3-dimensional model rendering and printing: enhanced visualisation for complex multi-compartment cases

Gavin J. Carmichael; John Kefalianos; Joshua Kovoor; Riteesh Bookun; Bruce Stewart; Lydia Johns-Putra; Mathew O. Jacob

doi:10.18203/2349-2902.isj20253459

Authors

Gavin J. Carmichael Grampians Research Initiative (GRIT), Ballarat, Victoria, Australia
John Kefalianos Department of Surgery, Grampians Health, Ballarat, Victoria, Australia https://orcid.org/0000-0002-5910-5224
Joshua Kovoor The University of Adelaide, Adelaide, South Australia, Australia https://orcid.org/0000-0002-3880-3840
Riteesh Bookun Department of Vascular Surgery, Grampians Health, Ballarat, Victoria, Australia https://orcid.org/0000-0002-6283-5826
Bruce Stewart The University of Melbourne, Ballarat, Victoria, Australia
Lydia Johns-Putra Department of Urology, Grampians Health, Ballarat, Victoria, Australia
Mathew O. Jacob Department of Urology, Grampians Health, Ballarat, Victoria, Australia https://orcid.org/0000-0002-5692-8241

DOI:

https://doi.org/10.18203/2349-2902.isj20253459

Keywords:

Printing, Three-dimensional, Colorectal surgery, Urology

Abstract

Complex surgical oncology demands meticulous preoperative planning, particularly in multi-specialty surgeries. Aligning surgical objectives, considering factors such as surgical intent, approach feasibility and minimization of trauma, is crucial. While traditional imaging modalities like MRI and CT are invaluable for planning, the integration of 3D modelling can provide enhanced visualisation of patient-specific anatomy and pathology. A 3D model was generated from MRI scans using 3DSlicer® software for segmentation and MeshLab® for refinement. Structures such as the bladder, rectum and prostate were manually contoured. The model was printed using a Bambu® Lab A1 3D printer with PLA filament. The printed model informed surgical planning for a multidisciplinary team managing a 60-year-old man with advanced bladder cancer invading the rectum. The 3D model provided detailed spatial understanding of anatomical relationships, improving preoperative planning and intraoperative execution. The surgical procedure, including cystoprostatectomy and Hartmann’s procedure, was successful, with the 3D model providing guidance in the approach and enhancing collaboration among team members. The model’s contribution extended beyond visualisation. It optimized surgical strategy by aiding in delineation of the tumour and enhancing interdisciplinary communication. Its educational utility helped trainees & students grasp pelvic anatomy and surgical techniques. Limitations included time-intensive manual segmentation and reliance on high-resolution imaging. Future advancements, such as automated segmentation and augmented reality, could improve efficiency and intraoperative applicability. 3D modelling and printing proved valuable in managing a rare, complex surgical case, fostering interdisciplinary collaboration and improved patient care. Further research and development could broaden its adoption and impact in surgical practice.

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References

Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, et al. The role of 3D printing in planning complex medical procedures and training of medical professionals-cross-sectional multispecialty review. Int J Environ Res Public Health. 2022;19(6):43. DOI: https://doi.org/10.3390/ijerph19063331

Martelli N, Serrano C, van den Brink H, Pineau J, Prognon P, Borget I, et al. Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review. Surgery. 2016;159(6):1485-500. DOI: https://doi.org/10.1016/j.surg.2015.12.017

Pietrabissa A, Marconi S, Negrello E, Mauri V, Peri A, Pugliese L, et al. An overview on 3D printing for abdominal surgery. Surgical Endoscopy. 2020;34(1):1-13. DOI: https://doi.org/10.1007/s00464-019-07155-5

Witowski JS, Coles-Black J, Zuzak TZ, Pędziwiatr M, Chuen J, Major P, et al. 3D Printing in Liver Surgery: A Systematic Review. Telemedicine and e-Health. 2017;23(12):943-7. DOI: https://doi.org/10.1089/tmj.2017.0049

Fadero PE, Shah M. Three dimensional (3D) modelling and surgical planning in trauma and orthopaedics. Surgeon. 2014;12(6):328-33. DOI: https://doi.org/10.1016/j.surge.2014.03.008

Shabbak A, Masoumkhani F, Fallah A, Amani-Beni R, Mohammadpour H, Shahbazi T, et al. 3D printing for cardiovascular surgery and intervention: a review article. Curr Prob Cardiol. 2024;49(1):102086. DOI: https://doi.org/10.1016/j.cpcardiol.2023.102086

Huang X, Fan N, Wang H-j, Zhou Y, Li X, Jiang X-B. Application of 3D printed model for planning the endoscopic endonasal transsphenoidal surgery. Scientific Reports. 2021;11(1):5333. DOI: https://doi.org/10.1038/s41598-021-84779-5

Moore RA, Riggs KW, Kourtidou S, Schneider K, Szugye N, Troja W, et al. Three-dimensional printing and virtual surgery for congenital heart procedural planning. Birth Def Res. 2018;110(13):1082-90. DOI: https://doi.org/10.1002/bdr2.1370

Auricchio F, Marconi S. 3D printing: clinical applications in orthopaedics and traumatology. EFORT Open Rev. 2016;1(5):121-7. DOI: https://doi.org/10.1302/2058-5241.1.000012

Robb H, Scrimgeour G, Boshier P, Przedlacka A, Balyasnikova S, Brown G, et al. The current and possible future role of 3D modelling within oesophagogastric surgery: a scoping review. Surg Endosc. 2022;36(8):5907-20. DOI: https://doi.org/10.1007/s00464-022-09176-z

