scholarly journals Desktop 3D Printing: Key for Surgical Navigation in Acral Tumors?

2020 ◽  
Vol 10 (24) ◽  
pp. 8984
Author(s):  
Rafael Moreta-Martinez ◽  
José Antonio Calvo-Haro ◽  
Rubén Pérez-Mañanes ◽  
Mónica García-Sevilla ◽  
Lydia Mediavilla-Santos ◽  
...  
Keyword(s):  
3D Printing ◽  
Open Source ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
Soft Tissue Sarcomas ◽  
Patient Specific ◽  
Deformation Analysis ◽  
Camera Tracking ◽  
Oncologic Surgery ◽  
3D Printed

Surgical navigation techniques have shown potential benefits in orthopedic oncologic surgery. However, the translation of these results to acral tumor resection surgeries is challenging due to the large number of joints with complex movements of the affected areas (located in distal extremities). This study proposes a surgical workflow that combines an intraoperative open-source navigation software, based on a multi-camera tracking, with desktop three-dimensional (3D) printing for accurate navigation of these tumors. Desktop 3D printing was used to fabricate patient-specific 3D printed molds to ensure that the distal extremity is in the same position both in preoperative images and during image-guided surgery (IGS). The feasibility of the proposed workflow was evaluated in two clinical cases (soft-tissue sarcomas in hand and foot). The validation involved deformation analysis of the 3D-printed mold after sterilization, accuracy of the system in patient-specific 3D-printed phantoms, and feasibility of the workflow during the surgical intervention. The sterilization process did not lead to significant deformations of the mold (mean error below 0.20 mm). The overall accuracy of the system was 1.88 mm evaluated on the phantoms. IGS guidance was feasible during both surgeries, allowing surgeons to verify enough margin during tumor resection. The results obtained have demonstrated the viability of combining open-source navigation and desktop 3D printing for acral tumor surgeries. The suggested framework can be easily personalized to any patient and could be adapted to other surgical scenarios.

scholarly journals The utility of 3D printing for surgical planning and patient-specific implant design for complex spinal pathologies: case report

2017 ◽  
Vol 26 (4) ◽  
pp. 513-518 ◽  
Author(s):  
Ralph J. Mobbs ◽  
Marc Coughlan ◽  
Robert Thompson ◽  
Chester E. Sutterlin ◽  
Kevin Phan
Keyword(s):  
3D Printing ◽  
Spinal Surgery ◽  
Surgical Planning ◽  
Tumor Resection ◽  
Implant Design ◽  
Patient Specific ◽  
Anterior Fusion ◽  
Potential Applications ◽  
3D Printed ◽  
Fusion Cage

OBJECTIVE There has been a recent renewed interest in the use and potential applications of 3D printing in the assistance of surgical planning and the development of personalized prostheses. There have been few reports on the use of 3D printing for implants designed to be used in complex spinal surgery. METHODS The authors report 2 cases in which 3D printing was used for surgical planning as a preoperative mold, and for a custom-designed titanium prosthesis: one patient with a C-1/C-2 chordoma who underwent tumor resection and vertebral reconstruction, and another patient with a custom-designed titanium anterior fusion cage for an unusual congenital spinal deformity. RESULTS In both presented cases, the custom-designed and custom-built implants were easily slotted into position, which facilitated the surgery and shortened the procedure time, avoiding further complex reconstruction such as harvesting rib or fibular grafts and fashioning these grafts intraoperatively to fit the defect. Radiological follow-up for both cases demonstrated successful fusion at 9 and 12 months, respectively. CONCLUSIONS These cases demonstrate the feasibility of the use of 3D modeling and printing to develop personalized prostheses and can ease the difficulty of complex spinal surgery. Possible future directions of research include the combination of 3D-printed implants and biologics, as well as the development of bioceramic composites and custom implants for load-bearing purposes.

scholarly journals Accessing 3D Printed Vascular Phantoms for Procedural Simulation

2021 ◽  
Vol 7 ◽  
Author(s):  
Jasamine Coles-Black ◽  
Damien Bolton ◽  
Jason Chuen
Keyword(s):  
3D Printing ◽  
Endovascular Procedures ◽  
Low Cost ◽  
3D Models ◽  
Routine Care ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Ct Angiogram ◽  
Abdominal Aortic ◽  
3D Printed

