V5-04: Resectable Physical 3-D Models Utilizing 3-D Printer Technology for Robotic Partial Nephrectomy
VideoIntroductions 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 to allow surgeons to use robotic platforms to resect the models prior to performing robot assisted nephron sparing surgery.
Specialized software was utilized to import patient’s diagnostic computerized tomography cross sectional imaging into 3-D printers and create physical 3-D models of renal units with enhancing in situ lesions. Sterolithography additive manufacturing, a technique in which an ultraviolet laser is used to cure a photosensitive resin in sequential, horizontally oriented layers was employed to build the models (Medical Modeling Inc., Golden, CO). Two 3-D models were constructed using flexible materials, which maintained high fidelity but whose physical properties approximated renal tissue. Models were resected using the Da Vinci surgical platform prior to operating on the patient for surgical simulation.
Both patients on whom the models were constructed successfully underwent partial nephrectomy. Average ischemic time was 21 minutes, nephrometry score was 6.8, and all 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.
Pre-operative resectable physical 3-D models can be constructed and used as individualized surgical simulation for improved outcomes of trainees and surgeons alike.