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.
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.
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.
Mitral valve disease is the most common cardiac valve disease. The main treatment of mitral valve disease is surgery or interventional therapy. However, as the anatomy of mitral valve is complicated, the operation is particularly difficult. As a result, it requires sophisticated experiences for surgeons. Three-dimensional (3D) printing technology can transform two-dimensional medical images into 3D solid models. So it can provide clear spatial anatomical information and offer safe and personalized treatment for the patients by simulating surgery process. This article reviews the applications of 3D printing technology in the treatment of mitral valve disease.
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.
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.
ObjectiveTo discuss the operation skill and clinical effects of using domestic balloon-expandable Prizvalve® transcatheter "valve-in-valve" to treat the degenerated bioprosthesis in the tricuspid position.MethodsAll the admitted surgical tricuspid valve bioprosthetic valve replacement patients were evaluated by computerized tomography angiography (CTA), ultrasound, and 3D printing technology, and 2 patients with a degenerated bioprosthesis were selected for tricuspid valve "valve-in-valve" operation. Under general anesthesia, the retro-preset Prizvalve® system was implanted into degenerated tricuspid bioprosthesis via the femoral vein approach under the guidance of transesophageal echocardiographic and fluoroscopic guidance.ResultsTranscatheter tricuspid valve implantation was successfully performed in both high-risk patients, and tricuspid regurgitation disappeared immediately. The operation time was 1.25 h and 2.43 h, respectively. There was no serious complication in both patients, and they were discharged from the hospital 7 days after the operation.ConclusionThe clinical effect of the degenerated tricuspid bioprosthetic valve implantation with domestic balloon-expandable valve via femoral vein approach "valve-in-valve" is good. Multimodality imaging and 3D printing technology can safely and effectively guide the implementation of this innovative technique.