Objective To evaluate the effect of the 3D-printed heart model on congenital heart disease (CHD) education through systematic review and meta-analysis. Methods The literature about the application of the 3D-printed heart model in CHD education was systematically searched by computer from PubMed, Web of Science, and EMbase from inception to November 10, 2022. The two researchers independently screened the literature, extracted data and evaluated the quality of the literature. Cochrane literature evaluation standard was used to evaluate the quality of randomized controlled trials, and JBI evaluation scale was used for cross-sectional and cohort studies. ResultsAfter screening, 23 literatures were included, including 7 randomized controlled trials, 15 cross-sectional studies and 1 cohort study. Randomized controlled trials were all at low-risk, cross-sectional studies and and the cohort study had potential bias. There were 4 literatures comparing 3D printing heart model with 2D image teaching and the meta-analysis result showed that the effect of 3D printing heart model on theoretical achievement was more significant compared with 2D image teaching (SMD=0.31, 95%CI –0.28 to 0.91, P=0.05). Conclusion The application of the 3D-printed heart model in CHD education can be beneficial. But more randomized controlled trials are still needed to verify this result.
ObjectiveTo explore the feasibility of lumbar puncture models based on 3D printing technology for training junior orthopaedic surgeons to find the optimal pedicle screw insertion points.MethodsMimics software was used to design 3D models of lumbar spine with the optimal channels and alternative channels. Then, the printed lumbar spine models, plasticine, and cloth were used to build lumbar puncture models. From January 2018 to June 2019, 43 orthopedic trainees performed simulated operations to search for the insertion points of pedicle screws base on the models. The operations were performed once a day for 10 consecutive days, and the differences in operation scores and operation durations of the trainees among the 10 days were compared.ResultsAll the trainees completed the surgical training operations successfully, and there were significant differences in the operation scores (13.05±2.45, 14.02±3.96, 17.58±3.46, 21.02±2.04, 23.40±4.08, 25.14±3.72, 27.26±6.09, 33.37±4.23, 35.00±4.15, 38.49±1.70; F=340.604, P<0.001) and operation durations [(22.51±4.28), (19.93±4.28), (18.05±2.89), (17.05±1.76), (16.98±1.97), (15.47±1.74), (13.51±1.42), (12.60±2.17), (12.44±1.71), (11.91±1.87) minutes; F=102.359, P<0.001] among the 10 days.ConclusionThe 3D models of lumbar puncture are feasible and repeatable, which can contribute to surgical training.
ObjectiveTo explore clinical value of 3D printing technology in hepatic resection.
MethodsFrom March to May 2015, multidetector-row computed tomography images of 12 patients, including hepatic carcinoma in 6, hepatic hemangioma in 3, intra-and extra-hepatic bile duct stones in 3, were used for 3D hepatic reconstruction, the final segmentation data were converted to stereolithography files for 3D printing, 50%-70% scale of the full-sized liver model was fabricated by polylactic acid to be used to analyze its anatomical structure, design surgical planning, select the optimal operative route and simulate hepatic resection. Hepatic resection was performed by referring to the 3D printing model.
ResultsThe hepatic resections were successful without complications by referring to the preoperative 3D printing models, the average blood loss was 340(100-1000) mL.
ConclusionHepatic resection is more accurate and safe by 3D printing technology.
Shear thinning is an ideal feature of bioink because it can reduce the chance of blocking. For extrusion based biological printing, bioink will experience shear force when passing through the biological printer. The shear rate will increase with the increase of extrusion rate, and the apparent viscosity of shear-thinning bioink will decrease, which makes it easier to block, thus achieving the structural fidelity of 3D printing tissue. The manufacturing of complex functional structures in tissue trachea requires the precise placement and coagulation of bioink layer by layer, and the shear-thinning bioink may well meet this requirement. This review focuses on the importance of mechanical properties, classification and preparation methods of shear-thinning bioink, and lists its current application status in 3D printing tissue trachea to discuss the more possibilities and prospects of this biological material in tissue trachea.
ObjectiveTo explore the clinical applications of 3D-CT reconstruction combined with 3D printing in the analysis of anatomical types and variations of bilateral pulmonary arteries. MethodsFrom January 2019 to February 2022, the clinical data of 547 patients who underwent anatomical lung lesion resection in our hospital were retrospectively collected. They were divided into a 3D-CT reconstruction plus printing technology group (n=298, 87 males and 211 females aged 53.84±12.94 years), a 3D-CT reconstruction group (n=148, 55 males and 93 females aged 54.21±11.39 years), and a non-3D group (n=101, 28 males and 73 females aged 53.17±10.60 years). ResultsIn the 3D-CT reconstruction plus printing technology group, the operation time of patients (right: 125.61±20.99 min, left: 119.26±28.44 min) was shorter than that in the 3D-CT reconstruction group (right: 130.48±11.28 min, left: 125.51±10.59 min) and non-3D group (right: 134.45±10.20 min, left: 130.44±9.53 min), which was not associated with the site of surgery; intraoperative blood loss (right: 20.92±8.22 mL, left: 16.85±10.43 mL) was not statistically different compared with the 3D-CT reconstruction group (right: 21.13±8.97 mL, left: 19.09±7.01 mL), but was less than that of the non-3D group (right: 24.44±10.72 mL, left: 23.72±11.45 mL). Variation was found in the right pulmonary artery of 7 (3.91%) patients and in the left pulmonary artery of 21 (17.65%) patients. We first found four-branched lingual pulmonary artery in 2 patients.ConclusionPreoperative CT image computer-assisted 3D reconstruction combined with 3D printing technology can help surgeons to formulate accurate surgical plans, shorten operation time and reduce intraoperative blood loss.
