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Three-D-printed simulator for kidney transplantation

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Abstract

Background

Three-Dimensional (3D) printing technology can be used to manufacture training platforms for surgeons. Kidney transplantation offers a suitable model, since it mostly entails vascular and ureteric anastomoses.

Methods

A new simulation platform for surgical training in kidney transplantation was realized and validated in this study. A combination of different 3-D printing technology was used to reproduce the key anatomy of lower abdomen, of pelvis, and of a kidney graft, including their mechanical properties.

Results

Thirty transplantations were performed by two junior trainees with no previous experience in the area. Analysis of the times required to perform the simulated transplantation showed that proficiency was reached after about ten cases, as indicated by a flattening of the respective curves that corresponded to a shortening of about 40% and 47%, respectively, of the total time initially needed to perform the whole simulated transplantation. Although an objective assessment of the technical quality of the anastomoses failed to show a significant improvement throughout the study, a growth in self-confidence with the procedure was reported by both trainees.

Conclusion

The quality of the presented simulation platform aimed at reproducing in the highest possible way a realistic model of the operative setting and proved effective in providing an integrated training environment where technical skills are enhanced together with a team-training experience. As a result the trainees’ self-confidence with the procedure resulted enforced. Three-D--printed models can also offer pre-operative patient-specific training when anatomical variants are anticipated by medical imaging. An analysis of the costs related to the use of this platform is also provided and discussed.

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References

  1. Lu J, Cuff RF, Mansour MA (2021) Simulation in surgical education. Am J Surg 221(3):509–514

    Article  Google Scholar 

  2. Araujo SEA, Perez RO, Klajner S (2021) Role of simulation-based training in minimally invasive and robotic colorectal surgery. Clin Colon Rectal Surg 34(3):136–143

    Article  Google Scholar 

  3. Soler-Silva Á, Sanchís-López A, Sánchez-Guillén L, López-Rodríguez-Arias F, Gómez-Pérez L, Quirós MJA, Sánchez-Ferrer ML, Escoriza JCM, Muñoz-Duyos A, Ramírez JM, Arroyo A (2021) The Thiel cadaveric model for pelvic floor surgery: Best rated in transferable simulation-based training for postgraduate studies. Eur J Obstet Gynecol Reprod Biol 256:165–171

    Article  Google Scholar 

  4. Hevia V, Gómez V, Hevia M, Lorca J, Santiago M, López-Plaza J, Álvarez S, Díez V, Gordaliza C, Burgos FJ (2020) Troubleshooting complex vascular cases in the kidney graft: multiple vessels, aneurysms, and injuries during harvesting procedures. Curr Urol Rep 21(1):5

    Article  Google Scholar 

  5. Ganguli A, Pagan-Diaz GJ, Grant L, Cvetkovic C, Bramlet M, Vozenilek J, Kesavadas T, Bashir R (2018) 3D printing for preoperative planning and surgical training: a review. Biomed Microdevices 20(3):65

    Article  Google Scholar 

  6. Bernhard JC, Isotani S, Matsugasumi T, Duddalwar V, Hung AJ, Suer E, Baco E, Satkunasivam R, Djaladat H, Metcalfe C, Hu B, Wong K, Park D, Nguyen M, Hwang D, Bazargani ST, De Castro Abreu AL, Aron M, Ukimura O, Gill IS (2016) Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol 34(3):337–345

    Article  Google Scholar 

  7. Andolfi C, Plana A, Kania P, Banerjee PP, Small S (2017) Usefulness of three-dimensional modeling in surgical planning, resident training, and patient education. J Laparoendosc Adv Surg Techn 27(5):512–515

    Article  Google Scholar 

  8. Zein NN, Hanouneh IA, Bishop BP, Samaan M, Eghtesad B, Quintini C, Miller C, Yerian L, Klatte R (2013) Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transplant 19(12):1304–1310

    Article  Google Scholar 

  9. Dickinson KJ, Matsumoto J, Cassivi SD, Reinersman JM, Flatcher JG, Morris J, Wong Kee Song LM, Blackmon SH. Individualizing management of complex esophageal pathology using three-dimensional printed models. Ann Thorac Surg 2015 100(2):692–697.

  10. Von Rundstedt FC, Scovell JM, Agrawal S, Zaneveld J, Link RE (2017) Utility of patient-specific silicone renal models for planning and rehearsal of complex tumor resections prior to robot-assisted laparoscopic partial nephrectomy. BJU Int 119(4):598–604

    Article  Google Scholar 

  11. Grab M, Hopfner C, Gesenhues A, König F, Haas NA, Hagl C, Curta A, Thierfelder N (2021) Development and evaluation of 3D-printed cardiovascular phantoms for interventional planning and training. J Vis Exp. https://doi.org/10.3791/62063

    Article  PubMed  Google Scholar 

  12. Pietrabissa A, Marconi S, Negrello E, Mauri V, Peri A, Pugliese L, Marone EM, Auricchio F (2020) An overview on 3D printing for abdominal surgery. Surg Endosc 34(1):1–13

