3D Printing in Surgical Strategies

A special issue of Surgeries (ISSN 2673-4095).

Deadline for manuscript submissions: 20 August 2024 | Viewed by 13226

Special Issue Editor


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Guest Editor
Division of Orthopaedic Surgery, Department of Surgery, McGill University, Montreal, QC H3A 0G4, Canada
Interests: 3D printing; biofabrication; drug delivery; musculoskeletal disease; bone/ligament repair; bone metastases; scaffolds

Special Issue Information

Dear Colleagues,

Over the past 5–10 years, additive manufacturing, or 3D printing, has become extremely inexpensive and highly accessible. Therefore, the use of 3D printing in biomedical applications has become somewhat mainstream. Low-cost, high-quality instruments, personalized devices and teaching tools have become widely used in industrial, academic and medical settings. Fused deposition modeling using polymers such as polylactic acid, polycaprolactone, or other composites including polyurethanes, are widely used for medical applications including pre-surgical planning, resident surgical training, and patient education. Moreover, these polymeric devices or scaffolds are now combined with bioprinting to open new avenues to cutting-edge research toward musculoskeletal repair and regeneration such as pre-vascularized bone or soft-tissue constructs. Most importantly, these tools are being widely used to generate composite scaffolds representing matrices on which to culture cells of various tissue types such as bone, cartilage, cardiac, and nervous tissue. 3D-printed composite matrix scaffolds are being tested in highly sophisticated in vitro and in vivo preclinical models, paving the way for future clinical translation where the ultimate goal is to generate functional replacement tissues. Other avenues include devices for personalized medicine and drug delivery highly applicable to the pharmaceutic industry and beyond. This Special Issue will focus on the current landscape of 3D printing or biofabrication with specific applications in experimental and innovative surgical approaches including tissue engineered grafts, tissue substitutes, surgical guides, models for surgical training and advanced pre-surgical models.

Dr. Derek H. Rosenzweig
Guest Editor

Manuscript Submission Information

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Keywords

  • 3D printing
  • additive manufacturing
  • surgical innovation
  • surgical guides
  • pre-surgery models
  • teaching
  • tissue repair
  • tissue engineering
  • orthopaedics
  • medical devices
  • surgical simulations

Published Papers (5 papers)

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Research

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13 pages, 4237 KiB  
Article
Optimizing Design Parameters of PLA 3D-Printed Scaffolds for Bone Defect Repair
by Alexandrine Dussault, Audrey A. Pitaru, Michael H. Weber, Lisbet Haglund, Derek H. Rosenzweig and Isabelle Villemure
Surgeries 2022, 3(3), 162-174; https://doi.org/10.3390/surgeries3030018 - 28 Jun 2022
Cited by 8 | Viewed by 2465
Abstract
Current materials used to fill bone defects (ceramics, cement) either lack strength or do not induce bone repair. The use of biodegradable polymers such as PLA may promote patient healing by stimulating the production of new bone in parallel with a controlled degradation [...] Read more.
Current materials used to fill bone defects (ceramics, cement) either lack strength or do not induce bone repair. The use of biodegradable polymers such as PLA may promote patient healing by stimulating the production of new bone in parallel with a controlled degradation of the scaffold. This project aims to determine the design parameters maximising scaffold mechanical performance in such materials. Starting from a base cylindrical model of 10 mm height and of outer and inner diameters of 10 and 4 mm, respectively, 27 scaffolds were designed. Three design parameters were investigated: pore distribution (crosswise, lengthwise, and eccentric), pore shape (triangular, circular, and square), and pore size (surface area of 0.25 mm2, 0.5625 mm2, and 1 mm2). Using the finite element approach, a compressive displacement (0.05 mm/s up to 15% strain) was simulated on the models and the resulting scaffold stiffnesses (N/mm2) were compared. The models presenting good mechanical behaviors were further printed along two orientations: 0° (cylinder sitting on its base) and 90° (cylinder laying on its side). A total of n = 5 specimens were printed with PLA for each of the retained models and experimentally tested using a mechanical testing machine with the same compression parameters. Rigidity and yield strength were evaluated from the experimental curves. Both numerically and experimentally, the highest rigidity was found in the model with circular pore shape, crosswise pore distribution, small pore size (surface area of 0.25 mm2), and a 90° printing orientation. Its average rigidity reached 961 ± 32 MPa from the mechanical testing and 797 MPa from the simulation, with a yield strength of 42 ± 1.5 MPa. The same model with a printing orientation of 0° resulted in an average rigidity of 515 ± 7 MPa with a yield strength of 32 ± 1.6 MPa. Printing orientation and pore size were found to be the most influential design parameters on rigidity. The developed design methodology should accelerate the identification of effective scaffolds for future in vitro and in vivo studies. Full article
(This article belongs to the Special Issue 3D Printing in Surgical Strategies)
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Review

