Multimaterial 3D printing preoperative planning for frontoethmoidal meningoencephalocele surgery

Coelho, Giselle; Chaves, Thailane Marie Feitosa; Goes, Ademil Franco; Massa, Emilio C. Del; Moraes, Osmar; Yoshida, Maurício

doi:10.1007/s00381-017-3616-6

Cited by 41 publications

(42 citation statements)

References 32 publications

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“…13 Although imaging modalities like CT and MRI combined with postprocessing software can provide adequate visualization of this pathology, there are notable limitations of the bidimensional view, and it is not unusual for surgeons to find different anatomical relationships intraoperatively. 2 The use of a physical hybrid model and AR in planning the operative technique involved in treating metopic craniosynostosis is particularly noteworthy. The preliminary results we report here support the utility of this mixed platform as an introductory adjunct to traditional surgical training.…”

Section: Discussionmentioning

confidence: 99%

“…11,15,17 Many simulators have been developed as a first step to enhance the development of the surgical skills of residents in plastic surgery and neurosurgery. 2 Cadaveric sheep craniums were previously used as a simulator, but this method has clear limitations, 8 and animal models may raise ethical objections and their use is even forbidden in some countries. 3 Besides that, with complex and high-risk procedures such as craniosynostosis surgery in infants, the opportunities for hands-on training have been very limited.…”

mentioning

confidence: 99%

“…16 The process of creating 3D models for use in surgical training begins with segmentation of image data to convert the anatomical imaging information obtained by CT scanning and MRI into a 3D patient-specific digital model of all relevant anatomical structures. 2,16 Augmented reality (AR) transforms virtual objects into lifelike video images in real time, providing the neurosurgeon with specific anatomical information and elaborated metrics. 10,11 With recent advancements, several systems have been proposed for surgical planning that enable the surgeon to be engaged with both the graphic AR representation and the actual surgical field simultaneously.…”

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confidence: 99%

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Augmented reality and physical hybrid model simulation for preoperative planning of metopic craniosynostosis surgery

Coelho

Rabelo

Vieira

et al. 2020

Neurosurgical Focus

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OBJECTIVEThe main objective of neurosurgery is to establish safe and reliable surgical techniques. Medical technology has advanced during the 21st century, enabling the development of increasingly sophisticated tools for preoperative study that can be used by surgeons before performing surgery on an actual patient. Laser-printed models are a robust tool for improving surgical performance, planning an operative approach, and developing the skills and strategy to deal with uncommon and high-risk intraoperative difficulties. Practice with these models enhances the surgeon’s understanding of 3D anatomy but has some limitations with regard to tactile perception. In this study, the authors aimed to develop a preoperative planning method that combines a hybrid model with augmented reality (AR) to enhance preparation for and planning of a specific surgical procedure, correction of metopic craniosynostosis, also known as trigonocephaly.METHODSWith the use of imaging data of an actual case patient who underwent surgical correction of metopic craniosynostosis, a physical hybrid model (for hands-on applications) and an AR app for a mobile device were created. The hybrid customized model was developed by using analysis of diagnostic CT imaging of a case patient with metopic craniosynostosis. Created from many different types of silicone, the physical model simulates anatomical conditions, allowing a multidisciplinary team to deal with different situations and to precisely determine the appropriate surgical approach. A real-time AR interface with the physical model was developed by using an AR app that enhances the anatomic aspects of the patient’s skull. This method was used by 38 experienced surgeons (craniofacial plastic surgeons and neurosurgeons), who then responded to a questionnaire that evaluated the realism and utility of the hybrid AR simulation used in this method as a beneficial educational tool for teaching and preoperative planning in performing surgical metopic craniosynostosis correction.RESULTSThe authors developed a practice model for planning the surgical cranial remodeling used in the correction of metopic craniosynostosis. In the hybrid AR model, all aspects of the surgical procedure previously performed on the case patient were simulated: subcutaneous and subperiosteal dissection, skin incision, and skull remodeling with absorbable miniplates. The pre- and postoperative procedures were also carried out, which emphasizes the role of the AR app in the hybrid model. On the basis of the questionnaire, the hybrid AR tool was approved by the senior surgery team and considered adequate for educational purposes. Statistical analysis of the questionnaire responses also highlighted the potential for the use of the hybrid model in future applications.CONCLUSIONSThis new preoperative platform that combines physical and virtual models may represent an important method to improve multidisciplinary discussion in addition to being a powerful teaching tool. The hybrid model associated with the AR app provided an effective training environment, and it enhanced the teaching of surgical anatomy and operative strategies in a challenging neurosurgical procedure.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Augmented reality and physical hybrid model simulation for preoperative planning of metopic craniosynostosis surgery