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software packages and a variety of 3D printing technologies.Methods: Although applicable to all vascular territories, we illustrate our methodology using Abdominal Aortic Aneurysms (AAAs) due to the strong interest in this area. CT aortograms acquired as part of routine care were converted to representative patient-specific 3D models, and then printed using a variety of 3D printing technologies to assess their material suitability as aortic phantoms. Depending on the technology, phantoms cost $20–$1,000 and were produced in 12–48 h. This technique was used to generate hollow 3D printed thoracoabdominal aortas visible under fluoroscopy.Results: 3D printed AAA phantoms were a valuable addition to standard CT angiogram reconstructions in the simulation of complex cases, such as short or very angulated necks, or for positioning fenestrations in juxtarenal aneurysms. Hollow flexible models were particularly useful for device selection and in planning of fenestrated EVAR. In addition, these models have demonstrated utility other settings, such as patient education and engagement, and trainee and anatomical education. Further study is required to establish a material with optimal cost, haptic and fluoroscopic fidelity.Conclusion: We share our experiences and methodology for developing inexpensive 3D printed vascular phantoms which despite material limitations, successfully mimic the procedural challenges encountered during live endovascular surgery. As the technology continues to improve, 3D printed vascular phantoms have the potential to disrupt how endovascular procedures are planned and taught.

scholarly journals Development of 3D Printed Symbrachydactyly Prosthetic Hand

2019 ◽  
Vol 9 (1) ◽  
pp. 5943-5947
Keyword(s):  
3D Printing ◽  
Minimum Cost ◽  
Acrylonitrile Butadiene Styrene ◽  
Design Stage ◽  
Patient Specific ◽  
Prosthetic Hand ◽  
Simple Task ◽  
3D Printed ◽  
Electrical Component ◽  
Hand Geometry

Symbrachydactyly is a genetical problem occurred to newborn where the newborn experienced underdeveloped or shorten fingers. This condition will limit their normal as even a simple task of holding an item or pushing a button. A device is needed to help them gain a better life. The aim of this project is to fabricate a customized prosthesis hand using 3D printing technology at minimum cost. The proposed prosthetic was not embedded with any electrical component. The patient can only use the wrist to control the prosthetic part which is the prosthetic fingers. The prosthetic hand was also being developed with the patient specific features, which the initial design stage was adapted from a person’s hand geometry using a 3D scanner. Next the model of the prosthesis was analyzed computationally to predict the performance of the product. Different material properties are considered in the analysis to present Polylactic Acid (PLA) and Acrylonitrile Butadiene Styrene (ABS) materials. Then, the prosthesis was fabricated using the 3D printing. The results suggested that PLA material indicated better findings and further be fabricated.

Investigation of three-dimensional printing materials for printing aorta model replicating Type B aortic dissection

2021 ◽  
Vol 17 ◽  
Author(s):  
Chia-An Wu ◽  
Andrew Squelch ◽  
Zhonghua Sun
Keyword(s):  
3D Printing ◽  
Aortic Dissection ◽  
Three Dimensional ◽  
Ct Images ◽  
Patient Specific ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Ct Attenuation ◽  
Significant Difference ◽  
3D Printed

Aim: To determine a printing material that has both elastic property and radiology equivalence close to real aorta for simulation of endovascular stent graft repair of aortic dissection. Background: With the rapid development of three-dimensional (3D) printing technology, a patient-specific 3D printed model is able to help surgeons to make better treatment plan for Type B aortic dissection patients. However, the radiological properties of most 3D printing materials have not been well characterized. This study aims to investigate the appropriate materials for printing human aorta with mechanical and radiological properties similar to the real aortic computed tomography (CT) attenuation. Objective: Quantitative assessment of CT attenuation of different materials used in 3D printed models of aortic dissection for developing patient-specific 3D printed aorta models to simulate type B aortic dissection. Method: A 25-mm length of aorta model was segmented from a patient’s image dataset with diagnosis of type B aortic dissection. Four different elastic commercial 3D printing materials, namely Agilus A40 and A50, Visijet CE-NT A30 and A70 were selected and printed with different hardness. Totally four models were printed out and conducted CT scanned twice on a 192-slice CT scanner using the standard aortic CT angiography protocol, with and without contrast inside the lumen.Five reference points with region of interest (ROI) of 1.77 mm2 were selected at the aortic wall and intimal flap and their Hounsfield units (HU) were measured and compared with the CT attenuation of original CT images. The comparison between the patient’s aorta and models was performed through a paired-sample t-test to determine if there is any significant difference. Result: The mean CT attenuation of aortic wall of the original CT images was 80.7 HU. Analysis of images without using contrast medium showed that the material of Agilus A50 produced the mean CT attenuation of 82.6 HU, which is similar to that of original CT images. The CT attenuation measured at images acquired with other three materials was significantly lower than that of original images (p<0.05). After adding contrast medium, Visijet CE-NT A30 had an average CT attenuation of 90.6 HU, which is close to that of the original images with statistically significant difference (p>0.05). In contrast, the CT attenuation measured at images acquired with other three materials (Agilus A40, A50 and Visiject CE-NT A70) was 129 HU, 135 HU and 129.6 HU, respectively, which is significantly higher than that of original CT images (p<0.05). Conclusion: Both Visijet CE-NT and Agilus have tensile strength and elongation close to real patient’s tissue properties producing similar CT attenuation. Visijet CE-NT A30 is considered the appropriate material for printing aorta to simulate contrast-enhanced CT imaging of type B aortic dissection. Due to lack of body phantom in the experiments, further research with simulation of realistic anatomical body environment should be conducted.