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16 pages, 1745 KiB  
Review
3D Printing for Medical Applications: Current State of the Art and Perspectives during the COVID-19 Crisis
by Andrew Hagen, Megan Chisling, Kevin House, Tal Katz, Laila Abelseth, Ian Fraser, Stephen Bradley, Rebecca Kirsch, Jacob Morris, Joshua W. Giles and Stephanie M. Willerth
Surgeries 2021, 2(3), 244-259; https://doi.org/10.3390/surgeries2030025 - 23 Jul 2021
Cited by 7 | Viewed by 6115
Abstract
The coronavirus SARS-CoV-2 pandemic has affected over one hundred million people worldwide and has resulted in over two million deaths. In addition to the toll that coronavirus takes on the health of humans infected with the virus and the potential long term effects [...] Read more.
The coronavirus SARS-CoV-2 pandemic has affected over one hundred million people worldwide and has resulted in over two million deaths. In addition to the toll that coronavirus takes on the health of humans infected with the virus and the potential long term effects of infection, the repercussions of the pandemic on the economy as well as on the healthcare system have been enormous. The global supply of equipment necessary for dealing with the pandemic experienced extreme stress as healthcare systems around the world attempted to acquire personal protective equipment for their workers and medical devices for treating COVID-19. This review describes how 3D printing is currently being used in life saving surgeries such as heart and lung surgery and how 3D printing can address some of the worldwide shortage of personal protective equipment, by examining recent trends of the use of 3D printing and how these technologies can be applied during and after the pandemic. We review the use of 3D printed models for treating the long term effects of COVID-19. We then focus on methods for generating face shields and different types of respirators. We conclude with areas for future investigation and application of 3D printing technology. Full article
(This article belongs to the Special Issue 3D Printing in Surgical Strategies)
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Other

