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Erschienen in: International Journal of Computer Assisted Radiology and Surgery 3/2021

22.02.2021 | Original Article

Patient-specific desktop 3D-printed guides for pelvic tumour resection surgery: a precision study on cadavers

verfasst von: Mónica García-Sevilla, Lydia Mediavilla-Santos, María Teresa Ruiz-Alba, Rubén Pérez-Mañanes, José Antonio Calvo-Haro, Javier Pascau

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 3/2021

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Abstract

Purpose

3D-printed patient-specific instruments have become a useful tool to improve accuracy in pelvic tumour resections. However, their correct placement can be challenging in some regions due to the morphology of the bone, so it is essential to be aware of the possible placement errors in each region. In this study, we characterize these errors in common pelvic osteotomies.

Methods

We conducted an experiment with 9 cadaveric specimens, for which we acquired a pre-operative computed tomography scan. Small PSIs were designed for each case following a realistic surgical approach for four regions of the pelvis: iliac crest (C), supra-acetabular (S), ischial (I), and pubic (P). Final surgical placement was based on a post-operative scan. The resulting positions were compared with pre-operative planning, obtaining translations, rotations, and maximum osteotomy deviations in a local reference frame defined based on the bone’s morphology.

Results

Mean translations and rotations in the direction of the osteotomy plane were as follows: C = 5.3 mm, 6.7°; S = 1.8 mm, 5.1°; I = 1.5 mm, 3.4°; P = 1.8 mm, 3.5°. Mean translations in the remaining axes were below 2 mm. Maximum osteotomy deviations (75% of cases) were below 11.8 mm in C (7.8 mm for half-length), 7.8 mm in S (5.5 mm for half-length), 5.5 mm in I, and 3.7 mm in P.

Conclusion

We have characterized placement errors for small PSIs in four regions of the pelvis. Our results show high errors in C and S PSIs in the direction of the resection plane’s normal, and thus large osteotomy deviations. Deviations in short osteotomies in S, I and P and placement errors in the remaining directions were low. The PSIs used in this study are biocompatible and can be produced with a desktop 3D printer, thus minimizing manufacturing cost.

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Literatur
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Zurück zum Zitat Brouwers L, Teutelink A, van Tilborg FAJB, de Jongh MAC, Lansink KWW, Bemelman M (2019) Validation study of 3D-printed anatomical models using 2 PLA printers for preoperative planning in trauma surgery, a human cadaver study. Eur J Trauma Emerg Surg 45:1013–1020CrossRef Brouwers L, Teutelink A, van Tilborg FAJB, de Jongh MAC, Lansink KWW, Bemelman M (2019) Validation study of 3D-printed anatomical models using 2 PLA printers for preoperative planning in trauma surgery, a human cadaver study. Eur J Trauma Emerg Surg 45:1013–1020CrossRef
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Zurück zum Zitat García-Sevilla M, García-Mato D, Calvo-Haro J, Pérez-Mañanes R, Pascau J (2019) Optimizing navigation with patient-specific 3D printed guides in pelvic tumor resection surgery. In: Proceedings of computer assisted radiology and surgery: CARS June 18–21, 2019, Rennes, France, pp 62–64 García-Sevilla M, García-Mato D, Calvo-Haro J, Pérez-Mañanes R, Pascau J (2019) Optimizing navigation with patient-specific 3D printed guides in pelvic tumor resection surgery. In: Proceedings of computer assisted radiology and surgery: CARS June 18–21, 2019, Rennes, France, pp 62–64
Metadaten
Titel
Patient-specific desktop 3D-printed guides for pelvic tumour resection surgery: a precision study on cadavers
verfasst von
Mónica García-Sevilla
Lydia Mediavilla-Santos
María Teresa Ruiz-Alba
Rubén Pérez-Mañanes
José Antonio Calvo-Haro
Javier Pascau
Publikationsdatum
22.02.2021
Verlag
Springer International Publishing
Erschienen in
International Journal of Computer Assisted Radiology and Surgery / Ausgabe 3/2021
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-021-02322-3

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