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da Costa AG, Albergaria D, Almeida J, Nave M, Oliveira J, Catarino A, Chi DS, Casanova J. Application of three-dimensional imaging software to map carcinomatosis in recurrent ovarian cancer. J Surg Case Rep 2024; 2024:rjae188. [PMID: 38572284 PMCID: PMC10984731 DOI: 10.1093/jscr/rjae188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
The treatment of recurrent ovarian cancer has been based on systemic therapy. The role of secondary cytoreductive surgery has been addressed recently in several trials. Imaging plays a key role in helping the surgical team to decide which patients will have resectable disease and benefit from surgery. The role of staging laparoscopy and several imaging and clinical scores has been extensively debated in the field. In other surgical fields there have been reports of using 3D imaging software and 3D printed models to help surgeons better plan the surgical approach. To the best of our knowledge, we report the first case of a patient with recurrent ovarian cancer undergoing 3D modeling before secondary cytoreductive surgery. The 3D modeling was of most value to evaluate the extension of the disease in our patient who underwent a successful secondary cytoreductive surgery and is currently free of the disease.
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Affiliation(s)
- Ana Gomes da Costa
- Gynecologic Oncology Unit, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
| | - Diogo Albergaria
- Department of General Surgery, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
| | - Joana Almeida
- Gynecologic Oncology Unit, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
- Department of Radiology, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
| | - Mónica Nave
- Gynecologic Oncology Unit, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
- Department of Oncology, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
| | - Joana Oliveira
- Department of Anesthesiology, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
| | - Ana Catarino
- Gynecologic Oncology Unit, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
- Department of Pathology, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
| | - Dennis S Chi
- Gynecology Service, Department of Surgery; Memorial Sloan-Kettering Cancer Center, New York, 1275 York Ave, New York, NY 10065, USA
| | - João Casanova
- Gynecologic Oncology Unit, Hospital da Luz, Lisboa, Avenida Lusíada, 100,1500-065, Portugal
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Byrd CT, Lui NS, Guo HH. Applications of Three-Dimensional Printing in Surgical Oncology. Surg Oncol Clin N Am 2022; 31:673-684. [DOI: 10.1016/j.soc.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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3
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Fletcher J, Miskovic D. The Mesentery in Complete Mesocolic Excision. Clin Colon Rectal Surg 2022; 35:288-297. [PMID: 35966980 PMCID: PMC9365457 DOI: 10.1055/s-0042-1743430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The following article summarizes technical aspects of how to operate in the mesentery during complete mesocolic excision (CME). Increasingly, CME is being adopted and as such it is important to establish the anatomical basis of the techniques involved. This review thus serves to provide that foundation and explains the surgical techniques built on it.
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Affiliation(s)
- Jordan Fletcher
- Department of Colorectal Surgery, St. Mark's Hospital, London, United Kingdom
| | - Danilo Miskovic
- Department of Colorectal Surgery, St. Mark's Hospital, London, United Kingdom
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4
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Chan DKH, Buczacki SJA. Stage migration - a negative quality indicator in colon cancer management. Colorectal Dis 2022; 24:153-154. [PMID: 35239257 DOI: 10.1111/codi.16091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Dedrick Kok Hong Chan
- Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Simon James Alexander Buczacki
- Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, UK.,Oxford Colorectal Unit, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
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5
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Przedlacka A, Pellino G, Fletcher J, Bello F, Tekkis PP, Kontovounisios C. Current and future role of three-dimensional modelling technology in rectal cancer surgery: A systematic review. World J Gastrointest Surg 2021; 13:1754-1769. [PMID: 35070078 PMCID: PMC8727188 DOI: 10.4240/wjgs.v13.i12.1754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/09/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) modelling technology translates the patient-specific anatomical information derived from two-dimensional radiological images into virtual or physical 3D models, which more closely resemble the complex environment encountered during surgery. It has been successfully applied to surgical planning and navigation, as well as surgical training and patient education in several surgical specialties, but its uptake lags behind in colorectal surgery. Rectal cancer surgery poses specific challenges due to the complex anatomy of the pelvis, which is difficult to comprehend and visualise.
AIM To review the current and emerging applications of the 3D models, both virtual and physical, in rectal cancer surgery.
