The use of 3D printed models on trainee and patient experience for partial nephrectomies.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 363-363
Author(s):  
E. Reilly Scott ◽  
Samuel Morano ◽  
Andrea Quinn ◽  
Erica Mann ◽  
Michelle Ho ◽  
...  
Keyword(s):  
3D Model ◽  
Standard Of Care ◽  
3D Models ◽  
University Hospital ◽  
Preoperative Imaging ◽  
Patient Specific ◽  
Tumor Characteristics ◽  
Educational Tool ◽  
Before And After ◽  
3D Printed

363 Background: 3D printing is a growing tool in surgical education due to the ability to visualize organs, tissue, and masses from multiple angles before operating on a patient. Previous studies using highly detailed and expensive 3D models costing between $1,000-250 per model have been shown to enhance patient and trainee comprehension of tumor characteristics, goals of surgery, and planned surgical procedure for partial nephrectomies. In our study we aim to use simpler and less expensive models in a greater range of patients receiving partial nephrectomies to determine the use of 3D models in patient, resident, and fellow education. Methods: 3D models of the effected kidney, mass, renal artery, and renal vein were created using preoperative imaging of undergoing partial nephrectomies at Thomas Jefferson University Hospital (TJUH) costing $35 per model. Residents and fellows filled out 3 surveys assessing their surgical plan and their confidence in the chosen plan at 3 time points: 1) Before seeing the model, 2) After seeing the model before surgery, and 3) After surgery. Ten patients filled out 2 surveys about their understanding of the kidney, their disease, the surgery they will undergo, and the risks involved with surgery before and after seeing the model. Results: Based on surveys to assess for surgical plan and confidence given to resident and fellow surgeons before and after seeing the 3D model, confidence significantly increased. Surveys given after surgery assessing anatomic and surgical comprehension found that resident and fellow surgeons rated the helpfulness of the models on their anatomical comprehension 7.6 out of 10 and the help of the models on their surgical confidence 7 out of 10. Patient understanding of their kidney, disease, and surgery significantly increased after seeing the 3D model, but the risks associated with surgery did not significantly increase. The extent that the model helped the patients learn about the kidney, their disease, the surgery, and the risks related to surgery were rated an average of 8.33, 9.67, 9.5, and 8.83 out of 10, respectively. Conclusions: Patient-specific 3D models for partial nephrectomies increase resident and fellow confidence in surgical approach and helped patients learn about their disease and feel comfortable going into surgery. Thus, it is important to continue to explore 3D models as an educational tool for both trainees and patients and potentially include 3D models as part of the standard of care. Further research could continue to explore the utility of 3D models as a pre-operative educational tool for both patients and trainees in other surgical fields.

Fabrication of 3D Models for Microtia Reconstruction Using Smartphone-Based Technology

2021 ◽  
pp. 000348942110240
Author(s):  
Peng You ◽  
Yi-Chun Carol Liu ◽  
Rodrigo C. Silva
Keyword(s):  
3D Model ◽  
Low Cost ◽  
Tertiary Care ◽  
Three Dimensional ◽  
Basic Research ◽  
3D Models ◽  
University Hospital ◽  
Patient Specific ◽  
Surface Scanning ◽  
Barrier To Entry

Objective: Microtia reconstruction is technically challenging due to the intricate contours of the ear. It is common practice to use a two-dimensional tracing of the patient’s normal ear as a template for the reconstruction of the affected side. Recent advances in three-dimensional (3D) surface scanning and printing have expanded the ability to create surgical models preoperatively. This study aims to describe a simple and affordable process to fabricate patient-specific 3D ear models for use in the operating room. Study design: Applied basic research on a novel 3D optical scanning and fabrication pathway for microtia reconstruction. Setting: Tertiary care university hospital. Methods: Optical surface scanning of the patient’s normal ear was completed using a smartphone with facial recognition capability. The Heges application used the phone’s camera to capture the 3D image. The 3D model was digitally isolated and mirrored using the Meshmixer software and printed with a 3D printer (MonopriceTM Select Mini V2) using polylactic acid filaments. Results: The 3D model of the ear served as a helpful intraoperative reference and an adjunct to the traditional 2D template. Collectively, time for imaging acquisition, editing, and fabrication was approximately 3.5 hours. The upfront cost was around $210, and the recurring cost was approximately $0.35 per ear model. Conclusion: A novel, low-cost approach to fabricate customized 3D models of the ear is introduced. It is feasible to create individualized 3D models using currently available consumer technology. The low barrier to entry raises the possibility for clinicians to incorporate 3D printing into various clinical applications.

