title: Initial experience with a tailor-made simulation and navigation program using a 3-D printer model of kidney transplantation surgery.
abstract: BACKGROUND
  Three-dimensional (3-D) printing systems allow for the creation of surgical models mimicking real tissue. We developed a kidney graft and pelvic cavity replica as a patient-specific 3-D model using a 3-D printing system with simultaneous jetting of different materials and subsequently evaluated the usefulness of surgical simulation and navigation of living kidney transplantation.
  
  
  METHODS
  After generating a stereolithographic file of the organ surface based on multidetector computed tomographic data, we created a 3-D organ model using an inkjet 3-D printer and manufactured a pelvic cavity replica using patient-specific data.
  
  
  RESULTS
  The patients' individual 3-D printed models were used to plan and guide the surgical procedures for laparoscopic donor nephrectomy and recipient transplantation surgery. The 3-D organ replicas obtained using transparent materials allowed for the creation of models that showed the visceral organs, blood vessels, and other details, thereby overcoming the limitations of conventional image-guided navigation. Our pelvic replicas can be made according to each patient's specific anatomical data, thus representing personalized surgical procedures. This level of detail of the anatomy enables the surgeons and trainees to virtually treat various pelvic conditions before they perform the surgical procedure. The use of these replicas may also reduce the length of the operation and provide better anatomical reference tools for tailor-made simulation and navigation of kidney transplantation surgery, consequently helping to improve training for the operating room staff, students, and trainees.
  
  
  CONCLUSIONS
  We believe that our sophisticated personalized donor graft and pelvic replications obtained using a 3-D printing system are advantageous for kidney transplantation surgery.
authors.affiliation: Department of Urology, Fujita-Health University School of Medicine, Toyoake, Aichi, Japan. Electronic address: mkusaka@fujita-hu.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Kusaka
authors.affiliation: Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Department of Urology, Fujita-Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Fukami
authors.affiliation: Department of Urology, Fujita-Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Urology, Fujita-Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Takenaka
authors.affiliation: Fasotec Co., Ltd, Chiba, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Anraku
authors.affiliation: Department of Organ Transplant Surgery, Fujita-Health University, Toyoake, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Organ Transplant Surgery, Fujita-Health University, Toyoake, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kenmochi
authors.affiliation: Department of Urology, Fujita-Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Shiroki
authors.affiliation: Department of Urology, Fujita-Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hoshinaga
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D016030:Kidney Transplantation / Q000193:education* / Q000379:methods; D010535:Laparoscopy / Q000193:education; D008297:Male; D008953:Models, Anatomic; D061330:Multidetector Computed Tomography; D009392:Nephrectomy / Q000193:education / Q000379:methods; D066330:Printing, Three-Dimensional; D020858:Tissue and Organ Harvesting / Q000193:education* / Q000379:methods