    Article  Google Scholar 

  13. Pietrabissa A, Marconi S, Peri A, Pugliese L, Cavazzi E, Vinci A, Botti M, Auricchio F (2016) From CT scanning to 3-D printing technology for the preoperative planning in laparoscopic splenectomy. Surg Endosc 30(1):366–371

    Article  Google Scholar 

  14. Marconi S, Negrello E, Mauri V, Pugliese L, Peri A, Argenti F, Auricchio F, Pietrabissa A (2019) Toward the improvement of 3D-printed vessels’ anatomical models for robotic surgery training. Int J Artif Organs 42(10):558–565

    Article  CAS  Google Scholar 

  15. Asthana S, Lochan R, Jacob M, Medappil N, Reddy J, Saif R, Raja K, Panackel C, Sakpal M, Ganjoo N (2018) Three-dimensional printing with biotexture modeling assisted donor left hepatectomy. Transplantation 102(5):130

    Google Scholar 

  16. Giron-Vallejo O, Garcia-Calderon D, Ruiz-Pruneda R, Cabello-Laureano R, Domenech- Abellan E, Fuster-Soler JL, Ruiz-Jimenez JI (2018) Three-dimensional printed model of bilateral Wilms tumor: a useful tool for planning nephron sparing surgery. Pediatr Blood Cancer 65(4):e26894

    Article  Google Scholar 

  17. Porpiglia F, Bertolo R, Checcucci E, Amparore D, Autorino R, Dasgupta P, Wiklund P, Tewari A, Liatsikos E, Fiori C (2017) Development and validation of 3D printed virtual models for robot-assisted radical prostatectomy and partial nephrectomy: urologists’ and patients’ perception. World J Urol 36(2):201–207

    Article  Google Scholar 

  18. Pugliese L, Marconi S, Negrello E, Mauri V, Peri A, Gallo V, Auricchio F, Pietrabissa A (2018) The clinical use of 3D printing in surgery. Updates Surg 70:381–388

    Article  Google Scholar 

  19. Kusaka M, Sugimoto M, Fukami N, Sasaki H, Takenaka M, Anraku T, Ito T, Kenmochi T, Shiroki R, Hoshinaga K (2015) Initial experience with a tailor-made simulation and navigation program using a 3-D printer model of kidney transplantation surgery. Transplant Proc 47(3):596–599

    Article  CAS  Google Scholar 

  20. Uwechue R, Gogalniceanu P, Kessaris N, Byrne N, Chandak P, Olsburgh J, Ahmed K, Mamode N, Loukopoulos I (2018) A novel 3D-printed hybrid simulation model for robotic-assisted kidney transplantation (RAKT). J Robot Surg 12(3):541–544

    Article  Google Scholar 

  21. Chandak P, Byrne N, Coleman A, Karunanithy N, Carmichael J, Marks SD, Stojanovic J, Kessaris N, Mamode N (2019) Patient-specific 3D printing: a novel technique for complex pediatric renal transplantation. Ann Surg 269(2):e18–e23

    Article  Google Scholar 

  22. Claflin J, Waits SA (2020) Three dimensionally printed interactive training model for kidney transplantation. J Surg Educ 77(5):1013–1017

    Article  Google Scholar 

  23. Saba P, Belfast E, Melnyk R, Patel A, Kashyap R, Ghazi A (2020) Development of a high-fidelity robot-assisted kidney transplant simulation platform using three-dimensional printing and hydrogel casting technologies. J Endourol 34(10):1088–1094

    Article  Google Scholar 

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Funding

This work was supported by the Italian Ministry of Health, Ricerca Corrente funding # 08065719.

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Authors and Affiliations

  1. Department of Surgery, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Andrea Peri, Virginia Gallo, Massimo Abelli, Elena Ticozzelli, Ottavia Caserini, Luigi Pugliese & Andrea Pietrabissa

  2. Department of Architecture and Civil Engineering, University of Pavia, Pavia, Italy

    Stefania Marconi & Ferdinando Auricchio

  3. 3D4Med Laboratory, Pavia, Italy

    Valeria Mauri & Erika Negrello

  4. Viale Golgi 69, 27100, Pavia, Italy

    Andrea Pietrabissa

Authors
  1. Andrea Peri
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  2. Stefania Marconi
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  3. Virginia Gallo
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  4. Valeria Mauri
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  5. Erika Negrello
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  6. Massimo Abelli
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  7. Elena Ticozzelli
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  8. Ottavia Caserini
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  9. Luigi Pugliese
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  10. Ferdinando Auricchio
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  11. Andrea Pietrabissa
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Corresponding author

Correspondence to Andrea Pietrabissa.

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Peri, A., Marconi, S., Gallo, V. et al. Three-D-printed simulator for kidney transplantation. Surg Endosc 36, 844–851 (2022). https://doi.org/10.1007/s00464-021-08788-1

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  • DOI: https://doi.org/10.1007/s00464-021-08788-1

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