METHODS Medline/PubMed, Embase and Scopus databases were searched using the keywords “rectal surgery”, “colorectal surgery”, “three-dimensional”, “3D”, “modelling”, “3D printing”, “surgical planning”, “surgical navigation”, “surgical education”, “patient education” to identify the eligible full-text studies published in English between 2001 and 2020. Reference list from each article was manually reviewed to identify additional relevant papers. The conference abstracts, animal and cadaveric studies and studies describing 3D pelvimetry or radiotherapy planning were excluded. Data were extracted from the retrieved manuscripts and summarised in a descriptive way. The manuscript was prepared and revised in accordance with PRISMA 2009 checklist.
RESULTS Sixteen studies, including 9 feasibility studies, were included in the systematic review. The studies were classified into four categories: feasibility of the use of 3D modelling technology in rectal cancer surgery, preoperative planning and intraoperative navigation, surgical education and surgical device design. Thirteen studies used virtual models, one 3D printed model and 2 both types of models. The construction of virtual and physical models depicting the normal pelvic anatomy and rectal cancer, was shown to be feasible. Within the clinical context, 3D models were used to identify vascular anomalies, for surgical planning and navigation in lateral pelvic wall lymph node dissection and in management of recurrent rectal cancer. Both physical and virtual 3D models were found to be valuable in surgical education, with a preference for 3D printed models. The main limitations of the current technology identified in the studies were related to the restrictions of the segmentation process and the lack of 3D printing materials that could mimic the soft and deformable tissues.
CONCLUSION 3D modelling technology has potential to be utilised in multiple aspects of rectal cancer surgery, however, it is still at the experimental stage of application in this setting.
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Affiliation(s)
- Anna Przedlacka
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
- Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona 08029, Spain
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
| | - Jordan Fletcher
- Department of Surgery and Cancer, St Mark’s Hospital Academic Institute, Imperial College London, London HA1 3UJ, United Kingdom
| | - Fernando Bello
- Centre for Engagement and Simulation Science, Imperial College London, London SW10 9NH, United Kingdom
| | - Paris P Tekkis
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
- Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
| | - Christos Kontovounisios
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
- Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
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Franceschilli M, Vinci D, Di Carlo S, Sensi B, Siragusa L, Guida A, Rossi P, Bellato V, Caronna R, Sibio S. Central vascular ligation and mesentery based abdominal surgery. Discov Oncol 2021; 12:24. [PMID: 35201479 PMCID: PMC8777547 DOI: 10.1007/s12672-021-00419-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022] Open
Abstract
In the nineteenth century the idea of a correct surgical approach in oncologic surgery moved towards a good lymphadenectomy. In colon cancer the segment is removed with adjacent mesentery, in gastric cancer or pancreatic cancer a good oncologic resection is obtained with adequate lymphadenectomy. Many guidelines propose a minimal lymph node count that the surgeon must obtain. Therefore, it is essential to understand the adequate extent of lymphadenectomy to be performed in cancer surgery. In this review of the current literature, the focus is on "central vascular ligation", understood as radical lymphadenectomy in upper and lower gastrointestinal cancer, the evolution of this approach during the years and the improvement of laparoscopic techniques. For what concerns laparoscopic surgery, the main goal is to minimize post-operative trauma introducing the "less is more" concept whilst preserving attention for oncological outcomes. This review will demonstrate the importance of a scientifically based standardization of oncologic gastrointestinal surgery, especially in relation to the expansion of minimally invasive surgery and underlines the importance to further investigate through new randomized trials the role of extended lymphadenectomy in the new era of a multimodal approach, and most importantly, an era where minimally invasive techniques and the idea of "less is more" are becoming the standard thought for the surgical approach.
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Affiliation(s)
- M Franceschilli
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - D Vinci
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy.
