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. 2023 Apr;48(4):1401-1408.
doi: 10.1007/s00261-023-03815-2. Epub 2023 Feb 7.

Impact of 3D printed models on quantitative surgical outcomes for patients undergoing robotic-assisted radical prostatectomy: a cohort study

Nicole Wake  1   2 , Andrew B Rosenkrantz  3 , Richard Huang  4 , Luke A Ginocchio  3 , James S Wysock  4 , Samir S Taneja  4 , William C Huang  4 , Hersh Chandarana  5   3
Affiliations

Impact of 3D printed models on quantitative surgical outcomes for patients undergoing robotic-assisted radical prostatectomy: a cohort study

Nicole Wake et al. Abdom Radiol (NY). 2023 Apr.

Abstract

Background: Three-dimensional (3D) printed anatomic models can facilitate presurgical planning by providing surgeons with detailed knowledge of the exact location of pertinent anatomical structures. Although 3D printed anatomic models have been shown to be useful for pre-operative planning, few studies have demonstrated how these models can influence quantitative surgical metrics.

Objective: To prospectively assess whether patient-specific 3D printed prostate cancer models can improve quantitative surgical metrics in patients undergoing robotic-assisted radical prostatectomy (RARP).

Methods: Patients with MRI-visible prostate cancer (PI-RADS V2 ≥ 3) scheduled to undergo RARP were prospectively enrolled in our IRB approved study (n = 82). Quantitative surgical metrics included the rate of positive surgical margins (PSMs), operative times, and blood loss. A qualitative Likert scale survey to assess understanding of anatomy and confidence regarding surgical approach was also implemented.

Results: The rate of PSMs was lower for the 3D printed model group (8.11%) compared to that with imaging only (28.6%), p = 0.128. The 3D printed model group had a 9-min reduction in operating time (213 ± 42 min vs. 222 ± 47 min) and a 5 mL reduction in average blood loss (227 ± 148 mL vs. 232 ± 114 mL). Surgeon anatomical understanding and confidence improved after reviewing the 3D printed models (3.60 ± 0.74 to 4.20 ± 0.56, p = 0.62 and 3.86 ± 0.53 to 4.20 ± 0.56, p = 0.22).

Conclusions: 3D printed prostate cancer models can positively impact quantitative patient outcomes such as PSMs, operative times, and blood loss in patients undergoing RARP.

Keywords: 3D printing; Magnetic resonance imaging; Prostate cancer; Robotic-assisted radical prostatectomy; Surgical planning.

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Conflict of interest statement

Conflict of interest NW—Employee, GE HealthCare. In-kind support, Stratasys. ABR—Royalties, Thieme Medical Publishers, Inc. DKS—Royalties, General Electric Company License agreement, General Electric Company; Royalties, Bruker Corporation License agreement, Bruker Corporation; Research collaboration, Siemens AG. HC—Equipment support, Siemens AG; Software support, Siemens AG; Speaker, Siemens AG; Speaker, Bayer AG. Speaker, PRECEDE consortium. No competing interests: RH, LG JSW.

Figures

Fig. 1
Fig. 1
Representative case including a T2-Weighted MR imaging, b image segmentation showing the prostate—yellow, dominant lesion—blue, neurovascular bundles—purple, and rectal wall—white, c 3D modeling showing the segmented regions of interest from parts B, with the prostate transparent and the bladder and urethra shown in yellow, and d multi-colored 3D printed prostate cancer model. Printing was performed with material jetting technology (J750, Stratasys, Eden Prairie, MN)
Fig. 2
Fig. 2
Patient with a 10 × 8 mm PI-RADS 4 lesion. a Axial T2 SPACE image showing image segmentation of the prostate (gray), rectal wall (white), lesion (blue), urethra (yellow), and neurovascular bundles (purple). b Computer-aided design model showing 3D representation of segmented regions of interest. c 3D printed model. d Resected prostate following RARP
See this image and copyright information in PMC

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