre.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, in recent years have been reported encouraging results of pre-surgical simulation on a patient-specific tissue-like 3D model [22]. The recent technological advances lead to print any kind of human parts, which can be made of soft and deformable materials mimicking the physical properties of human tissues [8, 19, 23]. Surgeons of any disciplines and expertise have the chance to improve their surgical skills through multiple repetitions of the same maneuvers outside the operating room getting ready for a real intervention before it is carried out on the patient.…”

Section: Discussionmentioning

confidence: 99%

From digital world to real life: a robotic approach to the esophagogastric junction with a 3D printed model

et al. 2019

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BackgroundThree-dimensional (3D) printing may represent a useful tool to provide, in surgery, a good representation of surgical scenario before surgery, particularly in complex cases. Recently, such a technology has been utilized to plan operative interventions in spinal, neuronal, and cardiac surgeries, but few data are available in the literature about their role in the upper gastrointestinal surgery. The feasibility of this technology has been described in a single case of gastroesophageal reflux disease with complex anatomy due to a markedly tortuous descending aorta.MethodsA 65-year-old Caucasian woman was referred to our Department complaining heartburn and pyrosis. A chest computed tomography evidenced a tortuous thoracic aorta and consequent compression of the esophagus between the vessel and left atrium. A “dysphagia aortica” has been diagnosed. Thus, surgical treatment of anti-reflux surgery with separation of the distal esophagus from the aorta was planned. To define the strict relationship between the esophagus and the mediastinal organs, a life-size 3D printed model of the esophagus including the proximal stomach, the thoracic aorta and diaphragmatic crus, based on the patient’s CT scan, was manufactured.ResultsThe robotic procedure was performed with the da Vinci Surgical System and lasted 175 min. The surgeons had navigational guidance during the procedure since they could consult the 3D electronically superimposed processed images, in a “picture-in-picture” mode, over the surgical field displayed on the monitor as well as on the robotic headset. There was no injury to the surrounding organs and, most importantly, the patient had an uncomplicated postoperative course.ConclusionsThe present clinical report highlights the feasibility, utility and clinical effects of 3D printing technology for preoperative planning and intraoperative guidance in surgery, including the esophagogastric field. However, the lack of published data requires more evidence to assess the effectiveness and safety of this novel surgical-applied printing technology.

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The clinical use of 3D printing in surgery

Cited by 154 publications

References 24 publications

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

3D-Printed PEEK Extravascular Stent in the Treatment of Nutcracker Syndrome: Imaging Evaluation and Short-Term Clinical Outcome

From digital world to real life: a robotic approach to the esophagogastric junction with a 3D printed model

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