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Published in: World Journal of Urology 2/2018

01-02-2018 | Original Article

Development and validation of 3D printed virtual models for robot-assisted radical prostatectomy and partial nephrectomy: urologists’ and patients’ perception

Authors: Francesco Porpiglia, Riccardo Bertolo, Enrico Checcucci, Daniele Amparore, Riccardo Autorino, Prokar Dasgupta, Peter Wiklund, Ashutosh Tewari, Evangelos Liatsikos, Cristian Fiori, The ESUT Research Group

Published in: World Journal of Urology | Issue 2/2018

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Abstract

Purpose

To test the face and content validity of 3D virtual-rendered printed models used before robot-assisted prostate cancer and nephron-sparing surgery.

Methods

Patients who underwent live surgery during an international urological meeting organized in January 2017 were enrolled. Those with organ-confined prostate cancer underwent robot-assisted radical prostatectomy. Patients with a single renal tumor underwent minimally invasive nephron-sparing surgery. High-resolution (HR) imaging was obtained for all patients. Those with kidney tumors received contrast-enhanced CT scan with angiography; those with prostate cancer underwent mp-MRI. Images in DICOM format were processed by dedicated software. The first step was the rendering of a 3D virtual model. The models were then printed. They were presented during the live surgery of the urological meeting. All the participants and the operated patients were asked to fill a questionnaire about their opinion expressed in Likert scale (1–10) about the use and application of the 3D printed models.

Results

18 patients were enrolled, including 8 undergoing robot-assisted radical prostatectomy and 10 undergoing minimally invasive partial nephrectomy. For each patient, a virtual 3D printed model was created. The attendants rated the utility of printed models in surgical planning, anatomical representation and the role of technology in surgical training as 8/10, 10/10 and 9/10, respectively. All patients reported favorable feedbacks (from 9 to 10/10) about the use of the technology during the case discussion with the surgeon.

