MP22-03 MALLEABLE PHYSICAL MODELS OF RENAL MALIGNANCIES CONSTRUCTED FROM 3-D PRINTERS TO ALLOW SURGICAL RESECTION FOR INDIVIDUALIZED PRE-SURGICAL SIMULATION

摘要

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment I1 Apr 2015MP22-03 MALLEABLE PHYSICAL MODELS OF RENAL MALIGNANCIES CONSTRUCTED FROM 3-D PRINTERS TO ALLOW SURGICAL RESECTION FOR INDIVIDUALIZED PRE-SURGICAL SIMULATION Michael Maddox, Allison Feibus, Benjamin Lee, Julie Wang, Raju Thomas, and Jonathan Silberstein Michael MaddoxMichael Maddox More articles by this author , Allison FeibusAllison Feibus More articles by this author , Benjamin LeeBenjamin Lee More articles by this author , Julie WangJulie Wang More articles by this author , Raju ThomasRaju Thomas More articles by this author , and Jonathan SilbersteinJonathan Silberstein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1015AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We constructed high fidelity individualized physical three-dimensional (3-D) models of renal units made with materials that approximate the properties of renal tissue which allow surgeons to use a robotic platform to simulate resection of the renal mass prior to performing robotic partial nephrectomy (RPN). METHODS Proprietary software was utilized to import patient's diagnostic computerized tomography cross-sectional imaging into 3-D printers and create hydrogel physical 3-D models of renal units with enhancing in situ lesions. Normal renal parenchyma was printed with a white resin, while the suspicious lesions as well as the renal vasculature and collecting system were delineated with a black opaque resin. Prospectively the DaVinci robot was used to extirpate the tumors from the surrounding renal tissue and perform renorrhaphy with the intent of simulating actual tumor resection. RPN was performed on the patient several days following resection of the model. RESULTS We constructed 5 physical models of renal units with suspected malignancies prior to RPN. A representative physical model is shown in figure 1, while figure 2 demonstrates a model during pre-operative simulative resection. All patients on whom the models were constructed underwent successful partial nephrectomy. Average ischemia time was 21 minutes, nephrometry score was 6.8, and all surgical margins were negative. Models themselves as well as the individualized surgical simulation they allowed were believed by surgeons to aid in identification, dissection, and resection of renal lesions. Resident trainees assisting in simulation achieved more console time during following renal vasculature clamping during actual RPN, when compared with similarly matched patients (16m vs 10m, p<0.01). CONCLUSIONS Pre-operative resectable physical 3-D models can be constructed and used as individualized surgical simulation. Such models may change surgical training and improve surgical outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e241-e242 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Maddox More articles by this author Allison Feibus More articles by this author Benjamin Lee More articles by this author Julie Wang More articles by this author Raju Thomas More articles by this author Jonathan Silberstein More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...