Advanced 3D "Modeling" and "Printing" for the Surgical Planning of a Successful Case of Thoraco-Omphalopagus Conjoined Twins Separation.

3D images 3D printing 3D printing in cardiothoracic surgery 3D printing in surgery conjoined twins

Journal

Frontiers in physiology
ISSN: 1664-042X
Titre abrégé: Front Physiol
Pays: Switzerland
ID NLM: 101549006

Informations de publication

Date de publication:
2020
Historique:
received: 28 05 2020
accepted: 13 10 2020
entrez: 7 12 2020
pubmed: 8 12 2020
medline: 8 12 2020
Statut: epublish

Résumé

The surgical separation of two Conjoined Twins is a particularly complex operation. Surgical times are particularly long and post-operative complications are very frequent in this type of procedure. We report a clinical case of surgical separation of two thoraco-omphalopagus conjoined twins in which, thanks to the use of (3D) three dimensional technologies, we were able to significantly reduce operative times and improve clinical outcomes. We performed a 3D reconstruction of the anatomical parts involved in congenital fusion using Computer Tomography (CT) images.We obtained virtual anatomical models of the patients which allowed us to estimate essential details as the residual post-operative thoracic volume as well as the exact position of resection planes for both the general separation and for the hepatic splitting procedure. Subsequently, we printed 3D anatomical models of the thoracic cage and sternum and of the liver with the plane of resection. Finally, we printed an additional 3D anatomical model of the two patients representing different organs with multiple colors and materials. The use of 3D printing reduced the duration of surgery by 30% with a favorable patient outcome. Two years after the operation, the patients do not present any type of deficit and have a normal life without any significant complication. Virtual anatomical 3D models and 3D printing represent a valid technological tool to support complex surgical operations, especially in pre-surgical planning. 3D models are important tools to better understand complex anatomy and to discuss clinical cases among members of the surgical team.

Sections du résumé

BACKGROUND BACKGROUND
The surgical separation of two Conjoined Twins is a particularly complex operation. Surgical times are particularly long and post-operative complications are very frequent in this type of procedure. We report a clinical case of surgical separation of two thoraco-omphalopagus conjoined twins in which, thanks to the use of (3D) three dimensional technologies, we were able to significantly reduce operative times and improve clinical outcomes.
METHODS METHODS
We performed a 3D reconstruction of the anatomical parts involved in congenital fusion using Computer Tomography (CT) images.We obtained virtual anatomical models of the patients which allowed us to estimate essential details as the residual post-operative thoracic volume as well as the exact position of resection planes for both the general separation and for the hepatic splitting procedure. Subsequently, we printed 3D anatomical models of the thoracic cage and sternum and of the liver with the plane of resection. Finally, we printed an additional 3D anatomical model of the two patients representing different organs with multiple colors and materials.
RESULTS RESULTS
The use of 3D printing reduced the duration of surgery by 30% with a favorable patient outcome. Two years after the operation, the patients do not present any type of deficit and have a normal life without any significant complication.
CONCLUSION CONCLUSIONS
Virtual anatomical 3D models and 3D printing represent a valid technological tool to support complex surgical operations, especially in pre-surgical planning. 3D models are important tools to better understand complex anatomy and to discuss clinical cases among members of the surgical team.

Identifiants

pubmed: 33281611
doi: 10.3389/fphys.2020.566766
pmc: PMC7691583
doi:

Types de publication

Journal Article

Langues

eng

Pagination

566766

Informations de copyright

Copyright © 2020 Inserra, Borro, Spada, Frediani and Secinaro.

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Auteurs

Alessandro Inserra (A)

Department of General Surgery, Bambino Gesù Children's Hospital, Rome, Italy.

Luca Borro (L)

Department of Imaging, Bambino Gesù Children's Hospital, Rome, Italy.

Marco Spada (M)

Department of General Surgery, Bambino Gesù Children's Hospital, Rome, Italy.

Simone Frediani (S)

Department of General Surgery, Bambino Gesù Children's Hospital, Rome, Italy.

Aurelio Secinaro (A)

Department of Imaging, Bambino Gesù Children's Hospital, Rome, Italy.

Classifications MeSH