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World Journal of Surgery

, Volume 38, Issue 12, pp 3163–3166 | Cite as

Application of a Three-dimensional Print of a Liver in Hepatectomy for Small Tumors Invisible by Intraoperative Ultrasonography: Preliminary Experience

  • Tsuyoshi Igami
  • Yoshihiko Nakamura
  • Tomoaki Hirose
  • Tomoki Ebata
  • Yukihiro Yokoyama
  • Gen Sugawara
  • Takashi Mizuno
  • Kensaku Mori
  • Masato Nagino
Original Scientific Report

Abstract

Background

Hepatectomy for an invisible small tumor using intraoperative ultrasonography requires technical ingenuity. We used a 3D print of a liver to perform a hepatectomy on two patients with synchronous multiple liver metastases from colorectal cancer. Because of preoperative chemotherapy, one of the tumors became smaller and invisible to ultrasonography in each case. We present our procedure here.

Methods

Multidetector-row computed tomography images of anatomical structures were digitally segmented using the original software “PLUTO,” which was developed at the Graduate School of Information Science, Nagoya University. After converting the final segmentation data to stereolithography files, a 3D printed liver at a 70 % scale was produced. The support material was washed and the mold charge was removed from the 3D-printed hepatic veins. The surface of the 3D-printed model was abraded and coated with urethane resin paint. After air-drying, the 3D-printed hepatic veins were colored by injecting a dye. The 3D printed portal veins were whitish because mold charge remained. All procedures after 3D printing were performed by hand.

Results

Hepatectomy for the small tumor that is invisible to intraoperative ultrasonography was performed by referring to a 3D-printed model. The planned resections were successful with histologically negative surgical margins.

Conclusions

The application of a 3D-printed liver to perform a hepatectomy for a small tumor that is invisible to intraoperative ultrasonography is an easy and feasible procedure. Use of 3D-printing technology in hepatectomy requires further improvement and automation of hand work after the 3D print has been made.

Keywords

Small Tumor Indigo Carmine MDCT Image Resection Line Hepatic Area 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Zein NN, Hanouneh IA, Bishop PD et al (2013) Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transpl 19:1304–1310PubMedCrossRefGoogle Scholar
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    Ikegami T, Maehara Y (2013) Transplantation: 3D printing of the liver in living donor liver transplantation. Nat Rev Gastroenterol Hepatol 10:697–698PubMedCrossRefGoogle Scholar
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    Nimura Y, Deguchi D, Kitasaka T et al (2008) PLUTO: a common platform for computer-aided diagnosis. Med Imaging Technol 26:187–191 (in Japanese)Google Scholar
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    Loresen WE, Cline HE (1987) Marching cubes: a high resolutuion 3D surface construction algorithm. In: Proceedings of SIGGRAPH, vol 21, pp 163–169Google Scholar

Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Tsuyoshi Igami
    • 1
  • Yoshihiko Nakamura
    • 2
  • Tomoaki Hirose
    • 1
  • Tomoki Ebata
    • 1
  • Yukihiro Yokoyama
    • 1
  • Gen Sugawara
    • 1
  • Takashi Mizuno
    • 1
  • Kensaku Mori
    • 2
    • 3
  • Masato Nagino
    • 1
  1. 1.Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Information Strategy Office, Information and CommunicationsNagoya UniversityNagoyaJapan
  3. 3.Graduate School of Information ScienceNagoya UniversityNagoyaJapan

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