Abstract
Preoperative assessment of tissue anatomy and accurate surgical planning is crucial in conjoined twin separation surgery. We developed a new method that combines three-dimensional (3D) printing, assembling, and casting to produce anatomic models of high fidelity for surgical planning. The related anatomic features of the conjoined twins were captured by computed tomography (CT), classified as five organ groups, and reconstructed as five computer models. Among these organ groups, the skeleton was produced by fused deposition modeling (FDM) using acrylonitrile-butadiene-styrene. For the other four organ groups, shell molds were prepared by FDM and cast with silica gel to simulate soft tissues, with contrast enhancement pigments added to simulate different CT and visual contrasts. The produced models were assembled, positioned firmly within a 3D printed shell mold simulating the skin boundary, and cast with transparent silica gel. The produced phantom was subject to further CT scan in comparison with that of the patient data for fidelity evaluation. Further data analysis showed that the produced model reassembled the geometric features of the original CT data with an overall mean deviation of less than 2 mm, indicating the clinical potential to use this method for surgical planning in conjoined twin separation surgery.
Highlights
Conjoined twinning is a rare congenital malformation[1,2,3,4,5]
As the organ group assembly was placed inside the shell mold, the positioning holes on the assembly and on the shell molds were aligned in order to ensure the positioning accuracy of the organ groups
We have demonstrated the feasibility of producing a high fidelity conjoined twin model with both visual and computed tomography (CT) contrasts by combining 3D printing and casting
Summary
Conjoined twinning is a rare congenital malformation[1,2,3,4,5]. most of the conjoined twins succumb in utero or are stillborn at birth, approximately 1: 30,000–1: 200,000 are born alive. Ultrasonography is used to assess the brain[11]; fluoroscopy is used to obtain the anatomic features of anal fistula[10]; and high-resolution computed tomography (CT) and magnetic resonance imaging (MRI) are used to reveal the geometric and positional details of the internal organs[12, 13] These imaging tools have been used to support successful surgical planning[2, 7, 14, 15]. Subsequent data analysis showed that the produced phantom had an overall mean deviation of less than 2 mm in comparison with the original models, closely reassembling the anatomic features of the conjoined twins These results support the technical potential of simulating structural, optical and CT properties of relevance in conjoined twins
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