scholarly journals Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Biomolecules ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1577
Author(s):  
Zhonghua Sun
Keyword(s):  
Cardiovascular Disease ◽  
3D Printing ◽  
Current Status ◽  
Patient Specific ◽  
Future Research ◽  
Junior Doctors ◽  
Imaging Data ◽  
Training Tool ◽  
Complex Anatomy ◽  
3D Printed

Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.

Custom Design & Fabrication of 3D printed cast for ankle immobilisation

2017 ◽  
Vol 2 (2) ◽  
pp. 98 ◽  
Author(s):  
Guruprasad Kuppu Rao ◽  
Tanmay Shah ◽  
Vijay Dayanand Shetty ◽  
B. Ravi
Keyword(s):  
3D Printing ◽  
Data Acquisition ◽  
Bone Fracture ◽  
Patient Specific ◽  
Post Processing ◽  
Tibia Bone ◽  
Joint Injuries ◽  
Custom Design ◽  
Inner Surface ◽  
3D Printed

<p>Management of bone and joint injuries is commonly done by immobilisation using plaster/fibreglass casts. This study describes design and fabrication of patient specific cast using 3D printing.  The 3D printed cast while being patient friendly is superior to earlier casts in healing efficacy and hence redefines the joint immobilisation practice. We present here a case of “walk on brace” design and fabrication using 3D printing. The custom design of ankle immobilisation cast was done for an 18-year-old boy having tibia bone fracture during gymnastic activity. The workflow comprises of anatomical data acquisition, CAD, 3D printing, post processing and clinical approval for use. Additional features such as straps, anti-slip inner surface and tread for floor grip were incorporated in the design. </p>

scholarly journals Beneath the Skin: Emulating human physiology using a novel bitmap-based “voxel” 3D-printing workflow.

2021 ◽  
Author(s):  
◽  
Ana Morris
Keyword(s):  
Medical Education ◽  
3D Printing ◽  
Biomedical Imaging ◽  
Human Anatomy ◽  
Patient Specific ◽  
Imaging Data ◽  
Anatomical Models ◽  
Medical Communication ◽  
Medical Models ◽  
3D Printed

<p>Novel technologies that produce medical models which are synthetic equivalents to human tissue may forever change the way human anatomy and medicine are explored. Medical modelling using a bitmap-based additive manufacturing workflow offers exciting opportunities for medical education, informed consent practices, skills acquisition, pre-operative planning and surgical simulation. Moving medical data from the 2D-world to tactile, highly detailed 3D-printed anatomical models may significantly change how we comprehend the body; revamping everything – from medical education to clinical practice.  Research Problem The existing workflow for producing patient-specific anatomical models from biomedical imaging data involves image thresholding and iso-surface extraction techniques that result in surface meshes (also known as objects or parts). This process restricts shape specification to one colour and density, limiting material blending and resulting in anatomically inequivalent medical models. So, how can the use of 3D-printing go beyond static anatomical replication? Imagine pulling back the layers of tissue to reveal the complexity of a procedure, allowing a family to understand and discuss their diagnosis. Overcoming the disadvantages of static medical models could be a breakthrough in the areas of medical communication and simulation. Currently, patient specific models are either rigid or mesh-based and, therefore, are not equivalents of physiology.  Research Aim The aim of this research is to create tangible and visually compelling patient-specific prototypes of human anatomy, offering an insight into the capabilities of new bitmap-based 3D-printing technology. It proposes that full colour, multi-property, voxel-based 3D-printing can emulate physiology, creating a new format of visual and physical medical communication.  Data Collection and Procedure For this study, biomedical imaging data was converted into multi-property 3D-printed synthetic anatomy by bypassing the conversion steps of traditional segmentation. Bitmap-based 3D-printing allows for the precise control over every 14-micron material droplet or “voxel”.  Control over each voxel involves a process of sending bitmap images to a high-resolution and multi-property 3D-printer. Bitmap-based 3D-printed synthetic medical models – which mimicked the colour and density of human anatomy – were successfully produced.  Findings This research presented a novel and streamlined bitmap-based medical modelling workflow with the potential to save manufacturing time and labour cost. Moreover, this workflow produced highly accurate models with graduated densities, translucency, colour and flexion – overcoming complexities that arise due to our body’s opaqueness. The presented workflow may serve as an incentive for others to investigate bitmap-based 3D-printing workflows for different manufacturing applications.</p>

scholarly journals Three-dimensional Printing Versus Conventional Machining in the Creation of a Meatal Urethral Dilator: a Cost and Mechanical Strength Analysis

