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Application of robotic-assisted in situ 3D printing in cartilage regeneration with HAMA hydrogel: An in vivo study.

ABSTRACT: The concept of in situ 3D bio-printing was previously reported, while its realization has still encountered with several difficulties. The present study aimed to report robotic-assisted in situ 3D bio-printing technology for cartilage regeneration, and explore its potential in clinical application. A six-degree-of-freedom (6-DOF) robot was introduced in this study, and a fast tool center point (TCP) calibration method was developed to improve printing accuracy. The bio-ink consisted of hyaluronic acid methacrylate and acrylate-terminated 4-armed polyethylene glycol was employed as well. The in vitro experiment was performed on a resin model to verify the printing accuracy. The in vivo experiment was conducted on rabbits to evaluate the cartilage treatment capability. According to our results, the accuracy of the robot could be notably improved, and the error of printed surface was less than 30 μm. The osteochondral defect could be repaired during about 60 s, and the regenerated cartilage in hydrogel implantation and in situ 3D bio-printing groups demonstrated the same biomechanical and biochemical performance. We found that the cartilage injury could be treated by using this method. The robotic-assisted in situ 3D bio-printing is highly appropriate for improving surgical procedure, as well as promoting cartilage regeneration.

SUBMITTER: Ma K

PROVIDER: S-EPMC7030996 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThree-dimensional (3D) printing technology has been utilized to create patient-specific (PS) replicas as visual aids for surgical planning.1-4 However, they cannot recreate the operative experience due to a lack of realistic tissue characteristics.ObjectivesDevelop anatomically accurate, realistic, PS partial nephrectomy platforms suitable for pre-operative surgical rehearsals using 3D-printing and hydrogel casting.MaterialPatient CT scans were segmented into a computer-aided design (CAD) file and used to create injection casts. Kidney and tumor casts along with hollow vascular and urinary structures were 3D-printed. The hilar structures and tumor were registered into the kidney cast, injected with poly-vinyl alcohol (PVA) hydrogel, and processed to create the kidney phantom. Mechanical and functional testing protocols were completed to confirm that the properties of PVA matched the live tissue.5 Anatomical accuracy was confirmed by CT scanning the phantom and creating another CAD, which was compared to the original patient CAD. Full-procedural PS rehearsals were completed 24-48 hours prior to their respective live surgeries. Clinically relevant metrics (warm ischemia time, estimated blood loss, and positive surgical margins) from each rehearsal and live case were compared using a Wilcoxon-rank sum test.ResultsThe 7%-3freeze/thaw PVA best recreated the mechanical and functional properties of porcine kidneys, while anatomical verification showed ≤1 mm deviation of the kidney and tumor from the patient anatomy and ≤3 mm for the hilar structures. PS rehearsal platforms were fabricated using these methods for 8 patients (average tumor size 5.92 cm and nephrometry score 9.8). A positive correlation was found for warm ischemia time and estimated blood loss between rehearsals and live surgeries.ConclusionThis reproducible method shows high anatomical accuracy, realistic tissue properties, and translational effects between rehearsals and live surgery. To determine the effects on patient outcomes, future studies will compare the impact of completing a pre-operative rehearsal vs standard surgical preparation.

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Application of robotic-assisted in situ 3D printing in cartilage regeneration with HAMA hydrogel: An in vivo study.

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