Use of 3D Prototypes for Complex Surgical Oncologic Cases

• Published in: World journal of surgery 2016-04, Vol.40 (4), p.889-894
• Main Authors: Krauel, Lucas, Fenollosa, Felip, Riaza, Lucía, Pérez, Martín, Tarrado, Xavier, Morales, Andrés, Gomà, Joan, Mora, Jaume
• Format: Article
• Language: English
• Subjects: Abdominal Neoplasms - diagnostic imaging; Abdominal Neoplasms - pathology; Abdominal Neoplasms - surgery; Abdominal Surgery; Biomedical engineering; Cardiac Surgery; Child; Child, Preschool; Ciències de la salut; Diagnòstic per la imatge; Enginyeria biomèdica; Feasibility Studies; General Surgery; Humans; Imaging, Three-Dimensional - methods; Imatges tridimensionals en medicina; Inferior Vena Cava; Magnetic Resonance Image Image; Magnetic Resonance Imaging; Male; Mediastinal Neoplasms - diagnostic imaging; Mediastinal Neoplasms - pathology; Mediastinal Neoplasms - surgery; Medicina; Medicina interna; Medicine; Medicine & Public Health; Models, Anatomic; Neuroblastoma - diagnostic imaging; Neuroblastoma - pathology; Neuroblastoma - surgery; Original Scientific Report; Printing, Three-Dimensional; Rapid Prototype; Sarcoma, Synovial - diagnostic imaging; Sarcoma, Synovial - pathology; Sarcoma, Synovial - surgery; Superior Vena Cava; Surgery; Synovial Sarcoma; Thoracic Surgery; Three-dimensional imaging in medicine; Tomography, X-Ray Computed; Vascular Surgery; Àrees temàtiques de la UPC
• ISSN: 0364-2313; 1432-2323; 1432-2323
• DOI: 10.1007/s00268-015-3295-y

Introduction Physical 3D models known by the industry as rapid prototyping involve the creation of a physical model from a 3D computer version. In recent years, there has been an increasing number of reports on the use of 3D models in medicine. Printing such 3D models with different materials integrating the many components of human anatomy is technically challenging. In this article, we report our technological developments along with our clinical implementation experience using high-fidelity 3D prototypes of tumors encasing major vessels in anatomically sensitive areas. Methods Three patients with tumors encasing major vessels that implied complex surgery were selected for surgical planning using 3D prototypes. 3D virtual models were obtained from routine CT and MRI images. The models, with all their anatomical relations, were created by an expert pediatric radiologist and a surgeon, image by image, along with a computerized-aided design engineer. Results Surgeons had the opportunity to practice on the model before the surgery. This allowed questions regarding surgical approach; feasibility and potential complications to be raised in advance of the actual procedure. All patients then successfully underwent surgery as planned. Conclusion Having a tumor physically printed in its different main component parts with its anatomical relationships is technically feasible. Since a gross total resection is prognostic in a significant percentage of tumor types, refinements in planning may help achieve greater and safer resections therefore contributing to improve surgical management of complex tumors. In this early experience, 3D prototyping helped significantly in the many aspects of surgical oncology planning.