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Sanchez-Garcia J, Lopez-Verdugo F, Shorti R, Krong J, Kastenberg ZJ, Walters S, Gagnon A, Paci P, Zendejas I, Alonso D, Fujita S, Contreras AG, Botha J, Esquivel CO, Rodriguez-Davalos MI. Three-dimensional Liver Model Application for Liver Transplantation. Transplantation 2024; 108:464-472. [PMID: 38259179 DOI: 10.1097/tp.0000000000004730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Children are removed from the liver transplant waitlist because of death or progressive illness. Size mismatch accounts for 30% of organ refusal. This study aimed to demonstrate that 3-dimensional (3D) technology is a feasible and accurate adjunct to organ allocation and living donor selection process. METHODS This prospective multicenter study included pediatric liver transplant candidates and living donors from January 2020 to February 2023. Patient-specific, 3D-printed liver models were used for anatomic planning, real-time evaluation during organ procurement, and surgical navigation. The primary outcome was to determine model accuracy. The secondary outcome was to determine the impact of outcomes in living donor hepatectomy. Study groups were analyzed using propensity score matching with a retrospective cohort. RESULTS Twenty-eight recipients were included. The median percentage error was -0.6% for 3D models and had the highest correlation to the actual liver explant (Pearson's R = 0.96, P < 0.001) compared with other volume calculation methods. Patient and graft survival were comparable. From 41 living donors, the median percentage error of the allograft was 12.4%. The donor-matched study group had lower central line utilization (21.4% versus 75%, P = 0.045), shorter length of stay (4 versus 7 d, P = 0.003), and lower mean comprehensive complication index (3 versus 21, P = 0.014). CONCLUSIONS Three-dimensional volume is highly correlated with actual liver explant volume and may vary across different allografts for living donation. The addition of 3D-printed liver models during the transplant evaluation and organ procurement process is a feasible and safe adjunct to the perioperative decision-making process.
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Affiliation(s)
- Jorge Sanchez-Garcia
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Fidel Lopez-Verdugo
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Rami Shorti
- Emerging Technologies, Intermountain Health, Murray, UT
| | - Jake Krong
- Transplant Research Department, Intermountain Medical Center, Murray, UT
| | - Zachary J Kastenberg
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Division of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Shannon Walters
- Department of Radiology, Stanford University School of Medicine, Stanford, CA
| | - Andrew Gagnon
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Philippe Paci
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Ivan Zendejas
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Diane Alonso
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Shiro Fujita
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Alan G Contreras
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Jean Botha
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Carlos O Esquivel
- Division of Abdominal Transplantation, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA
| | - Manuel I Rodriguez-Davalos
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Division of Transplant Surgery, University of Utah School of Medicine, Salt Lake City, UT
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To G, Hawke JA, Larkins K, Burke G, Costello DM, Warrier S, Mohan H, Heriot A. A systematic review of the application of 3D-printed models to colorectal surgical training. Tech Coloproctol 2023; 27:257-270. [PMID: 36738361 DOI: 10.1007/s10151-023-02757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of this review was to explore the role of three-dimensional (3D) printing in colorectal surgical education and procedural simulation, and to assess the effectiveness of 3D-printed models in anatomic and operative education in colorectal surgery. METHODS A systematic review of the literature was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify relevant publications relating to the use of 3D-printed models in colorectal surgery in an educational context. The search encompassed OVID Medline, Web of Science and EMBASE including papers in English published from 1 January 1995 to 1 January 2023. A total of 1018 publications were screened, and 5 met the criteria for inclusion in this review. RESULTS Four distinct 3D models were described across five studies. Two models demonstrated objective benefits in the use of 3D-printed models in anatomical education in academic outcomes at all levels of learner medical experience and were well accepted by learners. One model utilised for preoperative visualisation demonstrated improved operative outcomes in complete mesocolic excision compared with preoperative imaging review, with a 22.1% reduction in operative time (p < 0.001), 9.2% reduction in surgical duration (p = 0.035) and 37.3% reduction in intraoperative bleeding volume amongst novice surgeons (p < 0.01). Technical simulation has been demonstrated in a feasibility context in one model but remains limited in scope and application on account of the characteristics of available printing materials. CONCLUSIONS 3D printing is well accepted and effective for anatomic education and preoperative procedural planning amongst colorectal surgeons, trainees and medical students but remains a technology in the early stages of its possible application. Technological advancements are required to improve the tissue realism of 3D-printed organ models to achieve greater fidelity and provide realistic colorectal surgical simulations.
