Barrett P Cromeens1, William C Ray2, Brad Hoehne3, Fikir Abayneh2, Brent Adler3, Gail E Besner4. 1. Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio. 2. Battelle Center for Mathematical Medicine, Nationwide Children's Hospital, Columbus, Ohio. 3. Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio. 4. Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: gail.besner@nationwidechildrens.org.
Abstract
BACKGROUND: 3-dimensional prints (3DP) anecdotally facilitate surgeon understanding of anatomy and decision-making. However, the actual benefit to surgeons or patients has not been quantified. This study investigates how surgeon understanding of complex anatomy is altered by a 3DP compared to computed tomography (CT) scan or CT + digital reconstruction (CT + DR). MATERIALS AND METHODS: Key anatomic features were segmented from a CT-abdomen/pelvis of pygopagus twins to build a DR and printed in color on a 3D printer. Pediatric surgery trainees and attendings (n = 21) were tested regarding anatomy identification and their understanding of point-to-point distances, scale, and shape. RESULTS: There was no difference between media regarding point-to-point distances. The 3DP led to an increased number of correct answers for questions of scale and shape compared to CT (P < 0.05). CT + DR performance was intermediate but not statistically different from 3DP or CT. Identification of anatomy was inconsistent between media; however, answers were significantly closer to correct when using the 3DP. Participants completed the test faster with the 3DP (6.6 ± 0.5 min) (P < 0.05) than with CT (18.9 ± 2.5 min) or CT + 3DR (14.9 ± 1.5 min). CONCLUSIONS: Although point-to-point measurements were not different, 3DP increased the understanding of shape, scale, and anatomy. It enabled understanding significantly faster than other media. In difficult surgical cases with complex anatomy and a need for efficient multidisciplinary coordination, 3D printed models should be considered for surgical planning.
BACKGROUND: 3-dimensional prints (3DP) anecdotally facilitate surgeon understanding of anatomy and decision-making. However, the actual benefit to surgeons or patients has not been quantified. This study investigates how surgeon understanding of complex anatomy is altered by a 3DP compared to computed tomography (CT) scan or CT + digital reconstruction (CT + DR). MATERIALS AND METHODS: Key anatomic features were segmented from a CT-abdomen/pelvis of pygopagus twins to build a DR and printed in color on a 3D printer. Pediatric surgery trainees and attendings (n = 21) were tested regarding anatomy identification and their understanding of point-to-point distances, scale, and shape. RESULTS: There was no difference between media regarding point-to-point distances. The 3DP led to an increased number of correct answers for questions of scale and shape compared to CT (P < 0.05). CT + DR performance was intermediate but not statistically different from 3DP or CT. Identification of anatomy was inconsistent between media; however, answers were significantly closer to correct when using the 3DP. Participants completed the test faster with the 3DP (6.6 ± 0.5 min) (P < 0.05) than with CT (18.9 ± 2.5 min) or CT + 3DR (14.9 ± 1.5 min). CONCLUSIONS: Although point-to-point measurements were not different, 3DP increased the understanding of shape, scale, and anatomy. It enabled understanding significantly faster than other media. In difficult surgical cases with complex anatomy and a need for efficient multidisciplinary coordination, 3D printed models should be considered for surgical planning.