ObjectiveTo evaluate the clinical value of three-dimensional (3D) printing model in accurate and minimally invasive treatment of double outlet right ventricle (DORV).MethodsFrom August 2018 to August 2019, 35 patients (22 males and 13 females) with DORV aged from 5 months to 17 years were included in the study. Their mean weight was 21.35±8.48 kg. Ten patients who received operations guided by 3D printing model were allocated to a 3D printing model group, and the other 25 patients who received operations without guidance by 3D printing model were allocated to a non-3D printing model group. Preoperative transthoracic echocardiography and CT angiography were performed to observe the location and diameter of ventricular septal defect (VSD), and to confirm the relationship between VSD and double arteries.ResultsThe McGoon index of patients in the 3D printing model group was 1.91±0.70. There was no statistical difference in the size of VSD (13.20±4.57 mm vs. 13.40±5.04 mm, t=−0.612, P=0.555), diameter of the ascending aorta (17.10±2.92 mm vs. 16.90±3.51 mm, t=0.514, P=0.619) or diameter of pulmonary trunk (12.50±5.23 mm vs. 12.90±4.63 mm, t=−1.246, P=0.244) between CT and 3D printing model measurements. The Pearson correlation coefficients were 0.982, 0.943 and 0.975, respectively. The operation time, endotracheal intubation time, ICU stay time and hospital stay time in the 3D printing model group were all shorter than those in the non-3D printing model group (P<0.05).ConclusionThe relationship between VSD and aorta and pulmonary artery can be observed from a 3D perspective by 3D printing technology, which can guide the preoperative surgical plans, assist physicians to make reasonable and effective decisions, shorten intraoperative exploration time and operation time, and decrease the surgery-related risks.
The incidence of valvular heart disease (VHD) increases with age, and its principal therapy is valve replacement. However, in recent years, the emergence of transcatheter interventions has changed the traditional therapy, making high-risk patients of surgery see dawn of hope. 3D printing technology has developed rapidly since it was applied to the medical field in 1990. Moreover, it has been widely applied in many surgical majors via refined reduction technology. However, the application of 3D printing technology in cardiovascular surgery is still in the preliminary stage, especially in the field of VHD. This article aims to review basic principles of 3D printing technology, its advantages in the therapy of VHD, and its current status of clinical application. Furthermore, this article elaborates current problems and looks forward to the future development direction.
ObjectiveTo explore the clinical applications of 3D-CT reconstruction combined with 3D printing in the analysis of anatomical types and variations of bilateral pulmonary arteries. MethodsFrom January 2019 to February 2022, the clinical data of 547 patients who underwent anatomical lung lesion resection in our hospital were retrospectively collected. They were divided into a 3D-CT reconstruction plus printing technology group (n=298, 87 males and 211 females aged 53.84±12.94 years), a 3D-CT reconstruction group (n=148, 55 males and 93 females aged 54.21±11.39 years), and a non-3D group (n=101, 28 males and 73 females aged 53.17±10.60 years). ResultsIn the 3D-CT reconstruction plus printing technology group, the operation time of patients (right: 125.61±20.99 min, left: 119.26±28.44 min) was shorter than that in the 3D-CT reconstruction group (right: 130.48±11.28 min, left: 125.51±10.59 min) and non-3D group (right: 134.45±10.20 min, left: 130.44±9.53 min), which was not associated with the site of surgery; intraoperative blood loss (right: 20.92±8.22 mL, left: 16.85±10.43 mL) was not statistically different compared with the 3D-CT reconstruction group (right: 21.13±8.97 mL, left: 19.09±7.01 mL), but was less than that of the non-3D group (right: 24.44±10.72 mL, left: 23.72±11.45 mL). Variation was found in the right pulmonary artery of 7 (3.91%) patients and in the left pulmonary artery of 21 (17.65%) patients. We first found four-branched lingual pulmonary artery in 2 patients.ConclusionPreoperative CT image computer-assisted 3D reconstruction combined with 3D printing technology can help surgeons to formulate accurate surgical plans, shorten operation time and reduce intraoperative blood loss.
ObjectiveTo explore the feasibility of lumbar puncture models based on 3D printing technology for training junior orthopaedic surgeons to find the optimal pedicle screw insertion points.MethodsMimics software was used to design 3D models of lumbar spine with the optimal channels and alternative channels. Then, the printed lumbar spine models, plasticine, and cloth were used to build lumbar puncture models. From January 2018 to June 2019, 43 orthopedic trainees performed simulated operations to search for the insertion points of pedicle screws base on the models. The operations were performed once a day for 10 consecutive days, and the differences in operation scores and operation durations of the trainees among the 10 days were compared.ResultsAll the trainees completed the surgical training operations successfully, and there were significant differences in the operation scores (13.05±2.45, 14.02±3.96, 17.58±3.46, 21.02±2.04, 23.40±4.08, 25.14±3.72, 27.26±6.09, 33.37±4.23, 35.00±4.15, 38.49±1.70; F=340.604, P<0.001) and operation durations [(22.51±4.28), (19.93±4.28), (18.05±2.89), (17.05±1.76), (16.98±1.97), (15.47±1.74), (13.51±1.42), (12.60±2.17), (12.44±1.71), (11.91±1.87) minutes; F=102.359, P<0.001] among the 10 days.ConclusionThe 3D models of lumbar puncture are feasible and repeatable, which can contribute to surgical training.
