World Journal of Surgery

, Volume 40, Issue 4, pp 889–894 | Cite as

Use of 3D Prototypes for Complex Surgical Oncologic Cases

  • Lucas Krauel
  • Felip Fenollosa
  • Lucía Riaza
  • Martín Pérez
  • Xavier Tarrado
  • Andrés Morales
  • Joan Gomà
  • Jaume Mora
Original Scientific Report

Abstract

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.

Keywords

Inferior Vena Cava Rapid Prototype Superior Vena Cava Synovial Sarcoma Magnetic Resonance Image Image 
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.

Notes

Acknowledgments

The authors would like to thank Margarita Vancells MD, JM Caffarena MD, and Rosalia Carrasco MD PhD for their technical expertise.

Compliance with ethical standards

Conflict of interest

None.

References

  1. 1.
    Ventola CL (2014) Medical applications for 3D printing: current and projected uses. Pharm Ther 39:704Google Scholar
  2. 2.
    Webb PA (2000) A review of rapid prototyping (RP) techniques in the medical and biomedical sector. J Med Eng Technol 24:149–153CrossRefPubMedGoogle Scholar
  3. 3.
    Rengier F, Mehndiratta A, Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU et al (2010) 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 5:335–341CrossRefPubMedGoogle Scholar
  4. 4.
    Mavili ME, Canter HI, Saglam-Aydinatay B, Kamaci S, Kocadereli I (2007) Use of three-dimensional medical modeling methods for precise planning of orthognathic surgery. J Craniofac Surg 18:740–747CrossRefPubMedGoogle Scholar
  5. 5.
    Mankovich NJ, Cheeseman AM, Stoker NG (1990) The display of three-dimensional anatomy with stereolithographic models. J Digit Imaging 3:200–203CrossRefPubMedGoogle Scholar
  6. 6.
    Ikegami T, Maehara Y (2013) Transplantation: 3D printing of the liver in living donor liver transplantation. Nat Rev Gastroenterol Hepatol 10:697–698CrossRefPubMedGoogle Scholar
  7. 7.
    Jacobs S, Grunert R, Mohr FW, Falk V (2008) 3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact Cardiovasc Thorac Surg 7:6–9CrossRefPubMedGoogle Scholar
  8. 8.
    Costello JP, Olivieri LJ, Krieger A, Thabit O, Marshall MB, Yoo SJ, Kim PC, Jonas RA, Nath DS (2014) Utilizing three-dimensional printing technology to assess the feasibility of high-fidelity synthetic ventricular septal defect models for simulation in medical education. World J Pediatr Congenit Heart Surg 5:421–426CrossRefPubMedGoogle Scholar
  9. 9.
    Silberstein JL, Maddox MM, Dorsey P, Feibus A, Thomas R, Lee BR (2014) Physical models of renal malignancies using standard cross-sectional imaging and 3-dimensional printers: a pilot study. Urology 84:268–272CrossRefPubMedGoogle Scholar
  10. 10.
    Monclús E, Muñoz-Pandiella I, Brunet P, Conesa G (2012) Ventricular puncture trainer. In: CEIG 2012: XXII Spanish conference of computer graphics, pp 45–48Google Scholar
  11. 11.
    Horne R (2015) From reprap students to masters of 3d printing—a Spanish success story. Disruptive Magazine. http://disruptivemagazine.com/blog/from-reprap-students-to-masters-of-3d-printing-a-spanish-success-story-part-1/. Accessed 21 May 2015.
  12. 12.
    Chua CK, Leong KF, Lim CS (2010) Rapid prototyping principles and applications, 3rd edn. World Scientific, SingaporeCrossRefGoogle Scholar
  13. 13.
    Griffith ML, Harwell LD, Romero JT, Schlienger E, Atwood CL, Smugeresky JE (1997) Multi-material processing by LENS. In: Proceedings of the 1997 solid freeform fabrication symposium, vol 8, pp 387–393Google Scholar
  14. 14.
    Murphy SV, Atala A (2014) 3D bioprinting of tissues and organs. Nat Biotechnol 32:773–785CrossRefPubMedGoogle Scholar
  15. 15.
    Müller A, Krishnan KG, Uhl E, Mast G (2003) The application of rapid prototyping techniques in cranial reconstruction and preoperative planning in neurosurgery. J Craniofac Surg 14:899–914CrossRefPubMedGoogle Scholar
  16. 16.
    D’Urso PS, Barker TM, Earwaker WJ, Bruce LJ, Atkinson RL, Lanigan MW et al (1999) Stereolithographic biomodelling in cranio-maxillofacial surgery: a prospective trial. J Craniomaxillofac Surg 27:30–37CrossRefPubMedGoogle Scholar
  17. 17.
    Esses SJ, Berman P, Bloom AI, Sosna J (2011) Clinical applications of physical 3D models derived from MDCT data and created by rapid prototyping. Am J Roentgenol 196:W683–W688CrossRefGoogle Scholar
  18. 18.
    Mao K, Wang Y, Xiao S, Liu Z, Zhang Y, Zhang X et al (2010) Clinical application of computer-designed polystyrene models in complex severe spinal deformities: a pilot study. Eur Spine J 19:797–802PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Schievano S, Migliavacca F, Coats L, Khambadkone S, Carminati M, Wilson N et al (2007) Percutaneous pulmonary valve implantation based on rapid prototyping of right ventricular outflow tract and pulmonary trunk from MR data. Radiology 242:490–497CrossRefPubMedGoogle Scholar
  20. 20.
    Nakada T, Akiba T, Inagaki T, Morikawa T (2014) Thoracoscopic anatomical subsegmentectomy of the right S2b + S3 using a 3D printing model with rapid prototyping. Interact Cardiovasc Thorac Surg 19:696–698CrossRefPubMedGoogle Scholar
  21. 21.
    Sulaiman A, Boussel L, Taconnet F, Serfaty JM, Alsaid H, Attia C, Huet L, Douek P (2008) In vitro non-rigid life-size model of aortic arch aneurysm for endovascular prosthesis assessment. Eur J Cardiothorac Surg 33:53–57CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Lucas Krauel
    • 1
  • Felip Fenollosa
    • 2
  • Lucía Riaza
    • 3
  • Martín Pérez
    • 2
  • Xavier Tarrado
    • 1
  • Andrés Morales
    • 4
  • Joan Gomà
    • 2
  • Jaume Mora
    • 4
  1. 1.Pediatric Surgery Department, Hospital Sant Joan de DéuUniversitat de BarcelonaBarcelonaSpain
  2. 2.Fundació CIM, Department of Mechanical Engineering, ETSEIBUniversitat Politècnica de CatalunyaBarcelonaSpain
  3. 3.Pediatric Radiology Department, Hospital Sant Joan de DéuUniversitat de BarcelonaBarcelonaSpain
  4. 4.Pediatric Oncology and Hematology Department, Hospital Sant Joan de DéuUniversitat de BarcelonaBarcelonaSpain

Personalised recommendations