Search Results (186)

Background and Clinical Significance: Preoperative planning is crucial for improving surgical safety and outcomes, particularly in minimally invasive surgery, where tactile feedback is absent. Three-dimensional (3D) printing offers patient-specific anatomical models that can enhance surgical planning. Its application in diverticular disease remains underexplored. Case Presentation: We present the case of a 65-year-old male with recurrent diverticulitis involving the sigmoid and descending colon. After conservative management of an acute episode, preoperative imaging revealed extensive diverticulosis. A patient-specific 3D-printed model was created from CT images to plan the surgical approach. The model helped determine the need for a left hemicolectomy rather than a simple sigmoidectomy, anticipated technical challenges such as lowering the left colic flexure and ligating the inferior mesenteric artery, and improved patient counseling. The surgery was performed laparoscopically without complications, and the patient was discharged on postoperative day six. Histology confirmed diverticulosis with perivisceritis and reactive lymphadenitis. Conclusions: This case demonstrates the potential of 3D printing to optimize surgical planning in diverticular disease, enabling tailored resections and improving operative strategy. Broader adoption may be limited by time and cost but offers clear educational and clinical benefits. Full article

Background/Objectives: In reverse shoulder arthroplasty (RSA), precise K-wire positioning of the glenoid component is critical to prevent complications such as glenoid loosening or instability as well as premature implant failure. Optimal component placement must adhere to individualized preoperative plans to account for patient-specific anatomical conditions. Conventional methods often fail to achieve this level of accuracy, undermining the need for personalized medicine. Intraoperative navigation systems are growing in use to improve accuracy in orthopedic surgery. This study aimed to compare the accuracy of K-wire positioning in a 3D-printed model of the scapula using conventional versus navigated methods. Methods: We recruited 20 participants: 10 experienced surgeons and 10 inexperienced medical students. Each participant performed four K-wire drillings—two with conventional instruments and two with an intraoperative navigation system. A novel target system, BoneTrack3D, was used to measure accuracy. We assessed the absolute deviation of the entry and exit points as well as the three-dimensional drilling angle. Results: The navigated method was significantly more accurate for all measured parameters at a family-wise significance level of α = 0.05. The median absolute deviation for the entry point was 1.6 mm with navigation versus 3.0 mm with the conventional method (p < 0.001). Similarly, the exit point deviation was 1.8 mm with navigation versus 6.7 mm conventionally (p < 0.001). The drilling angle deviation also showed significant improvement with navigation, at 2.6° compared to 8.9° conventionally (p < 0.001). However, the navigated method took longer, with a median drilling time of 100.0 s compared to 55.0 s for the conventional method (p < 0.001). The navigated method provided consistent and superior results regardless of a participant’s surgical experience. Conclusions: Navigated techniques for K-wire positioning in RSA demonstrate enhanced accuracy in a 3D-printed model, effectively executing a precise, patient-specific preoperative plan. This could be a direct contribution to personalized medicine, ensuring the final implant alignment is tailored to the individual’s anatomy. Furthermore, intraoperative navigation may contribute to a flatter learning curve, thereby increasing accessibility for surgeons with varying levels of experience. Although navigation introduces additional costs and longer initial procedure times, these drawbacks could be offset by improved technical outcomes and a reduced risk of complications. Future studies, including randomized clinical trials and cost-effectiveness analyses, should seek to validate these results in clinical settings with longer follow-up periods and larger patient cohorts to define long-term value and utility of navigation systems in reverse shoulder arthroplasty. Full article

Suture anchors are widely used for tendon and ligament repair, but their fixation strength is compromised in osteoporotic bone and limited bone volume such as the coracoid process. Existing designs are prone to penetration and insufficient cortical engagement under such conditions. In this study, we developed a novel short expandable-wing (SEW) suture anchor (Ti6Al4V) designed to enhance pull-out resistance through a deployable wing mechanism that locks directly against the cortical bone. Finite element analysis based on CT-derived bone material properties demonstrated reduced intra-bone displacement and improved load transfer with the SEW compared to conventional anchors. Mechanical testing using matched artificial bone surrogates (N = 3 per group) demonstrated significantly higher static pull-out strength in both normal (581 N) and osteoporotic bone (377 N) relative to controls (p < 0.05). Although the sample size was limited, results were consistent and statistically significant. After cyclic loading, SEW anchor fixation strength increased by 25–56%. In a 3D-printed anatomical coracoclavicular ligament reconstruction model, the SEW anchor provided nearly double the fixation strength of the hook plate, underscoring its superior stability under high-demand clinical conditions. This straightforward implantation protocol—requiring only a 5 mm drill hole without tapping, followed by direct insertion and knob-driven wing deployment—facilitates seamless integration into existing surgical workflows. Overall, the SEW anchor addresses key limitations of existing anchor designs in small bone volume and osteoporotic environments, demonstrating strong potential for clinical translation. Full article