scholarly journals Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem
Keyword(s):  
Wall Thickness ◽  
Large Scale ◽  
Fused Deposition Modeling ◽  
Vascular Anatomy ◽  
3D Models ◽  
Patient Specific ◽  
Stl File ◽  
Fused Deposition ◽  
3D Printed ◽  
The Mean

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.

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.

Effect of 3D Manipulatives on Students with Visual Impairments Who Are Learning Chemistry Constructs: A Pilot Study

2020 ◽  
Vol 114 (5) ◽  
pp. 370-381
Author(s):  
Derrick W. Smith ◽  
Sandra A. Lampley ◽  
Bob Dolan ◽  
Greg Williams ◽  
David Schleppenbach ◽  
...  
Keyword(s):  
Stem Education ◽  
3D Model ◽  
Atomic Orbital ◽  
Visual Impairments ◽  
Three Dimensional ◽  
3D Models ◽  
Specific Content ◽  
3D Printed ◽  
Printed Materials ◽  
Tactile Graphics

Introduction: The emerging technology of three-dimensional (3D) printing has the potential to provide unique 3D modeling to support specific content in science, technology, engineering, and mathematics (STEM) education, particularly chemistry. Method: Seventeen ( n = 17) students with visual impairments were provided direct instruction on chemistry atomic orbital content and allowed to use either print or tactile graphics or 3D models in rotating order. Participants were asked specific content questions based upon the atomic orbitals. Results: The students were asked two sets of comprehension questions: general and specific. Overall, students’ responses for general questions increased per iteration regardless of which manipulative was used. For specific questions, the students answered more questions correctly when using the 3D model regardless of order. When asked about their perceptions toward the manipulatives, the students preferred the 3D model over print or tactile graphics. Discussion: The findings show the potential for 3D printed materials in learning complex STEM content. Although the students preferred the 3D models, they all mentioned that a combination of manipulatives helped them better understand the material. Implications for practitioners: Practitioners should consider the use of manipulatives that include 3D printed materials to support STEM education.

Custom Patient-Specific Three-Dimensional Printed Mitral Valve Models for Pre-Operative Patient Education Enhance Patient Satisfaction and Understanding

2019 ◽  
Vol 13 (3) ◽  
Author(s):  
Kay S. Hung ◽  
Michael J. Paulsen ◽  
Hanjay Wang ◽  
Camille Hironaka ◽  
Y. Joseph Woo
Keyword(s):  
Patient Education ◽  
Mitral Valve ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Imaging Data ◽  
Anatomical Models ◽  
Mitral Valves ◽  
Flexible Polymer ◽  
3D Printed

In recent years, advances in medical imaging and three-dimensional (3D) additive manufacturing techniques have increased the use of 3D-printed anatomical models for surgical planning, device design and testing, customization of prostheses, and medical education. Using 3D-printing technology, we generated patient-specific models of mitral valves from their pre-operative cardiac imaging data and utilized these custom models to educate patients about their anatomy, disease, and treatment. Clinical 3D transthoracic and transesophageal echocardiography images were acquired from patients referred for mitral valve repair surgery and segmented using 3D modeling software. Patient-specific mitral valves were 3D-printed using a flexible polymer material to mimic the precise geometry and tissue texture of the relevant anatomy. 3D models were presented to patients at their pre-operative clinic visit and patient education was performed using either the 3D model or the standard anatomic illustrations. Afterward, patients completed questionnaires assessing knowledge and satisfaction. Responses were calculated based on a 1–5 Likert scale and analyzed using a nonparametric Mann–Whitney test. Twelve patients were presented with a patient-specific 3D-printed mitral valve model in addition to standard education materials and twelve patients were presented with only standard educational materials. The mean survey scores were 64.2 (±1.7) and 60.1 (±5.9), respectively (p = 0.008). The use of patient-specific anatomical models positively impacts patient education and satisfaction, and is a feasible method to open new opportunities in precision medicine.