| | - S Di Carlo
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - B Sensi
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - L Siragusa
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - A Guida
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - P Rossi
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - V Bellato
- Department of Surgical Sciences, Minimally Invasive Surgery Unit, University of Rome "Tor Vergata", Rome, Italy
| | - R Caronna
- Department of Surgery Pietro Valdoni Unit of Oncologic and Minimally Invasive Surgery, Rome, Italy
- Department of Surgical Science, Sapienza University of Rome, Rome, Italy
| | - S Sibio
- Department of Surgery Pietro Valdoni Unit of Oncologic and Minimally Invasive Surgery, Rome, Italy
- Department of Surgical Science, Sapienza University of Rome, Rome, Italy
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7
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Superior mesenteric vessel anatomy features differ in Russian and Chinese patients with right colon cancer: computed tomography-based study. Chin Med J (Engl) 2021; 134:2495-2497. [PMID: 34101634 PMCID: PMC8654426 DOI: 10.1097/cm9.0000000000001566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hojo D, Kawai K, Murono K, Nozawa H, Hata K, Tanaka T, Nishikawa T, Shuno Y, Kaneko M, Sasaki K, Emoto S, Ishii H, Sonoda H, Ishihara S. Establishment of deformable three-dimensional printed models for laparoscopic right hemicolectomy in transverse colon cancer. ANZ J Surg 2021; 91:E493-E499. [PMID: 33634953 DOI: 10.1111/ans.16659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Applications of three-dimensional (3-D) printed solid organ models for navigation and simulation were previously reported for abdominal surgeries, and their usefulness was shown by subjective evaluation. However, thus far, no study has examined the effect of intraoperative movements for tissue handling. Novel, deformable 3-D printed models of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) were created to optimize laparoscopic right hemicolectomy. The aim of this study was to establish a method using these individualized models for use in surgical practice. METHODS Deformable 3-D models for laparoscopic right hemicolectomy were created using a 3-D printing flexible filamentous material (thermoplastic polyurethane). Five patients with transverse colon cancer who underwent laparoscopic right hemicolectomy with D3 lymphadenectomy between April 2017 and September 2019 were enrolled in this study. Then, the created patient-specific models were compared with the previously recorded intraoperative video views. RESULTS Transverse colon mobilization changed the spatial arrangement of the branches of the SMA and SMV. The 3-D models reproduced the intraoperative view, although approaches to the dominant vessels to complete D3 lymphadenectomy may vary. CONCLUSIONS Deformable 3-D models of the SMA and SMV with added branches may aid in optimizing laparoscopic right hemicolectomy operations.
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Affiliation(s)
- Daisuke Hojo
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koji Murono
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keisuke Hata
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeshi Nishikawa
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasutaka Shuno
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manabu Kaneko
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Ishii
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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9
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Ballard DH, Wake N, Witowski J, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions. 3D Print Med 2020; 6:13. [PMID: 32514795 PMCID: PMC7278118 DOI: 10.1186/s41205-020-00065-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications. Methods A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines. Results Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, pancreatitis, splenic disease, gastric pathology, small bowel pathology, colorectal cancer, perianal fistula, visceral trauma, hernia, abdominal sarcoma, abdominal wall masses, and intra-abdominal fluid collections. Conclusion This document provides initial appropriate use criteria for medical 3D printing in abdominal, hepatobiliary, and gastrointestinal conditions.
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Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO, 63110, USA.
| | - Nicole Wake
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jan Witowski
- 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Krakow, Poland
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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Semi-automated vs. manual 3D reconstruction of central mesenteric vascular models: the surgeon’s verdict. Surg Endosc 2019; 34:4890-4900. [DOI: 10.1007/s00464-019-07275-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022]
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Marano L, Ricci A, Savelli V, Verre L, Di Renzo L, Biccari E, Costantini G, Marrelli D, Roviello F. From digital world to real life: a robotic approach to the esophagogastric junction with a 3D printed model. BMC Surg 2019; 19:153. [PMID: 31653210 PMCID: PMC6814977 DOI: 10.1186/s12893-019-0621-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/10/2019] [Indexed: 01/17/2023] Open
Abstract
Background Three-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. Methods A 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. Results The 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. Conclusions The 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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Affiliation(s)
- Luigi Marano
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada delle Scotte, 4 - 53100, Siena, Italy.
