3D Printing for Complex Cranial Surgery Education: Technical Overview and Preliminary Validation Study
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ABSTRACT:
SUBMITTER: Graffeo C
PROVIDER: S-EPMC9272238 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.
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Project description:During the past 5 years, the body of literature surrounding the utilization of three-dimensional (3D) printing in the field of urology has grown exponentially. Incentivized by work hour restrictions, patient safety initiatives, and inspired by technical advances in biomaterials and rapid printing strategies, this emerging, and fascinating area of research has begun to make headway into clinical practice. However, concerns about cost, limited understanding of the technical processes involved, and lack of its potential uses remain barriers to its widespread adoption. We examined existing published literature on how 3D printing technologies have been utilized in the field of Urology to enhance pre-operative planning, revitalize surgical training, and modernize patient education, with particular focus on, robotic surgery. To date, 3D-printed models have been used and studied most commonly in the preoperative planning for nephron-sparing surgeries during the treatment of renal masses, where the challenges of complex renal anatomy and benefits of reducing renal ischemic injury create the most intuitive value. Prostate models are the second most common, particularly in the planning of nerve-sparing procedures. Early studies have demonstrated sufficient realism and educational effectiveness. Subsequent studies demonstrated improved surgeon confidence, operative performance, and optimized patient outcomes including high levels of patient satisfaction. Realistic, accurate, and reasonably priced models can currently be generated within hours using standard desktop 3D printers. While primarily utilized as anatomic replicas of diseased organs that restore a sense of haptic feedback lost in robotic procedures, innovations in polymers, improvements in 3D printer host and modeling software, and upgrades in printer hardware allow this technology to serve as a comprehensive, interactive, simulation platform that can be a critical surgical decision making as well as an effective teaching tool. As Urologists continue to rapidly diversify and iterate upon this adaptive modality, the benefits in patient outcomes will likely outpace the diminishing drawbacks, and we may well see the next revolution in surgical education, robotic techniques, and personalized medicine concurrently.
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Project description:Despite recent advances to control the spatial composition and dynamic functionalities of bacteria embedded in materials, bacterial localization into complex three-dimensional (3D) geometries remains a major challenge. We demonstrate a 3D printing approach to create bacteria-derived functional materials by combining the natural diverse metabolism of bacteria with the shape design freedom of additive manufacturing. To achieve this, we embedded bacteria in a biocompatible and functionalized 3D printing ink and printed two types of "living materials" capable of degrading pollutants and of producing medically relevant bacterial cellulose. With this versatile bacteria-printing platform, complex materials displaying spatially specific compositions, geometry, and properties not accessed by standard technologies can be assembled from bottom up for new biotechnological and biomedical applications.
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Project description:Ordered mesoporous silica materials gain high interest because of their potential applications in catalysis, selective adsorption, separation, and controlled drug release. Due to their morphological characteristics, mainly the tunable, ordered nanometric pores, they can be utilized as supporting hosts for confined chemical reactions. Applications of these materials, however, are limited by structural design. Here, we present a new approach for the 3D printing of complex geometry silica objects with an ordered mesoporous structure by stereolithography. The process uses photocurable liquid compositions that contain a structure-directing agent, silica precursors, and elastomer-forming monomers that, after printing and calcination, form porous silica monoliths. The objects have extremely high surface area, 1900 m2/g, and very low density and are thermally and chemically stable. This work enables the formation of ordered porous objects having complex geometries that can be utilized in applications in both the industry and academia, overcoming the structural limitations associated with traditional processing methods.
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Project description:Inkjet printing is widely considered a promising strategy to pattern hydrogels and living cells into three-dimensional (3D) constructs that structurally resemble tissues in our body. However, this approach is currently constrained by the limited control over multi-component deposition: the variable droplet ejection characteristics of different bioinks and dispensing units make synchronized printing very challenging. This invariably results in artificial tissues that lack the complexity and function of their native counterparts. By careful optimization of the printing parameters for two different bioink formulations, here we report the inkjet-based 3D-patterning of hydrogels according to relatively complex blueprints. 3D printing of bioinks containing living cells resulted in high-resolution, multi-component living constructs. Finally, we describe a sacrificial material approach to inkjet print perfuseable channels for improved long-term cultures of larger samples. We believe that this work provides a foundation for the generation of more complex 3D tissue models by inkjet printing.