scholarly journals 3D Printed Patient-Specific Complex Hip Arthroplasty Models Streamline the Preoperative Surgical Workflow: A Pilot Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Michael Jiang ◽  
Jasamine Coles-Black ◽  
Gordon Chen ◽  
Matthew Alexander ◽  
Jason Chuen ◽  
...  
Keyword(s):  
Pilot Study ◽  
Hip Arthroplasty ◽  
Planning Process ◽  
Cost Benefit ◽  
3D Models ◽  
Patient Specific ◽  
Risk Environment ◽  
Surgical Workflow ◽  
Operative Planning ◽  
3D Printed

Introduction: Surgical planning for complex total hip arthroplasty (THA) often presents a challenge. Definitive plans can be difficult to decide upon, requiring unnecessary equipment to be ordered and a long theatre list booked. We present a pilot study utilising patient-specific 3D printed models as a method of streamlining the pre-operative planning process.Methods: Complex patients presenting for THA were referred to the research team. Patient-specific 3D models were created from routine Computed Tomography (CT) imaging. Simulated surgery was performed to guide prosthesis selection, sizing and the surgical plan.Results: Seven patients were referred for this pilot study, presenting with complex conditions with atypical anatomy. Surgical plans provided by the 3D models were more detailed and accurate when compared to 2D CT and X ray imaging. Streamlined equipment selection was of great benefit, with augments avoided post simulation in three cases. The ability to tackle complex surgical problems outside of the operating theatre also flagged potential complications, while also providing teaching opportunities in a low risk environment.Conclusion: This study demonstrated that 3D printed models can improve the surgical plan and streamline operative logistics. Further studies investigating the optimal 3D printing material and workflow, along with cost-benefit analyses are required before this process is ready for routine use.

scholarly journals The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

F1000Research ◽  
2018 ◽  
Vol 6 ◽  
pp. 1603
Author(s):  
Jagannadha Avasarala ◽  
Todd Pietila
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Diseases ◽  
3D Models ◽  
Patient Specific ◽  
Surface Rendering ◽  
Reconstruction Algorithms ◽  
Imaging Data ◽  
Surgical Options ◽  
3D Printed ◽  
Magnetic Resonance Imaging Mri

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted.  Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient’s images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software designed for the purposes of image segmentation and 3D modeling.  The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging data were then segmented into regions and surface rendering was done to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options. The purpose of our study was to demonstrate that 3D depiction of chronic neurological diseases is possible in a printable model while serving a fundamental need for patient education. Medical teaching is moored in 2D graphics and it is time to evolve into 3D models that can be life-like and deliver instant impact.

scholarly journals Use of Patient Specific 3D Printed Neurovascular Phantoms To Simulate Mechanical Thrombectomy

2021 ◽  
Author(s):  
Kelsey Sommer ◽  
Mohammad Mahdi Shiraz Bhurwani ◽  
Vincent Tutino ◽  
Adnan Siddiqui ◽  
Jason Davies ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Blood Clot ◽  
Patient Specific ◽  
P Value ◽  
Fluid Temperature ◽  
Flow Loop ◽  
Vessel Occlusion ◽  
Before And After ◽  
Device Placement ◽  
3D Printed

Abstract Background: The ability of the patient specific 3D printed neurovascular phantoms to accurately replicate the anatomy and hemodynamics of the chronic neurovascular diseases has been demonstrated by many studies. Acute occurrences, however, may still require further development and investigation and therefore we studied acute ischemic stroke (AIS). The efficacy of endovascular procedures such as mechanical thrombectomy (MT) for the treatment of large vessel occlusion (LVO), can be improved by testing the performance of thrombectomy devices and techniques using patient specific 3D printed neurovascular models.Methods: 3D printed phantoms were connected to a flow loop with physiologically relevant flow conditions, including input flow rate and fluid temperature. A simulated blood clot was introduced into the model and placed in the proximal Middle Cerebral Artery (MCA) region. Clot location, composition, length, and arterial angulation were varied and MTs were simulated using stent retrievers. Device placement relative to the clot and the outcome of the thrombectomy were recorded for each situation. Digital subtraction angiograms (DSA) were captured before and after LVO simulation. Recanalization outcome was evaluated using DSA as either ‘no recanalization’ or ‘recanalization’. Forty-two 3DP neurovascular phantom benchtop experiments were performed. Results: Clot angulation within the MCA region had the most significant impact on the MT outcome, with a p-value of 0.016. Other factors such as clot location, clot composition, and clot length correlated weakly with the MT outcome.Conclusions: This project allowed us to gain knowledge of how such characteristics influence thrombectomy success and can be used in making clinical decisions when planning the procedure and selecting specific thrombectomy tools and approaches.

