Cysto-Vaginoscopy of a 3D-Printed Cloaca Model: A Step toward Personalized Noninvasive Preoperative Assessment in Patients with Complex Anorectal Malformations

Abstract

Introduction For the classification of the complexity of cloacal malformations and the decision on the operative approach, an exact anatomical assessment is mandatory. To benefit from using three-dimensional (3D)-printed models in preoperative planning and training, the practicability of these models should be guaranteed. The aim of this study was to evaluate the quality and feasibility of a real-size 3D-printed cloaca model for the purpose of cysto-vaginoscopic evaluation. Materials and Methods We performed a 3D reconstruction and printed a real-size, rubber-like 3D model of an infant pelvis with a cloacal malformation and asked invited pediatric surgeons and pediatric urologists to perform a cysto-vaginoscopy on the model and to complete a brief questionnaire to rate the quality and feasibility of the model and to indicate whether they would recommend the model for preoperative planning and training. Results Overall, 41 participants rated the model quality as good to very good (M = 3.28, standard deviation [SD] = 0.50, on a scale from 1 to 4). The model was rated as feasible for preoperative training (M = 4.10, SD = 0.75, on a scale from 1 to 5) and most participants (85.4%) would recommend the model for preoperative training. The cysto-vaginoscopy of the model was considered as a valid training tool for real-life cases and improved the confidence on the anatomy of a cloaca. Conclusion The results of our study indicate that patient-specific 3D-printed models might be a useful tool in the preoperative evaluation of complex anorectal malformations by simulation of cysto-vaginoscopy with an excellent view on anatomical structures to assess the whole spectrum of the individual cloacal malformation. Our model might be a valuable add-on tool for specialty training in pediatric colorectal surgery.

Correlation Analysis of Serum Pepsinogen, Interleukin, and TNF-α with Hp Infection in Patients with Gastric Cancer: A Randomized Parallel Controlled Clinical Study

“…Hp infection is an important trigger of chronic gastritis and peptic ulcer, and research data show that some immune mechanisms and inflammatory responses play an important role in the pathogenesis of gastric mucosa, and nowadays, diseases due to cytokine triggers are getting more and more attention [ 14 ]. Hp-positive chronic gastritis and peptic ulcer make some cells in patients to form an immune response, in which endocrine secretion of serum IL-6, IL-8, and TNF- α and other cytokines is endocrine raised [ 15 ].…”

Effect of Vaginoscopy versus Conventional Hysteroscopy on Pain, Complications, and Patient Satisfaction in Patients with Endometrial Polyps

“…The pathogenesis of endometrial polyps is the rapid proliferation of the basal endothelium, and the diameter of polyps is usually 0.5-2.0 cm. Traditionally, patients are examined for endometrial polyps by using the transvaginoscopy method, which depicts the general condition of the object based on the reflection of the detected object to ultrasound waves [16]. However, some studies have shown that although transvaginoscopy has a high positive value for Patient satisfaction data in this study were entered into excel software by the first author and corresponding author, respectively, and count data were described as whole numbers, and included data were tested for compliance with normal distribution using the Shapiro-Wilk method; count data were described as whole numbers, and the χ2 test was used between or within groups.…”

“…The pathogenesis of endometrial polyps is the rapid proliferation of the basal endothelium, and the diameter of polyps is usually 0.5-2.0 cm. Traditionally, patients are examined for endometrial polyps by using the transvaginoscopy method, which depicts the general condition of the object based on the reflection of the detected object to ultrasound waves [ 16 ]. However, some studies have shown that although transvaginoscopy has a high positive value for diagnosing endometrial polyps, it is difficult to diagnose polyps with a diameter of less than 0.5 cm, and the diagnostic value of multiple polyps is not high.…”

Simulation and Training for Pediatric Colorectal Surgery and Anorectal Malformation: A Scoping review

“…• Di cult to simulate an ARM in an animal patient -derived intestinal organoid epithelium in a physiodynamic mucosal interface on a chip has been developed [9] The multiaxial deformations in a convoluted microchannel not only induced dynamic cell strains but also enhanced particle mixing in the lumen microchannel [9]. 3D reconstructions have been used in surgical training to understand the anatomy, provide a simulated operative pro le simulation of cysto-vaginoscopy for training [10]. Evaluation of the quality and feasibility of a real-size 3D printed cloacal model for cysto-vaginoscopic evaluation as a valuable add-on tool for specialty training in pediatric colorectal surgery was done by Krois et al [10].…”