An ad hoc three dimensionally printed tool facilitates intraesophageal suturing in experimental surgery
Background: Three-dimensional printing (3DP) has become popular for development of anatomic models, preoperative planning, and production of tailored implants. A novel laparoscopic, transgastric procedure for distal esophageal mucosectomy was developed. During this procedure, a space holder had to b...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
November 14, 2017
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| In: |
Journal of surgical research
Year: 2017, Volume: 223, Pages: 87-93 |
| ISSN: | 1095-8673 |
| DOI: | 10.1016/j.jss.2017.10.026 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jss.2017.10.026 Verlag, lizenzpflichtig, Volltext: https://www.journalofsurgicalresearch.com/article/S0022-4804(17)30678-9/abstract 
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| Author Notes: | Daniel C. Steinemann, Philip C. Müller, Martin Apitz, Felix Nickel, Hannes G. Kenngott, Beat P. Müller-Stich, Georg R. Linke |
| Summary: | Background: Three-dimensional printing (3DP) has become popular for development of anatomic models, preoperative planning, and production of tailored implants. A novel laparoscopic, transgastric procedure for distal esophageal mucosectomy was developed. During this procedure, a space holder had to be introduced into the distal esophagus for exposure during suturing. The production process and evaluation of a 3DP space holder are described herein. Materials and methods: Computer-aided design software was used to develop models printed from polylactic acid. The prototype was adapted after testing in a cadaveric model. Subsequently, the device was evaluated in a nonsurvival porcine model. A mucosal purse-string suture was placed as orally as possible in the esophagus, in the intervention group with and in the control group without use of the tool (<i>n</i> = 8 each). The distance of the stitches from the Z-line was measured. The variability of stitches indicated the suture quality Results: The median maximum distance from the Z-line to purse-string suture was larger in the intervention group (5.0 [3.3-6.4] <i>versus</i> 2.4 [2.0-4.1] cm; <i>P</i> = 0.013). The time taken to place the sutures was shorter in the control group (<i>P</i> < 0.001). Stitch variance tended to be greater in the intervention group (2.3 [0.9-2.5] <i>versus</i> 0.7 [0.2-0.4] cm; <i>P</i> = 0.051). The time required for design and production of a tailored tool was less than 24 h. Conclusions: 3DP in experimental surgery enables rapid production, permits repeated adaptation until a tailored tool is obtained, and ensures independence from industrial partners. With the aid of the space holder more orally located esophageal lesions came within reach.</p> |
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| Item Description: | Gesehen am 14.04.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1095-8673 |
| DOI: | 10.1016/j.jss.2017.10.026 |