Improving serum calcium test ordering according to a decision algorithm

2018 ◽  
Vol 72 (3) ◽  
pp. 232-236
Author(s):  
Daniel K Faria ◽  
Leandro U Taniguchi ◽  
Luiz A M Fonseca ◽  
Mario Ferreira-Junior ◽  
Francisco J B Aguiar ◽  
...  
Keyword(s):  
Serum Calcium ◽  
University Hospital ◽  
Critical Conditions ◽  
Educational Tool ◽  
Internal Medicine Ward ◽  
Decision Algorithm ◽  
Ionised Calcium ◽  
Before And After ◽  
Algorithm Implementation ◽  
Test Ordering

AimTo detect differences in the pattern of serum calcium tests ordering before and after the implementation of a decision algorithm.MethodsWe studied patients admitted to an internal medicine ward of a university hospital on April 2013 and April 2016. Patients were classified as critical or non-critical on the day when each test was performed. Adequacy of ordering was defined according to adherence to a decision algorithm implemented in 2014.ResultsTotal and ionised calcium tests per patient-day of hospitalisation significantly decreased after the algorithm implementation; and duplication of tests (total and ionised calcium measured in the same blood sample) was reduced by 49%. Overall adequacy of ionised calcium determinations increased by 23% (P=0.0001) due to the increase in the adequacy of ionised calcium ordering in non-critical conditions.ConclusionsA decision algorithm can be a useful educational tool to improve adequacy of the process of ordering serum calcium tests.

Optimization of 3D Print Material for the Recreation of Patient-Specific Temporal Bone Models

2018 ◽  
Vol 127 (5) ◽  
pp. 338-343 ◽  
Author(s):  
Max Haffner ◽  
Austin Quinn ◽  
Tsung-yen Hsieh ◽  
E. Bradley Strong ◽  
Toby Steele
Keyword(s):  
Temporal Bone ◽  
Haptic Feedback ◽  
Acrylonitrile Butadiene Styrene ◽  
3D Models ◽  
Patient Specific ◽  
3D Print ◽  
Print Material ◽  
Unique Material ◽  
3D Printed ◽  
Study Participants

Objective: Identify the 3D printed material that most accurately recreates the visual, tactile, and kinesthetic properties of human temporal bone Subjects and Methods: Fifteen study participants with an average of 3.6 years of postgraduate training and 56.5 temporal bone (TB) procedures participated. Each participant performed a mastoidectomy on human cadaveric TB and five 3D printed TBs of different materials. After drilling each unique material, participants completed surveys to assess each model’s appearance and physical likeness on a Likert scale from 0 to 10 (0 = poorly representative, 10 = completely life-like). The 3D models were acquired by computed tomography (CT) imaging and segmented using 3D Slicer software. Results: Polyethylene terephthalate (PETG) had the highest average survey response for haptic feedback (HF) and appearance, scoring 8.3 (SD = 1.7) and 7.6 (SD = 1.5), respectively. The remaining plastics scored as follows for HF and appearance: polylactic acid (PLA) averaged 7.4 and 7.6, acrylonitrile butadiene styrene (ABS) 7.1 and 7.2, polycarbonate (PC) 7.4 and 3.9, and nylon 5.6 and 6.7. Conclusion: A PETG 3D printed temporal bone models performed the best for realistic appearance and HF as compared with PLA, ABS, PC, and nylon. The PLA and ABS were reliable alternatives that also performed well with both measures.

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