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Affiliation(s)
- Gloria To
- The University of Melbourne, Parkville, VIC, Australia
| | - Justin A Hawke
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia.
| | - Kirsten Larkins
- The University of Melbourne, Parkville, VIC, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Grace Burke
- International Medical Robotics Academy, North Melbourne, VIC, Australia
| | | | - Satish Warrier
- The University of Melbourne, Parkville, VIC, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
- International Medical Robotics Academy, North Melbourne, VIC, Australia
| | - Helen Mohan
- The University of Melbourne, Parkville, VIC, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Alexander Heriot
- The University of Melbourne, Parkville, VIC, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
- International Medical Robotics Academy, North Melbourne, VIC, Australia
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Cheng J, Wang Z, Liu J, Dou C, Yao W, Zhang C. Value of 3D printing technology combined with indocyanine green fluorescent navigation in complex laparoscopic hepatectomy. PLoS One 2022; 17:e0272815. [PMID: 35951521 PMCID: PMC9371281 DOI: 10.1371/journal.pone.0272815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background Laparoscopic hepatectomy (LH) has achieved rapid progress over the last decade. However, it is still challenging to apply laparoscopy to lesions located in segments I, VII, VIII, and IVa and the hepatic hilar region due to difficulty operating around complex anatomical structures. In this study, we applied three-dimensional printing (3DP) and indocyanine green (ICG) fluorescence imaging technology to complex laparoscopic hepatectomy (CLH) to explore the effects and value of the modified procedure. Materials and methods From January 2019 to January 2021, 54 patients with complex hepatobiliary diseases underwent LH at our center. Clinical data were collected from these patients and retrospectively analyzed. Results A total of 30 patients underwent CLH using the conventional approach, whereas 24 cases received CLH with 3DP technology and ICG fluorescent navigation. Preoperative data were compared between the two groups. In the 3DP group, we modified the surgical strategy of four patients (4/24, 16.7%) due to real-time intraoperative navigation with 3DP and ICG fluorescent imaging technology. We did not modify the surgical strategy for any patient in the non-3DP group (P = 0.02). There were no significant differences between the non-3DP and 3DP groups regarding operating time (297.7±104.1 min vs. 328.8±110.9 min, P = 0.15), estimated blood loss (400±263.8 ml vs. 345.8±356.1 ml, P = 0.52), rate of conversion to laparotomy (3/30 vs. 2/24, P = 0.79), or pathological outcomes including the incidence of microscopical R0 margins (28/30 vs. 24/24, P = 0.57). Additionally, there were no significant differences in postoperative complications or recovery conditions between the two groups. No instances of 30- or 90-day mortality were observed. Conclusion The optimal surgical strategy for CLH can be chosen with the help of 3DP technology and ICG fluorescent navigation. This modified procedure is both safe and effective, but without improvement of intraoperative and short-term outcomes.
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Affiliation(s)
- Jian Cheng
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Zhifei Wang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jie Liu
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Changwei Dou
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Weifeng Yao
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Chengwu Zhang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- * E-mail:
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Gavriilidis P, Edwin B, Pelanis E, Hidalgo E, de'Angelis N, Memeo R, Aldrighetti L, Sutcliffe RP. Navigated liver surgery: State of the art and future perspectives. Hepatobiliary Pancreat Dis Int 2022; 21:226-233. [PMID: 34544668 DOI: 10.1016/j.hbpd.2021.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/27/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In recent years, the development of digital imaging technology has had a significant influence in liver surgery. The ability to obtain a 3-dimensional (3D) visualization of the liver anatomy has provided surgery with virtual reality of simulation 3D computer models, 3D printing models and more recently holograms and augmented reality (when virtual reality knowledge is superimposed onto reality). In addition, the utilization of real-time fluorescent imaging techniques based on indocyanine green (ICG) uptake allows clinicians to precisely delineate the liver anatomy and/or tumors within the parenchyma, applying the knowledge obtained preoperatively through digital imaging. The combination of both has transformed the abstract thinking until now based on 2D imaging into a 3D preoperative conception (virtual reality), enhanced with real-time visualization of the fluorescent liver structures, effectively facilitating intraoperative navigated liver surgery (augmented reality). DATA SOURCES A literature search was performed from inception until January 2021 in MEDLINE (PubMed), Embase, Cochrane library and database for systematic reviews (CDSR), Google Scholar, and National Institute for Health and Clinical Excellence (NICE) databases. RESULTS Fifty-one pertinent articles were retrieved and included. The different types of digital imaging technologies and the real-time navigated liver surgery were estimated and compared. CONCLUSIONS ICG fluorescent imaging techniques can contribute essentially to the real-time definition of liver segments; as a result, precise hepatic resection can be guided by the presence of fluorescence. Furthermore, 3D models can help essentially to further advancing of precision in hepatic surgery by permitting estimation of liver volume and functional liver remnant, delineation of resection lines along the liver segments and evaluation of tumor margins. In liver transplantation and especially in living donor liver transplantation (LDLT), 3D printed models of the donor's liver and models of the recipient's hilar anatomy can contribute further to improving the results. In particular, pediatric LDLT abdominal cavity models can help to manage the largest challenge of this procedure, namely large-for-size syndrome.