Aortic valve disease is one of the major diseases threatening human health. Transcatheter aortic valve replacement (TAVR) is a new treatment for aortic disease. Preoperative evaluation is of great significance to the successful operation and the long-term quality of life of patients. The 3D printing technology can fully simulate the cardiac anatomy of patients, create personalized molds for patients, improve surgical efficiency, reduce surgical time and surgical trauma, and thus achieve better surgical results. In this review, the relevant literatures were searched, and the evaluation effect of 3D printing technology on the operation of TAVR was reviewed, so as to provide clinical reference.
Because of the characteristics such as accurate, efficient and individuation, 3D printing is being widely applied to manufacturing industry, and being gradually expanded into the medical field. Diseases of chest wall is a common type in thoracic surgery, and surgery is a proper treatment to this kind of disease. For the past few years, 3D printing is being gradually applied in surgery of chest wall diseases. The article mainly makes a statement of two parts that including the possibility to apply 3D printing including chest wall reconstruction and chest wall orthopedic, and to analyze the possibility and application prospect of applying 3D printing to the chest wall disease.
The esophageal disease is a major clinical disease. The esophageal stent has extensive clinical applications in the treatment of esophageal diseases. However, the clinical application of esophageal stent is limited, because there are lots of complications after implantation of esophageal stent. Biodegradable esophageal stent has two advantages: biodegradability and good histocompatibility. It is expected to solve a variety of complications of esophageal stent and provide a new choice for the treatment of esophageal diseases. Standardized esophageal stents are not fully applicable to all patients. The application of 3D printing technology in the manufacture of biodegradable esophageal stent can realize the individualized treatment of esophageal stent. And meanwhile, the 3D printing technology can reduce the manufacturing cost of the stent. This review aimed to summarize and discuss the application of esophageal stent, the current research status and prospect of biodegradable esophageal stent and the prospect of 3D printing technology in degradable esophageal stent, hoping to provide evidence and perspectives for the research of biodegradable esophageal stent.
Objective To explore the early clinical effect of 3D printing external fixed guide combined with video-assisted thoracic surgery (VATS) in the treatment of flail chest, and to provide evidence for the promotion of this technology. Methods Patients with flail chest treated in our hospital from January 2010 to January 2023 were retrospectively selected as the study objects. The trial group was treated with 3D printed external fixation guide combined with VATS, and the control group was treated with open reduction internal fixation. Operation time, intraoperative blood loss, closed thoracic drainage time, thoracic volume recovery, visual analogue scale (VAS) score 1 month after surgery and complications were compared between the two groups. Results A total of 40 patients were included, 20 in each group. In the experimental group, there were 13 males and 7 females, with an average age of 45.7±3.8 years. In the control group, there were 14 males and 6 females, with an average age of 47.3±4.1 years. There was no statistical difference in gender, age, number of rib fractures or VAS between the two groups (P>0.05). The surgery was successful in both groups, the wounds healed in stage Ⅰ, and the pain symptoms were significantly reduced. No postoperative complications occurred in the trial group, while chronic pain occurred in 1 patient, fracture malunion occurred in 1 patient and incision infection occurred in 1 patient in the control group, with a complication rate of 15.0%. Operation time, intraoperative blood loss and closed thoracic drainage time in trial group were lower than those in control group (P<0.05). There was no statistical difference in the recovery of thoracic volume and VAS at 1 month after operation (P>0.05). Conclusion 3D printing external fixation guide combined with VATS in the treatment of flail chest has satisfactory early curative effect, which has the advantages of minimally invasive, high efficiency, rapid recovery and reducing postoperative complications. This method can effectively reconstruct the shape of the chest, restore the volume of the chest.
3D printing technology has a promising prospect of medical use and clinical value, and may play an important role in the field of thoracic and cardiovascular surgery, such as preoperative diagnosis, surgical planning, surgical approach alternatives and organ replacement. This review focuses on the development of 3D printing technology in recent years and its use and prospect in the field of thoracic and cardiovascular surgery including surgical teaching and simulation, personalized prosthesis implantation, and artificial organ transplantation.
ObjectiveTo explore clinical value of 3D printing technology in hepatic resection. MethodsFrom March to May 2015, multidetector-row computed tomography images of 12 patients, including hepatic carcinoma in 6, hepatic hemangioma in 3, intra-and extra-hepatic bile duct stones in 3, were used for 3D hepatic reconstruction, the final segmentation data were converted to stereolithography files for 3D printing, 50%-70% scale of the full-sized liver model was fabricated by polylactic acid to be used to analyze its anatomical structure, design surgical planning, select the optimal operative route and simulate hepatic resection. Hepatic resection was performed by referring to the 3D printing model. ResultsThe hepatic resections were successful without complications by referring to the preoperative 3D printing models, the average blood loss was 340(100-1000) mL. ConclusionHepatic resection is more accurate and safe by 3D printing technology.