2020 ◽  
Author(s):  
Michael Yue-Cheng Chen ◽  
Jacob Skewes ◽  
Ryan Daley ◽  
Maria Ann Woodruff ◽  
Nicholas John Rukin
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Strength Analysis ◽  
Fused Deposition Modelling ◽  
3D Printer ◽  
Current Time ◽  
Fused Deposition ◽  
3D Printed ◽  
Conventional Machining

Abstract BackgroundThree-dimensional (3D) printing is a promising technology but the limitations are often poorly understood. We compare different 3D printingmethods with conventional machining techniques in manufacturing meatal urethral dilators which were recently removed from the Australian market. MethodsA prototype dilator was 3D printed vertically orientated on a low cost fused deposition modelling (FDM) 3D printer in polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS). It was also 3D printed horizontally orientated in ABS on a high-end FDM 3D printer with soluble support material, as well as on a SLS 3D printer in medical nylon. The dilator was also machined in stainless steel using a lathe. All dilators were tested mechanically in a custom rig by hanging calibrated weights from the handle until the dilator snapped. ResultsThe horizontally printed ABS dilator experienced failure at a greater load than the vertically printed PLA and ABS dilators respectively (503g vs 283g vs 163g, p < 0.001). The SLS nylon dilator and machined steel dilator did not fail. The steel dilator is most expensive with a quantity of five at 98 USD each, but this decreases to 30 USD each for a quantity of 1000. In contrast, the cost for the SLS dilator is 33 USD each for five and 27 USD each for 1000. ConclusionsAt the current time 3D printing is not a replacement for conventional manufacturing. 3D printing is best used for patient-specific parts, prototyping or manufacturing complex parts that have additional functionality that cannot otherwise beachieved.

scholarly journals Development of a Computer-Aided Design and Finite Element Analysis Combined Method for Affordable Spine Surgical Navigation With 3D-Printed Customized Template

2021 ◽  
Vol 7 ◽  
Author(s):  
Peter Endre Eltes ◽  
Marton Bartos ◽  
Benjamin Hajnal ◽  
Agoston Jakab Pokorni ◽  
Laszlo Kiss ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
3D Printing ◽  
Surgical Technique ◽  
Pedicle Screw ◽  
Physical Model ◽  
Investment Casting ◽  
Surgical Navigation ◽  
Patient Specific ◽  
Element Analysis

Introduction: Revision surgery of a previous lumbosacral non-union is highly challenging, especially in case of complications, such as a broken screw at the first sacral level (S1). Here, we propose the implementation of a new method based on the CT scan of a clinical case using 3D reconstruction, combined with finite element analysis (FEA), computer-assisted design (CAD), and 3D-printing technology to provide accurate surgical navigation to aid the surgeon in performing the optimal surgical technique by inserting a pedicle screw at the S1 level.Materials and Methods: A step-by-step approach was developed and performed as follows: (1) Quantitative CT based patient-specific FE model of the sacrum was created. (2) The CAD model of the pedicle screw was inserted into the sacrum model in a bicortical convergent and a monocortical divergent position, by overcoming the geometrical difficulty caused by the broken screw. (3) Static FEAs (Abaqus, Dassault Systemes) were performed using 500 N tensile load applied to the screw head. (4) A template with two screw guiding structures for the sacrum was designed and manufactured using CAD design and 3D-printing technologies, and investment casting. (5) The proposed surgical technique was performed on the patient-specific physical model created with the FDM printing technology. The patient-specific model was CT scanned and a comparison with the virtual plan was performed to evaluate the template accuracyResults: FEA results proved that the modified bicortical convergent insertion is stiffer (6,617.23 N/mm) compared to monocortical divergent placement (2,989.07 N/mm). The final template was created via investment casting from cobalt-chrome. The template design concept was shown to be accurate (grade A, Gertzbein-Robbins scale) based on the comparison of the simulated surgery using the patient-specific physical model and the 3D virtual surgical plan.Conclusion: Compared to the conventional surgical navigation techniques, the presented method allows the consideration of the patient-specific biomechanical parameters; is more affordable, and the intraoperative X-ray exposure can be reduced. This new patient- and condition-specific approach may be widely used in revision spine surgeries or in challenging primary cases after its further clinical validation.

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