| S-EPMC6244156 | biostudies-literature
Project description:Various incurable eye diseases in companion animals often result in phthisis bulbi and eye removal surgery. Currently, the evisceration method using silicone balls is useful in animals; however, it is not available to those with impaired cornea or severe ocular atrophy. Moreover, ocular implant and prostheses are not widely used because of the diversity in animal size and eye shape, and high manufacturing cost. Here, we produced low-cost and customized artificial eyes, including implant and prosthesis, using computer-aided design and three-dimensional (3D) printing technique. For 3D modeling, the size of the artificial eyes was optimized using B-mode ultrasonography. The design was exported to STL files, and then printed using polycaprolactone (PCL) for prosthesis and mixture of PCL and hydroxyapatite (HA) for ocular implant. The 3D printed artificial eyes could be produced in less than one and half hour. The prosthesis was painted using oil colors and biocompatible resin. Two types of eye removal surgery, including evisceration and enucleation, were performed using two beagle dogs, as a preliminary study. After the surgery, the dogs were clinically evaluated for 6 months and then histopathological evaluation of the implant was done. Ocular implant was biocompatible and host tissue ingrowth was induced after in vivo application. The custom-made prosthesis was cosmetically excellent. Although long-term clinical follow-up might be required, the use of 3D printed-customized artificial eyes may be beneficial for animals that need personalized artificial eye surgery.
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Project description:3D printing in adult cardiac and vascular surgery has been evaluated over the last 10 years, and all of the available literature reports benefits from the use of 3D models. In the present study, we analyzed the current applications of 3D printing for adult cardiovascular disease treated with surgical or catheter-based interventions, including the clinical medical simulation of physiological or pathology conducted with 3D printing in this field. A search of PubMed and MEDLINE databases were supplemented by searching through bibliographies of key articles. Thereafter, data on demographic, clinical scenarios and application, imaging modality, purposes of using with 3D printing, outcomes and follow-up were extracted. A total of 43 articles were deemed eligible and included. 296 patients (mean age: 65.4±14.2 years; male, 58.2%) received 3D printing for cardiac and vascular surgery or conditions [percutaneous left atrial appendage occlusion (LAAO), TAVR, mitral valve disease, aortic valve replacement, coronary artery abnormality, HOCM, aortic aneurysm and aortic dissection, Kommerell’s diverticulum, primary cardiac tumor and ventricular aneurysm]. Eight papers reported the utility of 3D printing in the medical simulator and training fields. Most studies were conducted starting in 2014. Twenty-six was case report. The major scenario used with 3D printing technology was LAAO (50.3%) and followed by TAVR (17.6%). CT and echocardiography were two main imaging techniques that were used to generate 3D-printed heart models. All studies showed that 3D-printed models were helpful for preoperative planning, orientation, and medical teaching. The important finding is that 3D printing provides a unique patient-specific method to assess complex anatomy and is helpful for intraoperative orientation, decision-making, creating functional models, and teaching adult cardiac and vascular surgery, including catheter-based heart surgery.
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Project description:BackgroundBone grafting has been considered the gold standard for hard tissue reconstructive surgery and is widely used for large mandibular defect reconstruction. However, the midface encompasses delicate structures that are surrounded by a complex bone architecture, which makes bone grafting using traditional methods very challenging. Three-dimensional (3D) bioprinting is a developing technology that is derived from the evolution of additive manufacturing. It enables precise development of a scaffold from different available biomaterials that mimic the shape, size, and dimension of a defect without relying only on the surgeon’s skills and capabilities, and subsequently, may enhance surgical outcomes and, in turn, patient satisfaction and quality of life.ReviewThis review summarizes different biomaterial classes that can be used in 3D bioprinters as bioinks to fabricate bone scaffolds, including polymers, bioceramics, and composites. It also describes the advantages and limitations of the three currently used 3D bioprinting technologies: inkjet bioprinting, micro-extrusion, and laser-assisted bioprinting.ConclusionsAlthough 3D bioprinting technology is still in its infancy and requires further development and optimization both in biomaterials and techniques, it offers great promise and potential for facial reconstruction with improved outcome.
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Project description:Biportal endoscopic spine surgery (BESS) for cervical disk herniation (CDH) has been rarely reported. The aim of the article is to describe a novel BESS as a posterior approach for CDH and report the preliminary outcomes and complications. This single-centered retrospective chart review included 109 consecutive patients who underwent BESS for symptomatic single-level CDH. Working and viewing portals were created in each unilateral paravertebral area at the target disk level. Endoscopic exploration allowed for effective and minimally invasive decompression via safe access to the medial foramen with minimal laminectomy and facetectomy. Clinical outcomes, including the visual analog scale, neck disability index, Macnab criteria, and the motor function of the involved arm, were evaluated at 4, 8, 12, and 24 postoperative weeks. Visual analog scale and neck disability index improved significantly at 24 weeks postoperatively (P < .01). According to the Macnab criteria, "excellent," "good," and "fair" results were obtained for 55.9%, 30.3%, and 13.8% of patients, respectively. The post 24-week distribution of the involved upper extremity strength grade was significantly improved compared to the initial value (P = .02). One patient had a motor weakness with a decreased grade over 4 weeks from excessive irrigation. The posterior approach of BESS was efficient and feasible for the treatment of CDH.
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Project description:BackgroundSurgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function.MethodsFrom January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union.ResultsOne patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%.ConclusionsHere, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.
| S-EPMC8161929 | biostudies-literature