Conclusions

In our experience, 3D printing technology has been perceived as a useful tool for the purpose of surgical planning, physician education/training and patient counseling. Further researches are expected to increase the level of evidence.
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Literature
1.
go back to reference Autorino R, Porpiglia F, Dasgupta P, Rassweiler J, Catto JW, Hampton LJ, Lima E, Mirone V, Derweesh IH, Debruyne FM (2017) Precision surgery and genitourinary cancers. Eur J Surg Oncol (Epub ahead of print) Autorino R, Porpiglia F, Dasgupta P, Rassweiler J, Catto JW, Hampton LJ, Lima E, Mirone V, Derweesh IH, Debruyne FM (2017) Precision surgery and genitourinary cancers. Eur J Surg Oncol (Epub ahead of print)
5.
go back to reference Bertolo RG, Zargar H, Autorino R, Fiori C, Kaouk JH, Russo P, Thompson RH, Porpiglia F (2017) Estimated glomerular filtration rate, renal scan and volumetric assessment of the kidney before and after partial nephrectomy: a review of the current literature. Minerva Urol Nefrol (Epub ahead of print) Bertolo RG, Zargar H, Autorino R, Fiori C, Kaouk JH, Russo P, Thompson RH, Porpiglia F (2017) Estimated glomerular filtration rate, renal scan and volumetric assessment of the kidney before and after partial nephrectomy: a review of the current literature. Minerva Urol Nefrol (Epub ahead of print)
6.
go back to reference Borofsky MS, Gill IS, Hemal AK, Marien TP, Jayaratna I, Krane LS, Stifelman MD (2013) Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischaemia robotic partial nephrectomy. BJU Int 111(4):604–610CrossRefPubMed Borofsky MS, Gill IS, Hemal AK, Marien TP, Jayaratna I, Krane LS, Stifelman MD (2013) Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischaemia robotic partial nephrectomy. BJU Int 111(4):604–610CrossRefPubMed
7.
go back to reference Maurer T, Weirich G, Schottelius M, Weineisen M, Frisch B, Okur A, Kübler H, Thalgott M, Navab N, Schwaiger M, Wester HJ, Gschwend JE, Eiber M (2015) Prostate-specific membrane antigen-radioguided surgery for metastatic lymph nodes in prostate cancer. Eur Urol 68(3):530–534CrossRefPubMed Maurer T, Weirich G, Schottelius M, Weineisen M, Frisch B, Okur A, Kübler H, Thalgott M, Navab N, Schwaiger M, Wester HJ, Gschwend JE, Eiber M (2015) Prostate-specific membrane antigen-radioguided surgery for metastatic lymph nodes in prostate cancer. Eur Urol 68(3):530–534CrossRefPubMed
8.
go back to reference Youssef RF, Spradling K, Yoon R et al (2015) Applications of three-dimensional printing technology in urological practice. BJU Int. 116(5):697–702CrossRefPubMed Youssef RF, Spradling K, Yoon R et al (2015) Applications of three-dimensional printing technology in urological practice. BJU Int. 116(5):697–702CrossRefPubMed
9.
go back to reference Shin T, Ukimura O, Gill IS (2016) Three-dimensional printed model of prostate anatomy and targeted biopsy-proven index tumor to facilitate nerve-sparing prostatectomy. Eur Urol 69(2):377–379CrossRefPubMed Shin T, Ukimura O, Gill IS (2016) Three-dimensional printed model of prostate anatomy and targeted biopsy-proven index tumor to facilitate nerve-sparing prostatectomy. Eur Urol 69(2):377–379CrossRefPubMed
10.
go back to reference Von Rundstedt FC, Scovell JM, Agrawal S, Zaneveld J, Link RE (2017) Utility of patient-specific silicone renal models for planning and rehearsal of complex tumour resections prior to robot-assisted laparoscopic partial nephrectomy. BJU Int 119(4):598–604CrossRef Von Rundstedt FC, Scovell JM, Agrawal S, Zaneveld J, Link RE (2017) Utility of patient-specific silicone renal models for planning and rehearsal of complex tumour resections prior to robot-assisted laparoscopic partial nephrectomy. BJU Int 119(4):598–604CrossRef
11.
go back to reference Gravetter Frederick J, Forzano Lori-Ann B (2012) Research methods for the behavioral sciences, 4th edn. Wadsworth, Belmont, p 78 Gravetter Frederick J, Forzano Lori-Ann B (2012) Research methods for the behavioral sciences, 4th edn. Wadsworth, Belmont, p 78
12.
13.