Habermann AC, Timmerman WR, Cohen SM, Burkhardt BW, Amendola MF. Clinical applications of 3D printing in colorectal surgery: A systematic review. International J Colorec Dis. 2024;39(1):127. DOI: https://doi.org/10.1007/s00384-024-04695-8

AlAli AB, Griffin MF, Calonge WM, Butler PE. Evaluating the Use of Cleft Lip and Palate 3D-Printed Models as a Teaching Aid. J Surg Educ. 2018;75(1):200-8. DOI: https://doi.org/10.1016/j.jsurg.2017.07.023

Biglino G, Capelli C, Koniordou D, Robertshaw D, Leaver LK, Schievano S, et al. Use of 3D models of congenital heart disease as an education tool for cardiac nurses. Congenit Heart Dis. 2017;12(1):113-8. DOI: https://doi.org/10.1111/chd.12414

Branson TM, Shapiro L, Venter RG. Observation of Patients' 3D Printed Anatomical Features and 3D Visualisation Technologies Improve Spatial Awareness for Surgical Planning and in-Theatre Performance. Adv Exp Med Biol. 2021;1334:23-37. DOI: https://doi.org/10.1007/978-3-030-76951-2_2

Hammoudeh JA, Howell LK, Boutros S, Scott MA, Urata MM. Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning. Plast Reconstr Surg Glob Open. 2015;3(2):307. DOI: https://doi.org/10.1097/GOX.0000000000000184

Hua J, Aziz S, Shum JW. Virtual Surgical Planning in Oral and Maxillofacial Surgery. Oral Maxillofac Surg Clin North Am. 2019;31(4):519-30. DOI: https://doi.org/10.1016/j.coms.2019.07.011

Dobson HD, Pearl RK, Orsay CP, Rasmussen M, Evenhouse R, Ai Z, et al. Virtual reality: new method of teaching anorectal and pelvic floor anatomy. Dis Colon Rectum. 2003;46(3):349-52. DOI: https://doi.org/10.1007/s10350-004-6554-9

Pujol S, Baldwin M, Nassiri J, Kikinis R, Shaffer K. Using 3D Modeling Techniques to Enhance Teaching of Difficult Anatomical Concepts. Acad Radiol. 2016;23(4):507-16. DOI: https://doi.org/10.1016/j.acra.2015.12.012

Hojo D, Murono K, Nozawa H, Kawai K, Hata K, Tanaka T, et al. Utility of a Three-Dimensional Printed Pelvic Model for Lateral Pelvic Lymph Node Dissection Education: A Randomized Controlled Trial. J American Coll Surg. 2019;229(6):87. DOI: https://doi.org/10.1016/j.jamcollsurg.2019.08.1443

Bangeas P, Drevelegas K, Agorastou C, Tzounis L, Chorti A, Paramythiotis D, et al. Three-dimensional printing as an educational tool in colorectal surgery. FBE. 2019;11(1):29-37. DOI: https://doi.org/10.2741/e844

Traynor G, Shearn AI, Milano EG, Ordonez MV, Velasco Forte MN, Caputo M, et al. The use of 3D-printed models in patient communication: a scoping review. J 3D Print Med. 2022;6(1):13-23. DOI: https://doi.org/10.2217/3dp-2021-0021

Zhuang YD, Zhou MC, Liu SC, Wu JF, Wang R, Chen CM. Effectiveness of personalized 3D printed models for patient education in degenerative lumbar disease. Patient Edu Couns. 2019;102(10):1875-81. DOI: https://doi.org/10.1016/j.pec.2019.05.006

Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care. A systematic review and methodologic critique of the literature. Ann Intern Med. 2002;137(6):511-20. DOI: https://doi.org/10.7326/0003-4819-137-6-200209170-00012

Auerbach AD, Maselli J, Carter J, Pekow PS, Lindenauer PK. The relationship between case volume, care quality, and outcomes of complex cancer surgery. J Am Coll Surg. 2010;211(5):601-8. DOI: https://doi.org/10.1016/j.jamcollsurg.2010.07.006

Küstner T, Hepp T, Fischer M, Schwartz M, Fritsche A, Häring H-U, et al. Fully Automated and Standardized Segmentation of Adipose Tissue Compartments via Deep Learning in 3D Whole-Body MRI of Epidemiologic Cohort Studies. Radiology: Artificial Intell. 2020;2(6):200010. DOI: https://doi.org/10.1148/ryai.2020200010

Hamabe A, Ishii M, Kamoda R, Sasuga S, Okuya K, Okita K, et al. Artificial intelligence-based technology to make a three-dimensional pelvic model for preoperative simulation of rectal cancer surgery using MRI. Ann Gastroenterol Surg. 2022;6(6):788-94. DOI: https://doi.org/10.1002/ags3.12574

Andrew TW, Baylan J, Mittermiller PA, Cheng H, Johns DN, Edwards MSB, et al. Virtual Surgical Planning Decreases Operative Time for Isolated Single Suture and Multi-suture Craniosynostosis Repair. Plast Reconstr Surg Glob Open. 2018;6(12):2038. DOI: https://doi.org/10.1097/GOX.0000000000002038

Lee YJ, Oh JH, Kim SG. Virtual surgical plan with custom surgical guide for orthognathic surgery: systematic review and meta-analysis. Maxillofacial Plast Reconstr Surg. 2024;46(1):39. DOI: https://doi.org/10.1186/s40902-024-00449-2

Bollen E, Awad L, Langridge B, Butler PEM. The intraoperative use of augmented and mixed reality technology to improve surgical outcomes: A systematic review. Int J Med Robot. 2022;18(6):2450. DOI: https://doi.org/10.1002/rcs.2450