| | | | - Vinno Savelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada delle Scotte, 4 - 53100, Siena, Italy
| | - Luigi Verre
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada delle Scotte, 4 - 53100, Siena, Italy
| | | | | | | | - Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada delle Scotte, 4 - 53100, Siena, Italy
| | - Franco Roviello
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada delle Scotte, 4 - 53100, Siena, Italy
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Emile SH, Wexner SD. Systematic review of the applications of three-dimensional printing in colorectal surgery. Colorectal Dis 2019; 21:261-269. [PMID: 30457180 DOI: 10.1111/codi.14480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/07/2018] [Indexed: 01/20/2023]
Abstract
AIM Three-dimensional (3D) printing has been recognized as a revolutionary technological innovation that has benefitted numerous disciplines, including medicine. The present systematic review aimed to demonstrate the current applications of 3D printing in colorectal surgery along with the limitations and potential future applications of this innovation. METHOD A PRISMA-compliant systematic literature search of studies that applied 3D printing in colorectal surgery in the period from January 1990 to July 2018 was conducted. Electronic databases including PubMed/Medline, Scopus and the Cochrane Library were searched. All full-text original articles were eligible for inclusion. RESULTS Nine studies including 58 patients with a median age of 60.7 years were reviewed. The studies assessed 3D printing in patients with planned stoma construction, colon cancer with liver metastasis, right colon cancer, rectal cancer, intractable constipation and anal fistula. The applications of 3D printing were classified into three categories: patient education, preoperative planning and evaluation of response of colorectal liver metastasis to chemotherapy. 3D printed models aided in planning resection of colorectal liver metastasis, facilitating D3 lymphadenectomy in complete mesocolic excision, improving the understanding of pelvic anatomy in laparoscopic rectal cancer treatment, guiding electrode implantation in sacral neuromodulation for intractable constipation, and elucidating the morphology of anal fistula tract and anal sphincter muscles. CONCLUSION Colorectal surgery may benefit from 3D printing in enhancing patient education before stoma construction, preoperative planning and evaluation of the response of liver metastasis to chemotherapy using 3D ultrasonography.
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Affiliation(s)
- S H Emile
- Colorectal Surgery Unit, Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - S D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
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13
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Papazarkadas X, Spartalis E, Patsouras D, Ioannidis A, Schizas D, Georgiou K, Dimitroulis D, Nikiteas N. The Role of 3D Printing in Colorectal Surgery: Current Evidence and Future Perspectives. In Vivo 2019; 33:297-302. [PMID: 30804106 PMCID: PMC6506312 DOI: 10.21873/invivo.11475] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/09/2018] [Accepted: 12/12/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Three-dimensional (3D) printing is an emerging and evolving technology with a variety of possible applications in surgery. The purpose of this study was to examine its potential applications in the field of colorectal surgery, as a tool in pre-operative planning and peri-operative navigation, as well as in training. Its cost-efficiency was also examined. MATERIALS AND METHODS A literature review was conducted on articles specifically presenting various applications of 3D printing in the field of colorectal surgery. PubMed was the primary database researched. RESULTS A total of seven studies were found to meet the inclusion criteria. The majority of the articles employed 3D printing technology to produce patient-specific anatomic replicas to enhance pre-operative planning, providing satisfactory results. One study used 3D printing technology as a therapy tool, stating superior results over traditional methods. CONCLUSION 3D printing is a novel technology with a broad spectrum of possible applications in colorectal surgery. Anatomic replicas specific to the anatomy of a patient with acceptable dimensional correlations can be produced using the currently available technology. Surgical and patient training can also be enhanced. Depending on the technology used, costs greatly vary and can thus hinder popularization of this technology in surgery.