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Affiliation(s)
- Paschalis Gavriilidis
- Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, B15 2TH, UK.
| | - Bjørn Edwin
- The Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Egidijus Pelanis
- The Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ernest Hidalgo
- Department of Hepato-Pancreatico-Biliary Surgery and Transplantation, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Nicola de'Angelis
- Department of Digestive Surgery, University Hospital Henri Mondor (AP-HP), 94010 Créteil and University of Paris Est, Créteil, France
| | - Riccardo Memeo
- Department of Hepatobiliary and Pancreatic Surgery, Miulli Hospital, Acquaviva delle Fonti, Bari 70021, Italy
| | - Luca Aldrighetti
- Division of Hepatobiliary Surgery, San Raffaele Hospital, Via Olgettina 60, Milan 20132, Italy
| | - Robert P Sutcliffe
- Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, B15 2TH, UK
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Saito Y, Shimada M, Morine Y, Yamada S, Sugimoto M. Essential updates 2020/2021: Current topics of simulation and navigation in hepatectomy. Ann Gastroenterol Surg 2021; 6:190-196. [PMID: 35261944 PMCID: PMC8889864 DOI: 10.1002/ags3.12542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 01/01/2023] Open
Abstract
With the development of three‐dimensional (3D) simulation software, preoperative simulation technology is almost completely established. The remaining issue is how to recognize anatomy three‐dimensionally. Extended reality is a newly developed technology with several merits for surgical application: no requirement for a sterilized display monitor, better spatial awareness, and the ability to share 3D images among all surgeons. Various technology or devices for intraoperative navigation have also been developed to support the safety and certainty of liver surgery. Consensus recommendations regarding indocyanine green fluorescence were determined in 2021. Extended reality has also been applied to intraoperative navigation, and artificial intelligence (AI) is one of the topics of real‐time navigation. AI might overcome the problem of liver deformity with automatic registration. Including the issues described above, this article focuses on recent advances in simulation and navigation in liver surgery from 2020 to 2021.
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Affiliation(s)
- Yu Saito
- Department of Surgery Tokushima University Tokushima Japan
| | - Mitsuo Shimada
- Department of Surgery Tokushima University Tokushima Japan
| | - Yuji Morine
- Department of Surgery Tokushima University Tokushima Japan
| | | | - Maki Sugimoto
- Department of Surgery Tokushima University Tokushima Japan
- Okinaga Research Institute Teikyo University Chiyoda‐ku Japan
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6
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Berardi G, Colasanti M, Meniconi RL, Ferretti S, Guglielmo N, Mariano G, Burocchi M, Campanelli A, Scotti A, Pecoraro A, Angrisani M, Ferrari P, Minervini A, Gasparoli C, Wakabayashi G, Ettorre GM. The Applications of 3D Imaging and Indocyanine Green Dye Fluorescence in Laparoscopic Liver Surgery. Diagnostics (Basel) 2021; 11:2169. [PMID: 34943406 DOI: 10.3390/diagnostics11122169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 02/06/2023] Open
Abstract
Laparoscopic liver resections have gained widespread popularity among hepatobiliary surgeons and is nowadays performed for both standard and more complex hepatectomies. Given the increased technical challenges, preoperative planning and intraoperative guidance is pivotal in laparoscopic surgery to safely carry out complex and oncologically safe hepatectomies. Modern tools can help both preoperatively and intraoperatively and allow surgeons to perform more precise hepatectomies. Preoperative 3D reconstructions and printing as well as augmented reality can increase the knowledge of the specific anatomy of the case and therefore plan the surgery accordingly and tailor the procedure on the patient. Furthermore, the indocyanine green retention dye is an increasingly used tool that can nowadays improve the precision during laparoscopic hepatectomies, especially when considering anatomical resection. The use of preoperative modern imaging and intraoperative indocyanine green dye are key to successfully perform complex hepatectomies such as laparoscopic parenchymal sparing liver resections. In this narrative review, we discuss the aspects of preoperative and intraoperative tools that are nowadays increasingly used in experienced hepatobiliary centers.