The purpose of this study is to characterize two different 3D-printed materials, glass fiber-filled polypropylene (GF-PP) and calcium carbonate-filled polypropylene (CaCO₃-PP), which make it possible to obtain surgical bone models at a reasonable cost. The methodology involved selecting two filaments, among six, which showed better processability in the fused filament fabrication (FFF) process. Then, samples of the two selected materials were 3D printed, followed by characterization in terms of dimensional error, porosity, surface roughness, and mechanical strength. The results showed that both materials can be sterilized, with an increase in dimensional error and porosity after sterilization and slight changes in roughness and tensile strength. Additionally, anatomical models of mandible and femur bones were clinically validated by surgeons. Full article

In the absence of standard procedures for testing 3D-printed soft polymers, an experimental protocol was proposed to assess the suitability of Flexible 80A Resin for a pediatric trachea anatomical 3D model for surgical simulation. Eighteen specimens printed via stereolithography are involved, including anatomical, cylindrical, and dog-bone shapes, to investigate the geometry effect on measured properties. Static tensile tests revealed that using standardized dog-bone specimens as a reference for the material’s Young’s modulus leads to a mean absolute percentage error (MAPE) up to 50% compared to anatomical specimens. Measurement uncertainty combined repeatability with input errors, and the ANOVA test confirmed the need for dedicated mechanical measurements when evaluating complex 3D-printed geometries. The study concludes the suitability of selected material: the average elastic modulus of anatomical specimens was 4.75 MPa, closely matching values reported for tracheal tissue in the literature, with a MAPE of only 2%. Dynamic mechanical tests showed trachea-like viscoelasticity: anatomical specimens were consistently stiffer and more dissipative than cylindrical ones. Creep tests confirmed the viscoelastic behavior simulating airway time scales. The anatomical specimens exhibit faster local relaxation, while cylindrical ones show slower long-term relaxation, both modeled by a two-element generalized Maxwell model (R² = 0.99 and 0.98). Full article

Advances in additive manufacturing (AM) have revolutionized various sectors, including aerospace engineering, where the use of lattice structures has enabled the development of lightweight high-performance components with optimized mechanical properties. Building on these engineering principles, this study explores the application of aerospace-derived lattice design strategies to the biomedical field, specifically for the replication of human lung alveolar structures. The objective is to create anatomically accurate 3D-printed lung models suitable for surgical planning. Finite element analyses have been conducted using a CAD model of adult lungs, including the application of lattice structures generated through nTopology software, to evaluate the elasticity and density, critical for simulating lung mechanics. A preliminary prototype has been produced using stereolithography and flexible resin, showing the potential for realistic tactile feedback. Full article

Background: Three-dimensional (3D) printing technology has rapidly emerged as a transformative tool in medicine, enabling the conversion of two-dimensional scans into highly accurate 3D models. This technology, especially when combined with artificial intelligence (AI) and advanced materials, offers numerous applications in surgical planning, simulation-based training, and patient-specific care. Methods: This review examines current literature and case studies on the use of 3D printing technology in various fields of medicine, especially in surgical specialties. Key applications include surgical planning, mock surgeries, biopsy guide creation, and customized implant fabrication across various surgical fields. Results: 3D printing is transforming surgery by enabling precise visualization of tumors and critical structures, significantly enhancing preoperative planning for conditions such as bone, soft tissue (e.g., neuroblastomas), renal, and maxillofacial tumors. In reconstruction surgeries, patient-specific 3D-printed implants ensure better anatomical compatibility, particularly in maxillofacial, neurosurgical, and vascular applications. Puncture guides improve procedural accuracy in interventions like percutaneous nephrolithotripsy. Detailed anatomical models aid in simulation-based training, increasing preparedness for complex procedures. Additionally, patient-specific implants and AI-integrated decision support systems are paving the way for more personalized and efficient surgical care. Conclusions: 3D printing technology, especially when combined with AI, is reshaping modern surgery by improving both accuracy, safety, and personalized healthcare. Its applications extend across multiple specialties, offering new possibilities in surgical planning, training, and patient-specific treatments. As AI and bioprinting continue to evolve, the potential for real-time applications, such as live-printed tissue implants and enhanced decision support, could drive the next phase of innovation in various fields. Full article