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Affiliation(s)
- Xenofon Papazarkadas
- Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece
| | - Eleftherios Spartalis
- Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece
| | - Dimitrios Patsouras
- Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece
| | - Argyrios Ioannidis
- Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece
| | - Dimitrios Schizas
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece
- First Department of Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantinos Georgiou
- Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece
| | - Dimitrios Dimitroulis
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece
- Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Nikolaos Nikiteas
- Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece
- Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece
- Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Luzon JA, Andersen BT, Stimec BV, Fasel JHD, Bakka AO, Kazaryan AM, Ignjatovic D. Implementation of 3D printed superior mesenteric vascular models for surgical planning and/or navigation in right colectomy with extended D3 mesenterectomy: comparison of virtual and physical models to the anatomy found at surgery. Surg Endosc 2019; 33:567-575. [PMID: 30014328 DOI: 10.1007/s00464-018-6332-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/06/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing technology has recently been well approved as an emerging technology in various fields of medical education and practice; e.g., there are numerous studies evaluating 3D printouts of solid organs. Complex surgery such as extended mesenterectomy imposes a need to analyze also the accuracy of 3D printouts of more mobile and complex structures like the diversity of vascular arborization within the central mesentery. The objective of this study was to evaluate the linear dimensional anatomy landmark differences of the superior mesenteric artery and vein between (1) 3D virtual models, (2) 3D printouts, and (3) peroperative measurements. METHODS The study included 22 patients from the ongoing prospective multicenter trial "Safe Radical D3 Right Hemicolectomy for Cancer through Preoperative Biphasic MDCT Angiography," with preoperative CT and peroperative measurements. The patients were operated in Norway between January 2016 and 2017. Their CT datasets underwent 3D volume rendering and segmentation, and the virtual 3D model produced was then exported for stereolithography 3D printing. RESULTS Four parameters were measured: distance between the origins of the ileocolic and the middle colic artery, distance between the termination of the gastrocolic trunk and the ileocolic vein, and the calibers of the middle colic and ileocolic arteries. The inter-arterial distance has proven a strong correlation between all the three modalities implied (Pearson's coefficient 0.968, 0.956, 0.779, respectively), while inter-venous distances showed a weak correlation between peroperative measurements and both virtual and physical models. CONCLUSION This study showed acceptable dimensional inter-arterial correlations between 3D printed models, 3D virtual models and authentic soft tissue anatomy of the central mesenteric vessels, and weaker inter-venous correlations between all the models, reflecting the highly variable nature of veins in situ.
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Affiliation(s)
- Javier A Luzon
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Bjarte T Andersen
- Department of Gastroenterological Surgery, Østfold Hospital Trust, Sarpsborg, Norway
| | - Bojan V Stimec
- Anatomy Sector, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jean H D Fasel
- Anatomy Sector, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Arne O Bakka
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Airazat M Kazaryan
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
- Department of Surgery №1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia
| | - Dejan Ignjatovic
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway.
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15
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García-Granero Á, Sánchez-Guillén L, Fletcher-Sanfeliu D, Sancho-Muriel J, Alvarez-Sarrado E, Pellino G, Delgado-Moraleda JJ, Sabater Ortí L, Valverde-Navarro AA, Frasson M. Surgical anatomy of D3 lymphadenectomy in right colon cancer, gastrocolic trunk of Henle and surgical trunk of Gillot - a video vignette. Colorectal Dis 2018; 20:935-936. [PMID: 30059191 DOI: 10.1111/codi.14358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Á García-Granero
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - L Sánchez-Guillén
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | - J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - E Alvarez-Sarrado
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - G Pellino
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - J J Delgado-Moraleda
- Radiodiagnosis Service, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - L Sabater Ortí
- Hepatobiliopancreatic Surgery Unit, Hospital Clínico Universitario, Valencia, Spain
| | - A A Valverde-Navarro
- Department of Human Embryology and Anatomy Department, University of Valencia, Valencia, Spain
| | - M Frasson
- Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain
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16
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Preoperative surgical planning based on cadaver simulation and 3D imaging for a retrorectal tumour: description and video demonstration. Tech Coloproctol 2018; 22:709-713. [PMID: 30225754 DOI: 10.1007/s10151-018-1854-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/08/2018] [Indexed: 12/19/2022]
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17
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Garcia-Granero A, Carreño O, Sancho-Muriel J, Alvarez-Sarrado E, Fletcher-Sanfeliu D, Sánchez-Guillén L, Pellino G, García-Amador C, Pamies J, Valverde-Navarro AA, Martinez-Soriano F, Frasson M. Anatomical strategy for complete laparoscopic mesocolic excision for splenic flexure colonic cancer - a video vignette. Colorectal Dis 2018; 20:555-556. [PMID: 29578304 DOI: 10.1111/codi.14111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/12/2018] [Indexed: 02/08/2023]
Affiliation(s)
- A Garcia-Granero
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - O Carreño
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - J Sancho-Muriel
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - E Alvarez-Sarrado
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - D Fletcher-Sanfeliu
- Department of Cardiovascular Surgery, Hospital Universitario Son Espases, Mallorca, Spain
| | - L Sánchez-Guillén
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - G Pellino
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - C García-Amador
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | - J Pamies
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
| | | | - F Martinez-Soriano
- Department of Anatomy and Embryology, University of Valencia, Valencia, Spain
| | - M Frasson
- Colorectal Unit, Hospital Universitario y Politecnico la Fe, Valencia, Spain
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