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8 pages, 4001 KiB  
Case Report
A Bosniak III Cyst Unmasking Tubulocystic Renal Cell Carcinoma in an Adolescent: Management with Selective Arterial Clamping and Robotic Enucleation
by Marcello Della Corte, Elisa Cerchia, Marco Allasia, Alessandro Marquis, Alessandra Linari, Martina Mandaletti, Elena Ruggiero, Andrea Sterrantino, Paola Quarello, Massimo Catti, Franca Fagioli, Paolo Gontero and Simona Gerocarni Nappo
Surgeries 2024, 5(2), 415-422; https://doi.org/10.3390/surgeries5020034 - 16 May 2024
Viewed by 201
Abstract
The Bosniak classification of renal cysts aims to provide a probabilistic risk assessment indicating the likelihood of malignancy from imaging findings. Originally designed to classify adult renal cysts based on computed tomography findings, the Bosniak classification has been extended to pediatric patients, with [...] Read more.
The Bosniak classification of renal cysts aims to provide a probabilistic risk assessment indicating the likelihood of malignancy from imaging findings. Originally designed to classify adult renal cysts based on computed tomography findings, the Bosniak classification has been extended to pediatric patients, with some adjustments made with the aim of accommodating magnetic resonance imaging (MRI) and ultrasonography (US). Bosniak IV lesions are rare in adolescents, indicating localized renal cell carcinoma and requiring surgical intervention. In contrast, Bosniak III lesions can be treated conservatively, although there is a lack of specific guidelines on their management. We present a case of a 14-year-old boy with a Bosniak III lesion, which was incidentally detected during the US evaluation of a left varicocele. After a 12-month follow-up, MRI revealed progression to a Bosniak IV cyst. Robot-assisted tumor enucleation was performed with selective artery clamping when the patient was 15. Histopathology showed tubulocystic renal cell carcinoma without adverse features. Immunocytochemistry supported a favorable prognosis of this rare tumor (<1% of renal tumor), thus obviating the need for adjuvant treatment. At the 18-month follow-up, no recurrence or distant metastasis were observed. This case highlights the importance of an aggressive treatment in persistent Bosniak III and Bosniak IV renal cysts in children and adolescents and the necessity to offer a nephron-sparing surgery. Full article
(This article belongs to the Special Issue 3D Printing in Surgical Strategies)
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10 pages, 1356 KiB  
Opinion
Pediatric Urology Metaverse
by Marcello Della Corte, Erica Clemente, Enrico Checcucci, Daniele Amparore, Elisa Cerchia, Berenice Tulelli, Cristian Fiori, Francesco Porpiglia and Simona Gerocarni Nappo
Surgeries 2023, 4(3), 325-334; https://doi.org/10.3390/surgeries4030033 - 28 Jun 2023
Cited by 5 | Viewed by 1306
Abstract
In the last decades, a digital revolution has transformed several aspects of people’s lives worldwide. Consequently, many substantial changes have concerned numerous professional environments, including medical ones. Among all the different new instruments available in this field, the metaverse is the most futuristic [...] Read more.
In the last decades, a digital revolution has transformed several aspects of people’s lives worldwide. Consequently, many substantial changes have concerned numerous professional environments, including medical ones. Among all the different new instruments available in this field, the metaverse is the most futuristic one and seems to be likewise promising. The metaverse is an emerging resource in healthcare, resulting from the integration of virtual and physical reality. It is particularly valuable in surgical operations, since it allows surgeons to perfectly visualize patients’ anatomy. Metaverse applications even include the pediatric field—in particular, the implementation of children and parents’ shared decision-making processes, as well as prenatal diagnosis and fetal surgery. This resource further represents a rising opportunity in pediatric urology: the development of 3D virtual models and robotic surgery will allow surgeons to explore surgical fields, perfectionating their own professional skills. The metaverse will empower pediatric urologists, patients and their families in many ways, and each one of them deserves to be explored to the fullest. In this work, we aim to discuss the current applications of the metaverse in pediatric urology and its future perspectives. Full article
(This article belongs to the Special Issue 3D Printing in Surgical Strategies)
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15 pages, 3255 KiB  
Technical Note
Utilizing Additive Manufacturing to Produce Organ Mimics and Imaging Phantoms
by Dmitri Karaman and Stephanie M. Willerth
Surgeries 2023, 4(1), 58-72; https://doi.org/10.3390/surgeries4010008 - 2 Feb 2023
Viewed by 1494
Abstract
The complex geometries and material properties necessary for generating accurate organ mimics require new procedures and methods to fully utilize current technologies. The increased accessibility of 3D printers, along with more specialized bioprinters, allow the creation of highly tunable models of various body [...] Read more.
The complex geometries and material properties necessary for generating accurate organ mimics require new procedures and methods to fully utilize current technologies. The increased accessibility of 3D printers, along with more specialized bioprinters, allow the creation of highly tunable models of various body parts. Three-dimensional printing can reduce lead-time on custom parts, produce structures based on imaging data in patients, and generate a test bench for novel surgical methods. This technical note will cover three unique case studes and offer insights for how 3D printing can be used for lab research. Each case follows a unique design process in comparison to traditional manufacturing workflows as they required significantly more iterative design. The strengths of different printing technologies, design choices, and structural/chemical requirements all influence the design process. Utilization of in-house manufacturing allows for greater flexibility and lower lead-times for novel research applications. Detailed discussions of these design processes will help reduce some of the major barriers to entry for these technologies and provide options for researchers working in the field. Full article
(This article belongs to the Special Issue 3D Printing in Surgical Strategies)
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