This study describes the design and validation of an experimental setup for testing photoplethysmographic (PPG) devices intended for the non-invasive monitoring of vascular accesses in hemodialysis patients. Continuous assessment of arteriovenous fistulas is essential to detect pathological conditions such as stenosis, which can compromise patient safety and dialysis efficacy. While PPG-based sensors are capable of detecting such anomalies, their clinical applicability must be supported by controlled in vitro validation. The developed system replicates the anatomical, mechanical, optical, and hemodynamic features of vascular accesses. A 3D fistula model was designed and fabricated via 3D printing and silicone casting. The hydraulic circuit used red India ink and a PWM-controlled pump to simulate physiological blood flow, including stenotic conditions. Quantitative validation confirmed anatomical accuracy within 0.1 mm tolerance. The phantom exhibited an average Shore A hardness of 20.3 ± 1.1, a Young’s modulus of 10.4 ± 0.9 MPa, and a compression modulus of 105 MPa—values consistent with soft tissue behavior. Burst pressure exceeded 2000 mmHg, meeting ISO 7198:2016 standards. Flow rates (400–700 mL/min) showed <1% error. Compliance was 2.4 ± 0.2, and simulated blood viscosity was 3.9 ± 0.3 mPa·s. Systolic and diastolic pressures fell within physiological ranges. Photoplethysmographic signals acquired using a MAX30102 sensor (Analog devices Inc., Wilmington, MA, USA) reproduced key components of in vivo waveforms, confirming the system’s suitability for device testing. Full article

Background: Accurate and stable instrument positioning is critical in dental implant procedures, particularly in anatomically constrained regions. Conventional navigation systems assume a static patient head, limiting adaptability in dynamic surgical conditions. This study proposes and validates a real-time motion compensation framework that integrates optical motion tracking with a collaborative robot to maintain tool alignment despite patient head movement. Methods: A six-camera OptiTrack Prime 13 system tracked rigid markers affixed to a 3D-printed human head model. Real-time head pose data were streamed to a Kuka LBR iiwa robot, which guided the implant handpiece to maintain alignment with a predefined target. Motion compensation was achieved through inverse trajectory computation and second-order Butterworth filtering to approximate realistic robotic response. Controlled experiments were performed using the MAiRA Pro M robot to impose precise motion patterns, including pure rotations (±30° at 10–40°/s), pure translations (±50 mm at 5–30 mm/s), and combined sinusoidal motions. Each motion profile was repeated ten times to evaluate intra-trial repeatability and dynamic response. Results: The system achieved consistent pose tracking errors below 0.2 mm, tool center point (TCP) deviations under 1.5 mm across all motion domains, and an average latency of ~25 ms. Overshoot remained minimal, with effective damping during motion reversal phases. The robot demonstrated stable and repeatable compensation behavior across all experimental conditions. Conclusions: The proposed framework provides reliable real-time motion compensation for dental implant procedures, maintaining high positional accuracy and stability in the presence of head movement. These results support its potential for enhancing surgical safety and precision in dynamic clinical environments. Full article

Three-dimensional (3D) modeling and printing technologies are increasingly used in pediatric surgery, offering improved anatomical visualization, surgical planning, and personalized approaches to complex conditions. Compared to standard imaging, patient-specific 3D models—virtual or printed—provide a more intuitive spatial understanding of congenital anomalies, tumors, and vascular anomalies. This review compiles evidence from pediatric surgical fields including oncology, abdominal, and thoracic surgery, highlighting the clinical relevance of 3D applications. The technological workflow—from image segmentation to computer-aided design (CAD) modeling and multimaterial printing—is described, emphasizing accuracy, reproducibility, and integration into hospital systems. Several clinical cases are presented: neuroblastoma, cloacal malformation, conjoined twins, and two cases of congenital diaphragmatic hernia (one with congenital pulmonary airway malformation, CPAM). In each, 3D modeling enhanced anatomical clarity, increased surgeon confidence, and supported safer intraoperative decision-making. Models also improved communication with families and enabled effective multidisciplinary planning. Despite these advantages, challenges remain, such as production time, cost variability, and lack of standardization. Future directions include artificial intelligence-based automation, expanded use of virtual and mixed reality, and prospective validation studies in pediatric cohorts. Overall, 3D modeling represents a significant advance in pediatric precision surgery, with growing evidence supporting its safety, clinical utility, and educational value. Full article

