Abstract
The purpose of this systematic review is to collate and analyse the current literature which examines clinical applications of 3D printing for renal disease, alongside cost and time duration factors associated with the printing process. A comprehensive search of the literature was performed across five different databases to identify studies that qualitatively and quantitatively assessed the value of 3D-printed kidney models for renal disease. Twenty-seven studies met the selection criteria for inclusion in the review. Twenty-five were original studies, and two were case reports. Of the 22 studies reporting a qualitative evaluation, the analysis of findings demonstrated the value of the 3D-printed models in areas of clinician and patient education, and pre-surgical simulation for complex cases of renal disease. Of five studies performing a quantitative analysis, the analysis of results displayed a high level of spatial and anatomical accuracy amongst models, with benefits including reducing estimated blood loss and risk of intra-operative complications. Fourteen studies evaluated manufacturing costs and time duration, with costs ranging from USD 1 to 1000 per model, and time duration ranging from 15 min to 9 days. This review shows that the use of customised 3D-printed models is valuable in the education of junior surgeons as well as the enhancement of operative skills for senior surgeons due to a superior visualisation of anatomical networks and pathologic morphology compared to volumetric imaging alone. Furthermore, 3D-printed kidney models may facilitate interdisciplinary communication and decision-making regarding the management of patients undergoing operative treatment for renal disease. It cannot be suggested that a more expensive material constitutes a higher level of user-satisfaction and model accuracy. However, higher costs in the manufacturing of the 3D-printed models reported, on average, a slightly shorter time duration for the 3D-printing process and total manufacturing time.
Highlights
Three-dimensional (3D) printing in medicine is a rapidly advancing area of research, with applications lying in the orthopaedic and dental industries, as well as recently for the treatment of disease [1,2,3,4]
Based on the analysed literature, it can be discerned that 3D-printed kidney models can be successfully generated from computed tomography (CT) and magnetic resonance imaging (MRI) imaging with a high level of anatomic accuracy
The inclusion of family members was advantageous as it provided an additional perspective on the value of 3D-printed kidney models that was not considered by other studies
Summary
Three-dimensional (3D) printing in medicine is a rapidly advancing area of research, with applications lying in the orthopaedic and dental industries, as well as recently for the treatment of disease [1,2,3,4]. 3D printing has been investigated for its use in creating customised prosthetic implants and medical devices, as well as for pre-surgical rehearsal, mainly in the context of cardiovascular and cerebrovascular diseases, and hepatic and renal tumours [1,2,3,4]. Surgical treatment of renal tumours is moving away from a radical approach, whereby minimally invasive, nephron-sparing approaches are being utilised where appropriate. This makes pre-surgical planning and confidence in the surgical approach crucial to salvaging the maximum possible amount of healthy tissue. The implementation of 3D-printing techniques in medical practice represents a new approach to facilitate this
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