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León-Calero M, Reyburn Valés SC, Marcos-Fernández Á, Rodríguez-Hernandez J. 3D Printing of Thermoplastic Elastomers: Role of the Chemical Composition and Printing Parameters in the Production of Parts with Controlled Energy Absorption and Damping Capacity. Polymers (Basel) 2021; 13:polym13203551. [PMID: 34685310 PMCID: PMC8540301 DOI: 10.3390/polym13203551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 10/31/2022] Open
Abstract
Additive manufacturing (AM) is a disruptive technology that enables one to manufacture complex structures reducing both time and manufacturing cost. Among the materials commonly used for AM, thermoplastic elastomers (TPE) are of high interest due to their energy absorption capacity, energy efficiency, cushion factor or damping capacity. Previous investigations have exclusively focused on the optimization of the printing parameters of commercial TPE filaments and the structures to analyse the mechanical properties of the 3D printed parts. In the present paper, the chemical, thermal and mechanical properties for a wide range of commercial thermoplastic polyurethanes (TPU) filaments were investigated. For this purpose, TGA, DSC, 1H-NMR and filament tensile strength experiments were carried out in order to determine the materials characteristics. In addition, compression tests have been carried out to tailor the mechanical properties depending on the 3D printing parameters such as: infill density (10, 20, 50, 80 and 100%) and infill pattern (gyroid, honeycomb and grid). The compression tests were also employed to calculate the specific energy absorption (SEA) and specific damping capacity (SDC) of the materials in order to establish the role of the chemical composition and the geometrical characteristics (infill density and type of infill pattern) on the final properties of the printed part. As a result, optimal SEA and SDC performances were obtained for a honeycomb pattern at a 50% of infill density.
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Affiliation(s)
- Marina León-Calero
- Adática Engineering, Av. Leonardo Da Vinci, 8, Oficina 216, 28906 Getafe, Spain;
- Institute of Polymer Science and Technology (ICTP-CSIC), Juan de la Cierva, 3, 28006 Madrid, Spain;
| | | | - Ángel Marcos-Fernández
- Institute of Polymer Science and Technology (ICTP-CSIC), Juan de la Cierva, 3, 28006 Madrid, Spain;
- Interdisciplinary Platform for “Sustainable Plastics towards a Circular Economy” (SUSPLAST-CSIC), 28006 Madrid, Spain
- Correspondence: (Á.M.-F.); (J.R.-H.); Tel.: +34-912587560 (J.R.-H.)
| | - Juan Rodríguez-Hernandez
- Institute of Polymer Science and Technology (ICTP-CSIC), Juan de la Cierva, 3, 28006 Madrid, Spain;
- Interdisciplinary Platform for “Sustainable Plastics towards a Circular Economy” (SUSPLAST-CSIC), 28006 Madrid, Spain
- Correspondence: (Á.M.-F.); (J.R.-H.); Tel.: +34-912587560 (J.R.-H.)
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Wang Y, Cao D, Chen SL, Li YM, Zheng YW, Ohkohchi N. Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery. World J Gastrointest Surg 2021; 13:904-922. [PMID: 34621469 PMCID: PMC8462083 DOI: 10.4240/wjgs.v13.i9.904] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/19/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
With the continuous development of digital medicine, minimally invasive precision and safety have become the primary development trends in hepatobiliary surgery. Due to the specificity and complexity of hepatobiliary surgery, traditional preoperative imaging techniques such as computed tomography and magnetic resonance imaging cannot meet the need for identification of fine anatomical regions. Imaging-based three-dimensional (3D) reconstruction, virtual simulation of surgery and 3D printing optimize the surgical plan through preoperative assessment, improving the controllability and safety of intraoperative operations, and in difficult-to-reach areas of the posterior and superior liver, assistive robots reproduce the surgeon’s natural movements with stable cameras, reducing natural vibrations. Electromagnetic navigation in abdominal surgery solves the problem of conventional surgery still relying on direct visual observation or preoperative image assessment. We summarize and compare these recent trends in digital medical solutions for the future development and refinement of digital medicine in hepatobiliary surgery.