The esophageal disease is a major clinical disease. The esophageal stent has extensive clinical applications in the treatment of esophageal diseases. However, the clinical application of esophageal stent is limited, because there are lots of complications after implantation of esophageal stent. Biodegradable esophageal stent has two advantages: biodegradability and good histocompatibility. It is expected to solve a variety of complications of esophageal stent and provide a new choice for the treatment of esophageal diseases. Standardized esophageal stents are not fully applicable to all patients. The application of 3D printing technology in the manufacture of biodegradable esophageal stent can realize the individualized treatment of esophageal stent. And meanwhile, the 3D printing technology can reduce the manufacturing cost of the stent. This review aimed to summarize and discuss the application of esophageal stent, the current research status and prospect of biodegradable esophageal stent and the prospect of 3D printing technology in degradable esophageal stent, hoping to provide evidence and perspectives for the research of biodegradable esophageal stent.
Congenital tracheal stenosis (CTS) is a rare but potentially life-threatening disease which results in congnital airway lesion. CTS is often associated with cardiovascular anomalies and presented with a wide spectrum of symptoms. CTS has challenged pediatric surgeons for decades. Various classic approaches and new techniques, including computational fluid dynamics, tissue-engineering trachea, and 3D printing have been proposed for diagnosis and treatment of CTS. This review provides a snapshot of the main progress of diagnosis and treatment of CTS.
ObjectiveTo evaluate the clinical value of three-dimensional (3D) printing model in accurate and minimally invasive treatment of double outlet right ventricle (DORV).MethodsFrom August 2018 to August 2019, 35 patients (22 males and 13 females) with DORV aged from 5 months to 17 years were included in the study. Their mean weight was 21.35±8.48 kg. Ten patients who received operations guided by 3D printing model were allocated to a 3D printing model group, and the other 25 patients who received operations without guidance by 3D printing model were allocated to a non-3D printing model group. Preoperative transthoracic echocardiography and CT angiography were performed to observe the location and diameter of ventricular septal defect (VSD), and to confirm the relationship between VSD and double arteries.ResultsThe McGoon index of patients in the 3D printing model group was 1.91±0.70. There was no statistical difference in the size of VSD (13.20±4.57 mm vs. 13.40±5.04 mm, t=?0.612, P=0.555), diameter of the ascending aorta (17.10±2.92 mm vs. 16.90±3.51 mm, t=0.514, P=0.619) or diameter of pulmonary trunk (12.50±5.23 mm vs. 12.90±4.63 mm, t=?1.246, P=0.244) between CT and 3D printing model measurements. The Pearson correlation coefficients were 0.982, 0.943 and 0.975, respectively. The operation time, endotracheal intubation time, ICU stay time and hospital stay time in the 3D printing model group were all shorter than those in the non-3D printing model group (P<0.05).ConclusionThe relationship between VSD and aorta and pulmonary artery can be observed from a 3D perspective by 3D printing technology, which can guide the preoperative surgical plans, assist physicians to make reasonable and effective decisions, shorten intraoperative exploration time and operation time, and decrease the surgery-related risks.
Objective To compare the effect of three-dimensional visual (3DV) model, three-dimensional printing (3DP) model and computer-aided design (CAD) modified 3DP model in video-assisted thoracoscopic surgery (VATS) sublobular resection. MethodsThe clinical data of patients who underwent VATS sublobular resection in the Affiliated Hospital of Hebei University from November 2021 to August 2022 were retrospectively analyzed. The patients were divided into 3 groups including a 3DV group, a 3DP group and a CAD-3DP group according to the tools used. The perioperative indexes and subjective evaluation of operators, patients and their families were compared. ResultsA total of 22 patients were included. There were 5 males and 17 females aged 32-77 (56.95±12.50) years. There were 9 patients in the 3DV group, 6 patients in the 3DP group, and 7 patients in the CAD-3DP group. There was no statistical difference in the operation time, intraoperative blood loss, drainage volume, hospital stay time or postoperative complications among the groups (P>0.05). Based on the subjective evaluations of 4 surgeons, the CAD-3DP group was better than the 3DV group in the preoperative planning efficiency (P=0.025), intuitiveness (P=0.045) and doctor-patient communication difficulty (P=0.034); the CAD-3DP group was also better than the 3DP group in the overall satisfaction (P=0.023), preoperative planning difficulty (P=0.046) and efficiency (P=0.014). Based on the subjective evaluations of patients and their families, the CAD-3DP group was better than the 3DP group in helping understand the vessel around the tumor (P=0.016), surgical procedure (P=0.020), procedure selection (P=0.029), and overall satisfaction (P=0.048); the CAD-3DP group was better than the 3DV group in helping understand the tumor size (P=0.038). ConclusionCAD-modified 3DP model has certain advantages in pre-planning, intraoperative navigation and doctor-patient communication in the VATS sublobectomy.
The incidence of valvular heart disease (VHD) increases with age, and its principal therapy is valve replacement. However, in recent years, the emergence of transcatheter interventions has changed the traditional therapy, making high-risk patients of surgery see dawn of hope. 3D printing technology has developed rapidly since it was applied to the medical field in 1990. Moreover, it has been widely applied in many surgical majors via refined reduction technology. However, the application of 3D printing technology in cardiovascular surgery is still in the preliminary stage, especially in the field of VHD. This article aims to review basic principles of 3D printing technology, its advantages in the therapy of VHD, and its current status of clinical application. Furthermore, this article elaborates current problems and looks forward to the future development direction.
