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Impact of 3D printing technology on the comprehension of surgical liver anatomy

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Abstract

Background and aims

Surgical planning in liver resection depends on the precise understanding of the three-dimensional (3D) relation of tumors to the intrahepatic vascular trees. This study aimed to investigate the impact of 3D printing (3DP) technology on the understanding of surgical liver anatomy.

Methods

We selected four hepatic tumors that were previously resected. For each tumor, a virtual 3D reconstruction (VIR) model was created from multi-detector computed tomography (MDCT) and was prototyped using a 3D printer. Forty-five surgical residents were evenly assigned to each group (3DP, VIR, and MDCT groups). After evaluation of the MDCT scans, VIR model, or 3DP model of each tumor, surgical residents were asked to assign hepatic tumor locations and state surgical resection proposals. The time used to specify the tumor location was recorded. The correct responses and time spent were compared between the three groups.

Results

The assignment of tumor location improved steadily from MDCT, to VIR, and to 3DP, with a mean score of 34.50, 55.25, and 80.92, respectively. These scores were out of 100 points. The 3DP group had significantly higher scores compared with other groups (p < 0.001). Furthermore, 3DP significantly improved the accuracy of surgical resection proposal (p < 0.001). The mean accuracy of the surgical resection proposal for 3DP, VIR, and MDCT was 57, 25, and 25%, respectively. The 3DP group took significantly less time, compared with other groups (p < 0.005). The mean time spent on assessing the tumor location for 3DP, VIR, and MDCT groups was 93, 223, and 286 s, respectively.

Conclusions

3D printing improves the understanding of surgical liver anatomy for surgical residents. The improved comprehension of liver anatomy may facilitate laparoscopy or open liver resection.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

3DP:

Three-dimensional printing

CT:

Computed tomography

MDCT:

Multi-detector computed tomography

VIR:

Three-dimensional virtual reconstruction

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Funding

This study was supported by the National Natural Science Foundation of China (Grant Number 81602199).

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Authors and Affiliations

  1. Department of Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, China

    Tianyou Yang, Tianbao Tan, Jiahao Li, Jiliang Yang, Jing Pan, Chao Hu & Yan Zou

  2. Department of Hepatobiliary Surgery, the Fifth People’s Hospital of Dongguan City, Dongguan, China

    Shuwen Lin

  3. First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Qigen Xie

  4. Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China

    Wenwei Ouyang

  5. The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China

    Wenwei Ouyang

  6. Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

    Zhiyuan Chen

  7. Department of Radiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

    Huiying Wu

Authors
  1. Tianyou Yang
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  2. Shuwen Lin
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  9. Huiying Wu
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  10. Jing Pan
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  11. Chao Hu
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  12. Yan Zou
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Corresponding author

Correspondence to Yan Zou.

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Disclosure

Tianyou Yang, Shuwen Lin, Qigen Xie, Wenwei Ouyang, Tianbao Tan, Jiahao Li, Zhiyuan Chen, Jiliang Yang, Huiying Wu, Jing Pan, Chao Hu, and Yan Zou have no conflicts of interest or financial ties to disclose.

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Yang, T., Lin, S., Xie, Q. et al. Impact of 3D printing technology on the comprehension of surgical liver anatomy. Surg Endosc 33, 411–417 (2019). https://doi.org/10.1007/s00464-018-6308-8

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  • DOI: https://doi.org/10.1007/s00464-018-6308-8

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