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3D 打印虚拟模型在机器人辅助根治性前列腺切除术和部分肾切除术的开发和验证:泌尿科医生和患者的感知。

Development and validation of 3D printed virtual models for robot-assisted radical prostatectomy and partial nephrectomy: urologists' and patients' perception.

机构信息

Division of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, Orbassano, 10043, Turin, Italy.

Virginia Commonwealth University, Richmond, VA, USA.

出版信息

World J Urol. 2018 Feb;36(2):201-207. doi: 10.1007/s00345-017-2126-1. Epub 2017 Nov 10.

Abstract

PURPOSE

To test the face and content validity of 3D virtual-rendered printed models used before robot-assisted prostate cancer and nephron-sparing surgery.

METHODS

Patients who underwent live surgery during an international urological meeting organized in January 2017 were enrolled. Those with organ-confined prostate cancer underwent robot-assisted radical prostatectomy. Patients with a single renal tumor underwent minimally invasive nephron-sparing surgery. High-resolution (HR) imaging was obtained for all patients. Those with kidney tumors received contrast-enhanced CT scan with angiography; those with prostate cancer underwent mp-MRI. Images in DICOM format were processed by dedicated software. The first step was the rendering of a 3D virtual model. The models were then printed. They were presented during the live surgery of the urological meeting. All the participants and the operated patients were asked to fill a questionnaire about their opinion expressed in Likert scale (1-10) about the use and application of the 3D printed models.

RESULTS

18 patients were enrolled, including 8 undergoing robot-assisted radical prostatectomy and 10 undergoing minimally invasive partial nephrectomy. For each patient, a virtual 3D printed model was created. The attendants rated the utility of printed models in surgical planning, anatomical representation and the role of technology in surgical training as 8/10, 10/10 and 9/10, respectively. All patients reported favorable feedbacks (from 9 to 10/10) about the use of the technology during the case discussion with the surgeon.

CONCLUSIONS

In our experience, 3D printing technology has been perceived as a useful tool for the purpose of surgical planning, physician education/training and patient counseling. Further researches are expected to increase the level of evidence.

摘要

目的

测试用于机器人辅助前列腺癌和肾部分切除术之前的 3D 虚拟渲染打印模型的表面效度和内容效度。

方法

纳入于 2017 年 1 月在一次国际泌尿外科会议上进行活体手术的患者。患有局灶性前列腺癌的患者接受机器人辅助根治性前列腺切除术。患有单个肾肿瘤的患者接受微创肾部分切除术。所有患者均接受高分辨率(HR)成像。接受肾肿瘤的患者行增强 CT 扫描加血管造影;接受前列腺癌的患者行 mp-MRI。以 DICOM 格式获取图像,并由专用软件进行处理。第一步是生成 3D 虚拟模型,然后对模型进行打印,在泌尿外科会议的活体手术中展示。所有参与者和接受手术的患者均被要求填写一份问卷,就他们对 3D 打印模型使用和应用的看法进行李克特量表(1-10 分)评分。

结果

共纳入 18 例患者,其中 8 例行机器人辅助根治性前列腺切除术,10 例行微创部分肾切除术。为每位患者创建了一个虚拟 3D 打印模型。与会者对打印模型在手术计划、解剖学表现以及技术在手术培训中的作用的评分分别为 8/10、10/10 和 9/10。所有患者在与外科医生讨论病例时均对该技术的使用给予了好评(9-10/10)。

结论

根据我们的经验,3D 打印技术已被认为是用于手术计划、医生教育/培训和患者咨询的有用工具。预计进一步的研究将提高证据水平。

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