CC BY 4.0 · European J Pediatr Surg Rep. 2018; 06(01): e70-e76
DOI: 10.1055/s-0038-1672165
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Three-Dimensional Printed Model and Virtual Reconstruction: An Extra Tool for Pediatric Solid Tumors Surgery

Ángela Sánchez-Sánchez
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
Óscar Girón-Vallejo
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
Ramón Ruiz-Pruneda
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
Maria Fernandez-Ibieta
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
Darío García-Calderon
2   Cathedra of Multidisciplinary Oncology, UCAM, Murcia, Spain
,
Vanesa Villamil
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
María Cristina Giménez-Aleixandre
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
Carlos Andrés Montoya-Rangel
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
,
Juan Pedro Hernández Bermejo
1   Department of Pediatric Surgery, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
› Author Affiliations
Further Information

Publication History

24 July 2018

16 August 2018

Publication Date:
18 October 2018 (online)

Abstract

Introduction Three-dimensional (3D) technology is increasingly applied for planning challenging surgical interventions. We report our experience using 3D printing and virtual reconstruction for surgical planning of complex tumor resections in children.

Methods Data were obtained from preoperative magnetic resonance. imaging analysis and 3D virtual recreations were performed using specialized computer software. 3D real-scale geometry models, including tumor, adjacent organs, and relevant vascularization, were printed in colorimetric scale and different materials for optimal structures discrimination.

Results Four complex cases were selected. The first case was a bilateral Wilms tumor. The volumetric reconstruction proved the presence of enough healthy renal tissue, allowing bilateral nephron-sparing surgery. In the second case, reconstruction contributed to the location of pulmonary metastases. The third case was an abdominal neuroblastoma stage L2. The 3D model was of high value for planning and as a reference during the intervention. The last case is a cervico-thoracic neuroblastoma with an anatomopathological diagnosis of ganglioneuroma, located at the cervico-mediastinal juncture, in close relationship with the cervical vessels.

Conclusions 3D reconstruction and the full-scale printing models are a useful tool in cases of complex tumor resections as they contribute to a better understanding of the relationships between the tumor and adjacent organs, helping to anticipate certain surgical complications. They also provide additional information to conventional imaging tests, being able to influence therapeutic decisions and facilitate the understanding by the family, improving doctor–patient communication.

 
  • References

  • 1 Souzaki R, Kinoshita Y, Ieiri S. , et al. Preoperative surgical simulation of laparoscopic adrenalectomy for neuroblastoma using a three-dimensional printed model based on preoperative CT images. J Pediatr Surg 2015; 50 (12) 2112-2115
  • 2 Krauel L, Fenollosa F, Riaza L. , et al. Use of 3D prototypes for complex surgical oncologic cases. World J Surg 2016; 40 (04) 889-894
  • 3 Zhao J, Zhou XJ, Zhu CZ. , et al. 3D simulation assisted resection of giant hepatic mesenchymal hamartoma in children. Comput Assist Surg (Abingdon) 2017; 22 (01) 54-59
  • 4 Fuchs I, Tutschek B, Henrich W. Visualization of the fetal fontanels and skull sutures by three-dimensional translabial ultrasound during the second stage of labor. Ultrasound Obstet Gynecol 2008; 31 (04) 484-486
  • 5 Vijayavenkataraman S, Fuh JYH, Lu WF. 3D Printing and 3D bioprinting in pediatrics. Bioengineering (Basel) 2017; 4 (03) E63
  • 6 Günther P, Ley S, Tröger J. , et al. 3D perfusion mapping and virtual surgical planning in the treatment of pediatric embryonal abdominal tumors. Eur J Pediatr Surg 2008; 18 (01) 7-12
  • 7 Günther P, Schenk JP, Wunsch R, Tröger J, Waag KL. Abdominal tumours in children: 3-D visualisation and surgical planning. Eur J Pediatr Surg 2004; 14 (05) 316-321
  • 8 Xu G, Gao L, Tao K. , et al. Three-dimensional-printed upper limb prosthesis for a child with traumatic amputation of right wrist: a case report. Medicine (Baltimore) 2017; 96 (52) e9426
  • 9 Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 2001; 166 (01) 6-18
  • 10 Hamilton TE, Ritchey ML, Haase GM. , et al. The management of synchronous bilateral Wilms tumor: a report from the National Wilms Tumor Study Group. Ann Surg 2011; 253 (05) 1004-1010
  • 11 Kantaria PR, Pankhaniya SA. Implementation of 3D printer. Int J Technol Res Eng 2014; 1: 819-822
  • 12 Singare S, Lian Q, Wang WP. , et al. Rapid prototyping assisted surgery planning and custom implant design. Rapid Prototyping J 2009; 15: 19-23
  • 13 Rengier F, Mehndiratta A, von Tengg-Kobligk H. , et al. 3D printing based on imaging data: review of medical applications. Int J CARS 2010; 5 (04) 335-341
  • 14 Youssef RF, Spradling K, Yoon R. , et al. Applications of three-dimensional printing technology in urological practice. BJU Int 2015; 116 (05) 697-702
  • 15 Silberstein JL, Maddox MM, Dorsey P, Feibus A, Thomas R, Lee BR. Physical models of renal malignancies using standard cross-sectional imaging and 3-dimensional printers: a pilot study. Urology 2014; 84 (02) 268-272
  • 16 Ventola CL. Medical applications for 3D printing: current and projected uses. P&T 2014; 39 (10) 704-711
  • 17 Srougi V, Rocha BA, Tanno FY. , et al. The use of three-dimensional printers for partial adrenalectomy: estimating the resection limits. Urology 2016; 90: 217-220
  • 18 Zhang Y, Ge HW, Li NC. , et al. Evaluation of three-dimensional printing for laparoscopic partial nephrectomy of renal tumors: a preliminary report. World J Urol 2016; 34 (04) 533-537
  • 19 Komai Y, Sugimoto M, Gotohda N. , et al. Patient-specific 3-dimensional printed kidney designed for “4D” surgical navigation—a novel aid to facilitate minimally invasive off-clamp partial nephrectomy in complex tumor cases. Urology 2016; 91: 226-233
  • 20 Girón-Vallejo Ó, García-Calderón D, Ruiz-Pruneda R. , et al. Three-dimensional printed model of bilateral Wilms tumor: A useful tool for planning nephron sparing surgery. Pediatr Blood Cancer 2018;65(4)