For the first time, surgeons have used 3D printing to produce exact models of tumour-containing kidneys, allowing them to simulate surgery prior to the real operation. These models can be personalised to each patient, giving doctors a 3D model of each individual’s tumour.
Note: photos and video available see notes for editors.
Kidney cancers are the 8th most common cancer affecting adults, accounting for around 3% of all cancers in Europe; In 2012 it was estimated that there would be approximately 84.400 new cases of Kidney cancer with 34,700 deaths. It is usually treated surgically, but the operations can be stressful, and speed and accuracy are essential.
The ability to produce exact 3-dimensional models of objects means that 3D printing is set to revolutionise many fields. Now a group of surgeons from Kobe University in Japan has combined the 3D imaging capabilities of Computer Tomography, with 3D printing, to produce exact scale model of kidneys prior to surgery. This allows surgeons to practice surgery in difficult kidney cancer cases. So far they have produced ten 3D kidney models to assist in kidney cancer operations.
The group used computer tomography to produce a 3D scan of a diseased kidney. They then fed this information into a commercially-available 3D printer to produce a 3D model of the diseased kidney. As the scan is personalised for each patient, this meant that the surgeons were able to construct a 3D scale model of each individual’s kidney cancer.
The model – which was printed using two different materials- allowed the surgeons to accurately determine the margins of the kidney tumours. The 3D printed organ model was made of transparent material so that the blood vessels could be seen from the outside, meaning that surgeons could see the exact position of the blood vessels prior to surgery. This allowed the surgeons to simulate surgery on the kidney tumour prior to real surgery. The surgery itself was then performed robotically.
Presenting the work at the European Association of Urology congress in Stockholm, lead researcher Dr Yoshiyuki Shiga said
“The use of this “hands-on” model system gave us a 3D anatomical understanding of the kidney and the tumour. This enabled the surgeon to work on a smaller area. This is important, as it means that the area where the blood supply is interrupted during surgery can be reduced, in fact we found that the shortest interruption time* was only 8 minutes, compared to a normal average of 22 minutes. We also found that where we had to remove part of the kidney, the fact that we knew the exact location of the blood vessels helped us greatly.
At the moment this is still an expensive technique, adding between $500 and $1500 to the cost of surgery, but we hope that if it is more widely used then costs will fall”.
Commenting for the EAU, Professor Joan Palou (Barcelona, Director of the European School of Urology), said:
“It looks interesting as a new methodology to improve and facilitate to learn robotic surgery. It shows great potential, especially in the most difficult cases. Any surgery benefits from the surgeon being experienced and knowing what to expect, and at this point this seems to be the best simulation we have.
The learning process has been a matter of debate, and with the introduction of new technologies during the last few years, training has become an important issue. This is why the EAU has created the European School of Urology training group, to order to promote, stimulate and standardize the learning process. If it is developed appropriately, this new 3D process may feed into our training programme”.
*This refers to the ischaemic time.