3D Printed Models for Anatomical Comprehension and Surgical Planning of Kidney Tumors’ Enucleation

The Urology Department requested 3D printing support for surgical planning and educational purposes regarding two patients referred to Fondazione IRCCS Policlinico San Matteo for kidney cancer. The 3D virtual models have been reconstructed from CT scans through image segmentation techniques and then 3D printed using both deformable and rigid photopolymer resin, exploiting Material Jetting technology.

CASE1-min

A 72-years old female with a tumor mass of about 2cm in diameter in the middle third and two angiomyolipomas – respectively in the upper and lower lobe – of the left kidney.

The patient underwent a laparoscopic intervention for kidney tumor enucleation; the surgery was performed following a selective clamping procedure of the left renal artery with fluorescence for the selective ischemia of the kidney parenchyma next to the tumor mass.

The 3D printed models involve different anatomical structures of interest, printed with the appropriate photopolymer resins:

  • Renal arteries and veins printed with VeroMagenta (rigid) and VeroCyano (rigid) respectively;
  • Kidney parenchima printed with VeroClear (rigid and transparent);
  • Tumor and Angiomyolipomas printed with a different mix of VeroCyano and VeroMagenta, for a chromatic differentiation;
  • Ureter printed with Agilus30 Clear (deformable).
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The model is made up of interlocking parts, enabling the assessment of the infiltration level of the tumor and an eventual (not occurred) involvement of blood vessels or ureter.

The clinical case will be presented as a video case report to the Asian Urology WebCongress taking place this month.

CASE 2-min

A 42-years old male arrived at the hospital following an accident. During the CT scans performed in an emergency regime, a suspicious mass of about 4cm was found in the right kidney; further investigation revealed the mass oncologic nature.

As the previously described clinical case, the 3D printed model is produced with interlocking parts and involves both arterial and venous blood vessels, the ureter, the tumor mass, and the kidney parenchyma. The same materials of Case 1 are here employed, thus with a deformable urether. Here the tumor has significantly larger dimensions, it infiltrates deeper in the kidney parenchyma and it extends very close to the arterial and venous vessels and the ureter.

The 3D printed model will be used as a didactic tool to improve the anatomical comprehension and the study of the degree of infiltration of kidney tumors’.

Clinical Specialty: Urology

3D Printer: J750 Digital Anatomy (Stratasys®)

Technology: Material Jetting

Materials: VeroMagenta, VeroCyano, VeroClear, Agilus30 Clear, GelMatrix and VeroPureWhite

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