go back to reference Bernhard JC, Isotani S, Matsugasumi T, Duddalwar V, Hung AJ, Suer E, Baco E, Satkunasivam R, Djaladat H, Metcalfe C, Hu B, Wong K, Park D, Nguyen M, Hwang D, Bazargani ST, de Castro Abreu AL, Aron M, Ukimura O, Gill IS (2016) Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol 34(3):337–345CrossRefPubMed Bernhard JC, Isotani S, Matsugasumi T, Duddalwar V, Hung AJ, Suer E, Baco E, Satkunasivam R, Djaladat H, Metcalfe C, Hu B, Wong K, Park D, Nguyen M, Hwang D, Bazargani ST, de Castro Abreu AL, Aron M, Ukimura O, Gill IS (2016) Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education. World J Urol 34(3):337–345CrossRefPubMed
14.
go back to reference Hurson C, Tansey A, O’Donnchadha B, Nicholson P, Rice J, McElwain J (2007) Rapid prototyping in the assessment, classification and preoperative planning of acetabular fractures. Injury 38(10):1158–1162CrossRefPubMed Hurson C, Tansey A, O’Donnchadha B, Nicholson P, Rice J, McElwain J (2007) Rapid prototyping in the assessment, classification and preoperative planning of acetabular fractures. Injury 38(10):1158–1162CrossRefPubMed
15.
go back to reference Spottiswoode BS, van den Heever DJ, Chang Y, Engelhardt S, Du Plessis S, Nicolls F, Hartzenberg HB, Gretschel A (2013) Preoperative three-dimensional model creation of magnetic resonance brain images as a tool to assist neurosurgical planning. Stereotact Funct Neurosurg 91(3):162–169CrossRefPubMed Spottiswoode BS, van den Heever DJ, Chang Y, Engelhardt S, Du Plessis S, Nicolls F, Hartzenberg HB, Gretschel A (2013) Preoperative three-dimensional model creation of magnetic resonance brain images as a tool to assist neurosurgical planning. Stereotact Funct Neurosurg 91(3):162–169CrossRefPubMed
16.
go back to reference Schmauss D, Gerber N, Sodian R (2013) Three-dimensional printing of models for surgical planning in patients with primary cardiac tumors. J Thorac Cardiovasc Surg 145(5):1407–1408CrossRefPubMed Schmauss D, Gerber N, Sodian R (2013) Three-dimensional printing of models for surgical planning in patients with primary cardiac tumors. J Thorac Cardiovasc Surg 145(5):1407–1408CrossRefPubMed
17.
go back to reference Ukimura O, Aron M, Nakamoto M, Shoji S, Abreu AL, Matsugasumi T, Berger A, Desai M, Gill IS (2014) Three-dimensional surgical navigation model with TilePro display during robot-assisted radical prostatectomy. J Endourol 28(6):625–630CrossRefPubMed Ukimura O, Aron M, Nakamoto M, Shoji S, Abreu AL, Matsugasumi T, Berger A, Desai M, Gill IS (2014) Three-dimensional surgical navigation model with TilePro display during robot-assisted radical prostatectomy. J Endourol 28(6):625–630CrossRefPubMed
18.
go back to reference Ukimura O, Nakamoto M, Gill IS (2012) Three-dimensional reconstruction of renovascular-tumor anatomy to facilitate zero-ischemia partial nephrectomy. Eur Urol 61(1):211–217CrossRefPubMed Ukimura O, Nakamoto M, Gill IS (2012) Three-dimensional reconstruction of renovascular-tumor anatomy to facilitate zero-ischemia partial nephrectomy. Eur Urol 61(1):211–217CrossRefPubMed
19.
go back to reference Porpiglia F, Manfredi M, Checcucci E, Mele F, Bertolo R, De Luca S, Garrou D, Cattaneo G, Amparore D, Fiori C (2017) 66–3D prostate MRI reconstruction for cognitive robot assisted radical prostatectomy: Is it able to reduce the positive surgical margin rate? Eur Urol Suppl 16(3):e110CrossRef Porpiglia F, Manfredi M, Checcucci E, Mele F, Bertolo R, De Luca S, Garrou D, Cattaneo G, Amparore D, Fiori C (2017) 66–3D prostate MRI reconstruction for cognitive robot assisted radical prostatectomy: Is it able to reduce the positive surgical margin rate? Eur Urol Suppl 16(3):e110CrossRef
20.
go back to reference Ayodeji ID, Schijven M, Jakimowicz J, Greve JW (2007) Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum. Surg Endosc 21(9):1641–1649CrossRefPubMed Ayodeji ID, Schijven M, Jakimowicz J, Greve JW (2007) Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum. Surg Endosc 21(9):1641–1649CrossRefPubMed
21.
go back to reference Hruby GW, Sprenkle PC, Abdelshehid C, Clayman RV, McDougall EM, Landman J (2008) The EZ trainer: validation of a portable and inexpensive simulator for training basic laparoscopic skills. J Urol 179(2):662–666CrossRefPubMed Hruby GW, Sprenkle PC, Abdelshehid C, Clayman RV, McDougall EM, Landman J (2008) The EZ trainer: validation of a portable and inexpensive simulator for training basic laparoscopic skills. J Urol 179(2):662–666CrossRefPubMed
22.