Coelho

Rabelo

Vieira

et al. 2020

Neurosurgical Focus

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“…The technique is also not suitable for simulation of soft tissue. To simulate brain tissue, for example, it might be necessary to either print it with a method that is able to produce soft and hard materials directly 12,13 or to print molds that can be used to cast soft objects, such as silicone rubber 14 .…”

Section: Discussionmentioning

confidence: 99%

Multicolor 3D Printing of Complex Intracranial Tumors in Neurosurgery

Kosterhon¹,

Neufurth²,

Neulen³

et al. 2020

JoVE

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Three-dimensional (3D) printing technologies offer the possibility of visualizing patient-specific pathologies in a physical model of correct dimensions. The model can be used for planning and simulating critical steps of a surgical approach. Therefore, it is important that anatomical structures such as blood vessels inside a tumor can be printed to be colored not only on their surface, but throughout their whole volume. During simulation this allows for the removal of certain parts (e.g., with a high-speed drill) and revealing internally located structures of a different color. Thus, diagnostic information from various imaging modalities (e.g., CT, MRI) can be combined in a single compact and tangible object. However, preparation and printing of such a fully colored anatomical model remains a difficult task. Therefore, a step-by-step guide is provided, demonstrating the fusion of different cross-sectional imaging data sets, segmentation of anatomical structures, and creation of a virtual model. In a second step the virtual model is printed with volumetrically colored anatomical structures using a plaster-based color 3D binder jetting technique. This method allows highly accurate reproduction of patient-specific anatomy as shown in a series of 3D-printed petrous apex chondrosarcomas. Furthermore, the models created can be cut and drilled, revealing internal structures that allow for simulation of surgical procedures.

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“…These promising techniques are being explored not only in the development of biomaterials that require reliability and maximum performance in vivo, but also for the manufacture of products that might not have been possible using traditional methods. As an AM technology, bioprinting may find numerous applications across the healthcare industry including its utilization in surgical planning, 28 implant design, 29 therapeutic delivery, 30 and tissue engineering 31 . Over the past few years, bioprinting has emerged as a unique and fast‐growing application of AM that supports the biofabrication of implantable tissues such as cartilage, 32 skin, 33 or bone 34 .…”

Section: Fabrication Methodsmentioning

confidence: 99%

Biological evaluation of preceramic organosilicon polymers for various healthcare and biomedical engineering applications: A review

Francis

2020

J Biomed Mater Res

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Preceramic organosilicon materials combining the properties of a polymer and an inorganic ceramic phase are of great interest to scientists working in biomedical sciences. The interdisciplinary nature of organosilicon polymers and their molecular structures, as well as their diversity of applications have resulted in an unprecedented range of devices and synergies cutting across unrelated fields in medicine and engineering. Organosilicon materials, especially the polysiloxanes, have a long history of industrial and medical uses in many versatile aspects as they can be easily fabricated into complex‐shaped products using a wide variety of computer‐aided or polymer manufacturing techniques. Thus far, intensive research activities have been mainly devoted to the processing of preceramic organosilicon polymers toward magnetic, electronic, structural, optical, and not biological applications. Herein we present innovative research studies and recent developments of preceramic organosilicon polymers at the interface with biological systems, displaying the versatility and multi‐functionality of these materials. This article reviews recent research on preceramic organosilicon polymers and corresponding composites for bone tissue regeneration and medical engineering implants, focusing on three particular topics: (a) surface modifications to create tailorable and bioactive surfaces with high corrosion resistance and improved biological properties; (b) biological evaluations for specific applications, such as in glaucoma drainage devices, orthopedic implants, bone tissue regeneration, wound dressing, drug delivery systems, and antibacterial activity; and (c) in vitro and in vivo studies for cytotoxicity, genotoxicity, and cell viability. The interest in organosilicon materials stems from the fact that a vast array of these materials have complementary attributes that, when integrated appropriately with functional fillers and carefully controlled conditions, could be exploited either as polymeric Si‐based composites or as organosilicon polymer‐derived Si‐based ceramic composites to tailor and optimize properties of the Si‐based materials for various proposed applications.

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Multimaterial 3D printing preoperative planning for frontoethmoidal meningoencephalocele surgery

Cited by 41 publications

References 32 publications

Augmented reality and physical hybrid model simulation for preoperative planning of metopic craniosynostosis surgery

Augmented reality and physical hybrid model simulation for preoperative planning of metopic craniosynostosis surgery

Multicolor 3D Printing of Complex Intracranial Tumors in Neurosurgery

Biological evaluation of preceramic organosilicon polymers for various healthcare and biomedical engineering applications: A review

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