Background: Severe glenoid bone loss presents a major challenge in both primary and revision reverse shoulder arthroplasty (RSA). Standard implants often fail to achieve reliable fixation in these cases. Custom-made, 3D-printed glenoid components have emerged as a potential solution, offering anatomically tailored fit and fixation. This study evaluates the clinical and radiographic outcomes of custom-made glenoid implants in managing severe glenoid bone loss. Methods: A retrospective, multicenter study was conducted on 23 shoulders (11 primary and 12 revision RSAs) that received a custom-made glenoid component using the Enovis ProMade System (San Daniele del Friuli, Udine, Italy) between 2017 and 2022, with a minimum follow-up of 24 months. Preoperative planning utilized CT-based 3D modeling to design implants with patient-specific instrumentation. Clinical outcomes (ROM, pain, Constant–Murley score) and radiographic results were assessed. Statistical comparisons were made between primary and revision groups. Results: Both groups demonstrated significant improvements in shoulder mobility, pain relief, and Constant–Murley scores (all p < 0.001), with no significant differences between primary and revision groups in delta scores. Radiographically, no loosening was observed, with minimal radiolucent lines and low complication rates. Four cases of instability occurred, all in the revision group, with only one requiring conversion to hemiarthroplasty. No differences in radiographic outcomes were observed between groups. Conclusions: Custom-made glenoid implants provide a reliable solution for severe glenoid bone loss in both primary and revision RSA, yielding consistent functional improvement and implant stability. Further prospective studies with larger cohorts and long-term follow-up are warranted to confirm these findings and assess cost-effectiveness. Full article

The Maxillary Skeletal Expander (MSE) is used for maxillary expansion in adolescents and young adults. Virtual planning using 3D models, CBCT and 3D printers help in case selection, appliance design and fabrication. Using the proposed digital workflow, the accuracy of the patient selection phase and appliance delivery are increased, and the required number of visits to the clinic is decreased. The MSE serves as a guide for the insertion of mini-implants, reducing the number of appointments needed for installation. (1) Introduction: Mini-Implant-Assisted Rapid Palatal Expansion (MARPE) appliances, like the MSE, decrease the side effects that regular tooth-anchored appliances have on dental and periodontal structures, especially for skeletally mature patients, combining palatal anchorage with dental support for guidance. The digital planning of the insertion sites, length and angulation of the mini screws, and the fabrication of the 3D-printed appliance that stands as a mini-implant insertion guide give an undeniable precision. (2) Materials and methods: The laboratory steps used in the digital design and fabrication, and clinical steps needed for the insertion protocol are described. (3) Discussions: The individual assessment of the anatomical structures and the use of virtual integrated dental impressions and CBCT increase the accuracy of diagnosis, appliance fabrication and treatment progress. Implementing a digital workflow for mini-implant-supported expansion is a real advantage for both dental teams and patients. (4) Conclusions: The wide range of advantages and the ease of the process support the introduction of this digital workflow in every orthodontic practice. Full article

