Transcending Dimensions: a Comparative Analysis of Cloaca Imaging in Advancing the Surgeon’s Understanding of Complex Anatomy

Gasior, Alessandra C.; Reck, Carlos A.; Lane, Victoria A.; Wood, Richard J.; Patterson, Jeremy; Strouse, Robert; Lin, Simon; Cooper, Jennifer N.; Bates, D. Gregory; Levitt, Marc A.

doi:10.1007/s10278-018-0139-y

Cited by 8 publications

(11 citation statements)

References 10 publications

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“… 16 Gasior et al reported that it took approximately 18 hours to print a 3D model demonstrating cloacal malformation. 25 …”

Section: Resultsmentioning

confidence: 99%

“…10 The studies in paediatric gynaecology and general surgery revealed better self-reported and objective measured outcomes when using 3DP models. [24][25][26] Open access Facilitating surgeon understanding of complex anatomy using a threedimensional printed model. 24 Use of 3DP to improve understanding of complex anatomy (conjoined twins) versus CT scan and digital reconstruction.…”

Section: Primary Outcomesmentioning

confidence: 99%

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Role of 3D printing technology in paediatric teaching and training: a systematic review

Asif

Lee

Caputo

et al. 2021

bmjpo

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BackgroundIn the UK, undergraduate paediatric training is brief, resulting in trainees with a lower paediatric knowledge base compared with other aspects of medicine. With congenital conditions being successfully treated at childhood, adult clinicians encounter and will need to understand these complex pathologies. Patient-specific 3D printed (3DP) models have been used in clinical training, especially for rarer, complex conditions. We perform a systematic review to evaluate the evidence base in using 3DP models to train paediatricians, surgeons, medical students and nurses.MethodsOnline databases PubMed, Web of Science and Embase were searched between January 2010 and April 2020 using search terms relevant to “paediatrics”, “education”, “training” and “3D printing”. Participants were medical students, postgraduate trainees or clinical staff. Comparative studies (patient-specific 3DP models vs traditional teaching methods) and non-comparative studies were included. Outcomes gauged objective and subjective measures: test scores, time taken to complete tasks, self-reported confidence and personal preferences on 3DP models. If reported, the cost of and time taken to produce the models were noted.ResultsFrom 587 results, 15 studies fit the criteria of the review protocol, with 5/15 being randomised controlled studies and 10/15 focussing on cardiovascular conditions. Participants using 3DP models demonstrated improved test scores and faster times to complete procedures and identify anatomical landmarks compared with traditional teaching methods (2D diagrams, lectures, videos and supervised clinical events). User feedback was positive, reporting greater user self-confidence in understanding concepts with users wishing for integrated use of 3DP in regular teaching. Four studies reported the costs and times of production, which varied depending on model complexity and printer. 3DP models were cheaper than ‘off-the-shelf’ models available on the market and had the benefit of using real-world pathologies. These mostly non-randomised and single-centred studies did not address bias or report long-term or clinically translatable outcomes.Conclusions3DP models were associated with greater user satisfaction and good short-term educational outcomes, with low-quality evidence. Multicentred, randomised studies with long-term follow-up and clinically assessed outcomes are needed to fully assess their benefits in this setting.PROSPERO registration numberCRD42020179656.

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“… 16 Gasior et al reported that it took approximately 18 hours to print a 3D model demonstrating cloacal malformation. 25 …”

Section: Resultsmentioning

confidence: 99%

Section: Primary Outcomesmentioning

confidence: 99%

Role of 3D printing technology in paediatric teaching and training: a systematic review

Asif

Lee

Caputo

et al. 2021

bmjpo

View full text Add to dashboard Cite

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“…Gasior detailed 3D-printings use in improving understanding of complex cloacal anomalies for trainees and faculty surgeons alike (26). Tangible 3D-printed model demonstrated improved questionnaire-assessed understanding compared to 2D cloacagrams, rotatable 3D virtual models and 3D video animations.…”

