MP22-03 MALLEABLE PHYSICAL MODELS OF RENAL MALIGNANCIES CONSTRUCTED FROM 3-D PRINTERS TO ALLOW SURGICAL RESECTION FOR INDIVIDUALIZED PRE-SURGICAL SIMULATION

Abstract

INTRODUCTION AND OBJECTIVES: The goal of partial nephrectomy is to remove renal cell carcinoma completely and to preserve normal renal parenchyma maximally, which make surgeons predict anatomical status of the kidney from image like pre-operative twodimensional CT. Patient-specific three-dimensional (3D) printed model could be useful during operation. METHODS: Nine patients successfully underwent partial nephrectomy with complete excision of the suspicious renal cell carcinoma by open (N1⁄47) or robotic assisted laparoscopic (N1⁄42) approach. Volumetric CT examinations were performed to evaluate renal mass. Aview software (In-house software, Asan Medical Center, Seoul, South Korea) has been used to reformat the renal anatomy, renal mass and measure tumor volume. The virtual resection simulation followed an adequate safety margin with 5 mm distance away from the renal mass. 3D printed kidney model was fabricated with Objet 500 CONNEX3 3D printer (Stratasys CO, USA) with high quality color resolution and Any desired color can be obtained with mixture of the three base colors , translucent, cyan, magenta. With a clear and translucent resin the kidney model was constructed with different colors. RESULTS: The renal mass could be visualized and differentiated from blood vessels and renal collecting system in this model. (Figure) The mean tumor size was 2.2 cm, tumor volume, 7.65 cm, expected remained renal tissue volume 169 cm (94%) and the RENAL nephrometry score ranges 5e9. Mean ischemic time and mean operation time were 16 min and 190 min. 3D printed kidney has an advantage that it enables them to obtain an incision line and depth of dissection. Additionally, it could measure tumor volume, expected resected renal tissue volume and predict remain renal parenchymal volume after operation. So these model could useful for predict renal function after nephrectomy. When we explain the operation procedure with 3D printed kidney model to patients, satisfaction of patients was increased and their concern was decreased. CONCLUSIONS: The use of the simulated patient-specific 3D printed kidney model facilitates the surgical procedure, due to enhancement of preoperative planning and intraoperative orientation of risk structure and target tissue, and may improve surgical outcome. Source of Funding: none