Digital dentistry is undergoing rapid evolution, with three-dimensional imaging technologies increasingly integrated into routine clinical workflows. Originally developed for accurate dental arch reconstruction, modern intraoral scanners have demonstrated expanding versatility in capturing intraoral mucosal as well as perioral cutaneous structures. Concurrently, photogrammetry has emerged as a powerful method for full-face digital reconstruction, particularly valuable in orthodontic and prosthodontic treatment planning. These advances offer promising applications in forensic sciences, where high-resolution, three-dimensional documentation of anatomical details such as palatal rugae, lip prints, and bite marks can provide objective and enduring records for legal and investigative purposes. This study explores the forensic potential of two digital acquisition techniques by presenting two cadaveric cases of animal bite injuries. In the first case, an intraoral scanner (Dexis 3600) was used in an unconventional extraoral application to directly scan skin lesions. In the second case, photogrammetry was employed using a digital single-lens reflex (DSLR) camera and Agisoft Metashape, with standardized lighting and metric scale references to generate accurate 3D models. Both methods produced analyzable digital reconstructions suitable for forensic archiving. The intraoral scanner yielded dimensionally accurate models, with strong agreement with manual measurements, though limited by difficulties in capturing complex surface morphology. Photogrammetry, meanwhile, allowed for broader contextual reconstruction with high texture fidelity, albeit requiring more extensive processing and scale calibration. A notable advantage common to both techniques is the avoidance of physical contact and impression materials, which can compress and distort soft tissues, an especially relevant concern when documenting transient evidence like bite marks. These results suggest that both technologies, despite their different origins and operational workflows, can contribute meaningfully to forensic documentation of bite-related injuries. While constrained by the exploratory nature and small sample size of this study, the findings support the viability of digitized, non-destructive evidence preservation. Future perspectives may include the integration of artificial intelligence to assist with morphological matching and the establishment of digital forensic databases for pattern comparison and expert review. Full article

Introduction: The radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) originating from the right ventricular outflow tract (RVOT) is a well-established therapy. Traditionally, RFCA is guided using electroanatomical 3D mapping systems involving manual catheter navigation within cardiac chambers. While effective, this approach may be time-consuming, and it carries a potential risk of cardiac wall perforation. Although the risk is low, it cannot be underestimated. Therefore, alternative mapping methods are sought to reduce procedural times and improve the overall efficiency of RVOT-VAs ablation. Aim: To evaluate the safety, feasibility, and efficacy of a universal RVOT 3D model implementation for the ablation of idiopathic RVOT-VAs. Methods: Consecutive patients undergoing VA ablation supported with a universal RVOT 3D model (3D-MODEL group) were included in the study. The RVOT universal model in this group was created by processing DICOM images for the improved segmentation of anatomical structures, followed by production using 3D printing technology. Patients who underwent classic endocardial electroanatomical mapping served as controls (EAM group). Results: A total of 228 patients were included in the study (143 women, age 50 ± 17 years): 149 in the 3D-MODEL group and 79 in the EAM group. The acute complete elimination of clinical VAs was achieved for 133 (89%) of patients in the 3D-MODEL group vs. 65 (82%) in the EAM group (p = 0.14). The procedural time was significantly shorter in the 3D-MODEL group compared to the EAM group (38 ± 14 min vs. 80 ± 39 min, p < 0.001). A significant difference was also observed in the radiofrequency time between the 3D-MODEL and EAM groups (251 ± 176 s vs. 503 ± 425 s, p < 0.001). No significant difference in fluoroscopy time was found between the groups (284 ± 167 s vs. 260 ± 327 s, p = 0.49). Two cases of cardiac tamponade occurred, both in patients from the EAM group. During follow-up, lasting 14 ± 10 months, 87% of patients in the 3D-MODEL group and 75% in the EAM group remained arrhythmia-free (p = 0.45). Conclusions: The use of universal RVOT 3D modeling is a feasible, safe, and effective alternative to classic electroanatomical mapping in the ablation of idiopathic RVOT-VAs. Full article

Three-dimensional (3D) printing offers new opportunities in surgical planning and medical education, yet high costs and technological complexity often limit its widespread use, especially in low-resource settings. This study presents a personalized, cost-effective, and anatomically accurate liver model designed using open-source tools and affordable 3D-printing techniques. Segmentation of hepatic CT images was performed in 3D Slicer using a region-growing method, and the resulting models were optimized and exported as STL files. The external mold was printed with Fused Deposition Modeling (FDM) using PLA+, while internal structures such as vessels and tumors were fabricated via Liquid Crystal Display (LCD) printing using PLA Pro resin. The final assembly was cast in food-grade gelatin to mimic liver tissue texture. The complete model was produced for under USD 50, with an average total production time of under 128 h. An exploratory pedagogical evaluation with five medical trainees yielded high Likert scores for anatomical understanding (4.6), spatial awareness (4.4), planning confidence (4.2), and realism (4.4). This model demonstrated utility in preoperative discussions and training simulations. The proposed workflow enables the fabrication of low-cost, realistic hepatic phantoms suitable for education and surgical rehearsal, promoting the integration of 3D printing into everyday clinical practice. Full article