go back to reference Koch AD, Buzink SN, Heemskerk J, Botden SM, Veenendaal R, Jakimowicz JJ, Schoon EJ (2008) Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy. Surg Endosc 22(1):158–162CrossRefPubMed Koch AD, Buzink SN, Heemskerk J, Botden SM, Veenendaal R, Jakimowicz JJ, Schoon EJ (2008) Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy. Surg Endosc 22(1):158–162CrossRefPubMed
23.
go back to reference Schijven M, Jakimowicz J (2002) Face-, expert, and referent validity of the Xitact LS500 laparoscopy simulator. Surg Endosc 16(12):1764–1770CrossRefPubMed Schijven M, Jakimowicz J (2002) Face-, expert, and referent validity of the Xitact LS500 laparoscopy simulator. Surg Endosc 16(12):1764–1770CrossRefPubMed
24.
go back to reference Schout BM, Bemelmans BL, Martens EJ, Scherpbier AJ, Hendrikx AJ (2009) How useful and realistic is the uro trainer for training transurethral prostate and bladder tumor resection procedures? J Urol 181(3):1297–1303CrossRefPubMed Schout BM, Bemelmans BL, Martens EJ, Scherpbier AJ, Hendrikx AJ (2009) How useful and realistic is the uro trainer for training transurethral prostate and bladder tumor resection procedures? J Urol 181(3):1297–1303CrossRefPubMed
25.
go back to reference Zhang Y, Ge HW, Li NC, Yu CF, Guo HF, Jin SH, Liu JS, Na YQ (2016) Evaluation of three-dimensional printing for laparoscopic partial nephrectomy of renal tumors: a preliminary report. World J Urol 34(4):533–537CrossRefPubMed Zhang Y, Ge HW, Li NC, Yu CF, Guo HF, Jin SH, Liu JS, Na YQ (2016) Evaluation of three-dimensional printing for laparoscopic partial nephrectomy of renal tumors: a preliminary report. World J Urol 34(4):533–537CrossRefPubMed
26.
go back to reference Golab A, Smektala T, Kaczmarek K, Stamirowski R, Hrab M, Slojewski M (2017) Laparoscopic partial nephrectomy supported by training involving personalized silicone replica poured in three-dimensional printed casting mold. J Laparoendosc Adv Surg Tech A (Epub ahead of print) Golab A, Smektala T, Kaczmarek K, Stamirowski R, Hrab M, Slojewski M (2017) Laparoscopic partial nephrectomy supported by training involving personalized silicone replica poured in three-dimensional printed casting mold. J Laparoendosc Adv Surg Tech A (Epub ahead of print)
27.
go back to reference Silberstein JL, Maddox MM, Dorsey P, Feibus A, Thomas R, Lee BR (2014) Physical models of renal malignancies using standard cross-sectional imaging and 3-dimensional printers: a pilot study. Urology. 84(2):268–272CrossRefPubMed Silberstein JL, Maddox MM, Dorsey P, Feibus A, Thomas R, Lee BR (2014) Physical models of renal malignancies using standard cross-sectional imaging and 3-dimensional printers: a pilot study. Urology. 84(2):268–272CrossRefPubMed
28.
go back to reference Knoedler M, Feibus AH, Lange A, Maddox MM, Ledet E, Thomas R, Silberstein JL (2015) individualized physical 3-dimensional kidney tumor models constructed from 3-dimensional printers result in improved trainee anatomic understanding. Urology 85(6):1257–1261CrossRefPubMed Knoedler M, Feibus AH, Lange A, Maddox MM, Ledet E, Thomas R, Silberstein JL (2015) individualized physical 3-dimensional kidney tumor models constructed from 3-dimensional printers result in improved trainee anatomic understanding. Urology 85(6):1257–1261CrossRefPubMed
29.
go back to reference Srougi V, Rocha BA, Tanno FY, Almeida MQ, Baroni RH, Mendonça BB, Srougi M, Fragoso MC, Chambô JL (2016) the use of three-dimensional printers for partial adrenalectomy: estimating the resection limits. Urology 90:217–220CrossRefPubMed Srougi V, Rocha BA, Tanno FY, Almeida MQ, Baroni RH, Mendonça BB, Srougi M, Fragoso MC, Chambô JL (2016) the use of three-dimensional printers for partial adrenalectomy: estimating the resection limits. Urology 90:217–220CrossRefPubMed
Metadata
Title
Development and validation of 3D printed virtual models for robot-assisted radical prostatectomy and partial nephrectomy: urologists’ and patients’ perception
Authors
Francesco Porpiglia
Riccardo Bertolo
Enrico Checcucci
Daniele Amparore
Riccardo Autorino
Prokar Dasgupta
Peter Wiklund
Ashutosh Tewari
Evangelos Liatsikos
Cristian Fiori
The ESUT Research Group
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 2/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-017-2126-1

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