背景:深下胃穿支皮瓣(DIEP)外科手术近年来受益于3D打印模型的引入,然而,新技术正在扩大设计机会,有望改善患者的具体护理。大量研究,利用DIEP的3D打印模型,除了标准CT成像的审查外,还显示出手术时间和并发症的减少。DIEP游离皮瓣手术需要定位横穿腹直肌并穿孔的下腹壁穿支血管,灌注腹部皮肤和脂肪组织。由于脂肪组织和肌肉的不透明,解剖腹壁下穿支血管的目的很复杂。以前从CT成像中3D打印DIEP游离皮瓣病例的患者特定模型的尝试已经显示出广泛的设计,这些设计仅显示穿支动脉的变化。脂肪组织,和腹直肌.
方法:为了弥补这一限制,我们利用基于体素的建模环境来复合复杂的建模元素,并在肌肉上加入规则的网格,提供毫不费力的“沸腾”和测量的指导。
结果:基于数字表面的建模工具的局限性导致现有模型缺乏合成关键解剖特征的能力,例如通过不同组织的血管分化,连贯成一个模型,提供更类似于手术挑战的信息。
结论:有了新技术,高度详细的多材料3D打印模型允许在3D打印模型中表达来自医学成像的更多信息。这些额外的数据,再加上利用基于体素和网格的建模环境的先进数字建模工具,允许扩展的建模技术库,这些建模技术库创建了外科医生可以用来组装适合其设置的术前计划模型的丰富概念,设备,和需要。
背景:COMIRB21-3135,ClinicalTrials.govID:NCT05144620。
BACKGROUND: Deep Inferior Epigastric Perforator Flap (DIEP) surgical procedures have benefited in recent years from the introduction of 3D printed models, yet new technologies are expanding design opportunities which promise to improve patient specific care. Numerous studies, utilizing 3D printed models for DIEP, have shown a reduction of surgical time and complications when used in addition to the review of standard CT imaging. A DIEP free flap procedure requires locating the inferior epigastric perforator vessels traversing and perforating the rectus abdominis muscle, perfusing the abdominal skin and fatty tissue. The goal of dissecting the inferior epigastric perforator vessels is complicated by the opacity of the fatty tissue and muscle. Previous attempts to 3D print patient specific models for DIEP free flap cases from CT imaging has shown a wide range of designs which only show variations of perforator arteries, fatty tissue, and the abdominis rectus muscle.
METHODS: To remedy this limitation, we have leveraged a voxel-based modeling environment to composite complex modeling elements and incorporate a ruled grid upon the muscle providing effortless \'booleaning\' and measured guidance.
RESULTS: A limitation of digital surface-based modeling tools has led to existing models lacking the ability to composite critical anatomical features, such as differentiation of vessels through different tissues, coherently into one model, providing information more akin to the surgical challenge.
CONCLUSIONS: With new technology, highly detailed multi-material 3D printed models are allowing more of the information from medical imaging to be expressed in 3D printed models. This additional data, coupled with advanced digital modeling tools harnessing both voxel- and mesh-based modeling environments, is allowing for an expanded library of modeling techniques which create a wealth of concepts surgeons can use to assemble a presurgical planning model tailored to their setting, equipment, and needs.
BACKGROUND: COMIRB 21-3135, ClinicalTrials.gov ID: NCT05144620.