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Affiliation(s)
- Yun Wang
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Di Cao
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Si-Lin Chen
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yu-Mei Li
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yun-Wen Zheng
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, and School of Biotechnology and Heath Sciences, Wuyi University, Jiangmen 529020, Guangdong Province, China
- School of Medicine, Yokohama City University, Yokohama 234-0006, Kanagawa, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
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Jin Z, Li Y, Yu K, Liu L, Fu J, Yao X, Zhang A, He Y. 3D Printing of Physical Organ Models: Recent Developments and Challenges. Adv Sci (Weinh) 2021; 8:e2101394. [PMID: 34240580 PMCID: PMC8425903 DOI: 10.1002/advs.202101394] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Indexed: 05/05/2023]
Abstract
Physical organ models are the objects that replicate the patient-specific anatomy and have played important roles in modern medical diagnosis and disease treatment. 3D printing, as a powerful multi-function manufacturing technology, breaks the limitations of traditional methods and provides a great potential for manufacturing organ models. However, the clinical application of organ model is still in small scale, facing the challenges including high cost, poor mimicking performance and insufficient accuracy. In this review, the mainstream 3D printing technologies are introduced, and the existing manufacturing methods are divided into "directly printing" and "indirectly printing", with an emphasis on choosing suitable techniques and materials. This review also summarizes the ideas to address these challenges and focuses on three points: 1) what are the characteristics and requirements of organ models in different application scenarios, 2) how to choose the suitable 3D printing methods and materials according to different application categories, and 3) how to reduce the cost of organ models and make the process simple and convenient. Moreover, the state-of-the-art in organ models are summarized and the contribution of 3D printed organ models to various surgical procedures is highlighted. Finally, current limitations, evaluation criteria and future perspectives for this emerging area are discussed.
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Affiliation(s)
- Zhongboyu Jin
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Yuanrong Li
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Kang Yu
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Linxiang Liu
- Zhejiang University HospitalZhejiang UniversityHangzhouZhejiang310027China
| | - Jianzhong Fu
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang ProvinceSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Xinhua Yao
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Aiguo Zhang
- Department of OrthopedicsWuxi Children's Hospital affiliated to Nanjing Medical UniversityWuxiJiangsu214023China
| | - Yong He
- State Key Laboratory of Fluid Power and Mechatronic SystemsSchool of Mechanical EngineeringZhejiang UniversityHangzhouZhejiang310027China
- Key Laboratory of Materials Processing and MoldZhengzhou UniversityZhengzhou450002China
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Raichurkar KK, Lochan R, Jacob M, Asthana S. The Use of a 3D Printing Model in Planning a Donor Hepatectomy for Living Donor Liver Transplantation: First in India. J Clin Exp Hepatol 2021; 11:515-517. [PMID: 34276158 PMCID: PMC8267362 DOI: 10.1016/j.jceh.2020.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Three-dimensional (3D) anatomical relationships between the hepatic veins and portal structures can serve as a guide to plan resections in donor hepatectomy during living donor liver transplantation. We present the first case report from India on the use of a 3D printed liver model, as an assist to living donor liver transplantation. METHODS A 3D model of the donor liver with hepatic venous structures printed within it was prepared using image acquisition data. The model was used for a simulated cut preoperatively, to mimic the donor hepatectomy based on the venous structures seen through the transparent material used for making the liver model. The volume of the graft measured by volume displacement in the actual surgery was compared with the volume of the model after the simulated cut. RESULTS The calculated volume of the graft was 359 ml as per the preoperative simulation, and the observed weight/volume was 380 gm/310 ml. CONCLUSION Three-dimensional printing of liver models using imaging data can help predict the actual size of the graft after donor hepatectomy, in patients undergoing living donor liver transplantation.
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Affiliation(s)
| | | | | | - Sonal Asthana
- Address for correspondence. Sonal Asthana, 43/2, New Airport road, NH-7, Sahakarnagar, Bengaluru, Karnataka, 560092, India.
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