Section: Surgical Trainingmentioning

confidence: 99%

Innovation in Urology: Three Dimensional Printing and Its Clinical Application

2020

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Three-dimensional (3D) printing allows rapid prototyping of novel equipment as well as the translation of medical imaging into tangible replicas of patient-specific anatomy. The technology has emerged as a versatile medium for innovation in medicine but with ever-expanding potential uses, does 3D printing represent a valuable adjunct to urological practice? We present a concise systematic review of articles on 3D printing within urology, outlining proposed benefits and the limitations in evidence supporting its utility. We review publications prior to December 2019 using guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Of 117 identified articles, 67 are included highlighting key areas of research as the use of patient-specific models for patient education, surgical planning, and surgical training. Further novel applications included printed surgical tools, patient-specific surgical guides, and bioprinting of graft tissues. We conclude to justify its adoption within standard practice, further research is required demonstrating that use of 3D printing can produce; direct and measurable improvements in patient experience, consistent evidence of superior surgical outcomes or simulation which surpasses existing means' both in fidelity and enhancement of surgical skills. Although exploration of 3D printing's urological applications remains nascent, the seemingly limitless scope for innovation and collaborative design afforded by the technology presents undeniable value as a resource and assures a place at the forefront of future advances.

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“…The necessary measurements would appear to be obtainable from any of these modalities however their interpretation differs between the different modalities. Levels of experience definitely affects the ability to understand these images with less experienced surgeons faring better on more complex imaging, approaching the abilities of experienced surgeons (15). The fact that cloacal malformations are rare further emphasizes the need to use more complex imaging modalities.…”

Section: Factors In the Initial Assessment Which Affect Treatmentmentioning

confidence: 99%

“…The fact that cloacal malformations are rare further emphasizes the need to use more complex imaging modalities. While 3D printing may be beneficial for the purposes of explanation to families (16), it adds significant cost and does not add significantly to the understanding of the anatomy by the surgical team (15). MRI is able show great soft tissue definition which may further aid the spatial understanding of the anatomy of pelvic musculature and hollow visceral structures (17).…”

Section: Factors In the Initial Assessment Which Affect Treatmentmentioning

confidence: 99%

Cloacal Malformations: Technical Aspects of the Reconstruction and Factors Which Predict Surgical Complexity

2019

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Cloacal malformations are rare anomalies which occur in one in 50,000 live births. Anatomically these anomalies are defined by the presence of a single perineal orifice. There is however a substantial range in their complexity. Defining these differences is key to surgical planning and timely referral of selected cases to centers with the capabilities to manage the most challenging cases. Traditionally the common channel length as measured during cysto-vaginoscopy has been used to differentiate between patients that can be repaired with a reproducible operation and those requiring a more complex repair. The quality and range of imaging available has advanced and thus a more detailed anatomic picture is now possible to help with pre-operative planning. Cross sectional imaging with 3D reconstruction has enhanced the understanding of the anatomic variations in these patients. In addition, the sacral ratio, previously thought to only have an influence on long term continence predictions, has been shown to not only forecast the presence of urological anomalies, but also the complexity of the malformation. In principle, cloacal malformations have two major components to the reconstruction. First, the rectum needs to be separated from the urogenital tract and second, the urogenital sinus needs to be managed to create a urethral orifice and vaginal introitus. The length of the urethra has been shown to be vital in deciding between the two main surgical maneuvers; a total urogenital mobilization (TUM) and a urogenital separation. The technical demands of a urogenital separation are significant and discussed here in detail. The need for vaginal replacement adds further complexity to the care of these patients and has also been shown to be related to the length of the urethra. Predicting complexity in an accurate and non-invasive way will facilitate the care of the most complex cloacal malformations and improve outcomes.

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Transcending Dimensions: a Comparative Analysis of Cloaca Imaging in Advancing the Surgeon’s Understanding of Complex Anatomy

Cited by 8 publications

References 10 publications

Role of 3D printing technology in paediatric teaching and training: a systematic review

Role of 3D printing technology in paediatric teaching and training: a systematic review

Innovation in Urology: Three Dimensional Printing and Its Clinical Application

Cloacal Malformations: Technical Aspects of the Reconstruction and Factors Which Predict Surgical Complexity

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