3D haptic modelling for preoperative planning of hepatic resection: A systematic review

Abstract

Introduction and background: Three dimensional (3D) printing has gained popularity in the medical field because of increased research in the field of haptic 3D modeling. We review the role of 3D printing with specific reference to liver directed applications.

Methods: A literature search was performed using the scientific databases Medline and PubMed. We performed this in-line with the PRISMA [20] statement. We only included articles in English, available in full text, published about adults, about liver surgery and published between 2005 and 2015. The 3D model of a patient's liver venous vasculature and metastasis was prepared from a CT scan using Osirix software (Pixmeo, Gineva, Switzerland) and printed using our 3D printer (MakerBot Replicator Z18, US). To validate the model, measurements from the inferior vena cava (IVC) were compared between the CT scan and the 3D printed model.

Results: A total of six studies were retrieved on 3D printing directly related to a liver application. While stereolithography (STL) remains the gold standard in medical additive manufacturing, Fused Filament Fabrication (FFF), is cheaper and may be more applicable. We found our liver 3D model made by FFF had a 0.1 ± 0.06 mm margin of error (mean ± standard deviation) compared with the CT scans.

Conclusion: 3D printing in general surgery is yet to be thoroughly exploited. The most relevant feature of interest with regard to liver surgery is the ability to view the 3D dimensional relationship of the various hepatic and portal veins with respect to tumor deposits when planning hepatic resection. Systematic review registration number: researchregistry1348.

Keywords: 3D Haptic model; 3D Printing; 3D Printing liver; General surgery.

Fig. 1

Flow diagram for study selection.

Fig. 2

Posterior (a) and Anterior (b) view of the printed 3D model. Metastases in different segments are labeled as metastasis (mets) 4a/4b, 6 and 7. Inferior Vena Cava labeled as IVC. Magnified view of metastasis in segment 6. (c).

Fig. 3

CT scan in Coronal view (a). Points of measurements in axial view, taken transverse and longitudinal (b, c and d) color-coded accordingly. Measurements plotted comparing measurements in CT versus 3D printed model.