title: From CT scanning to 3-D printing technology for the preoperative planning in laparoscopic splenectomy.
abstract: BACKGROUND
  Three-dimensional printing technology is rapidly changing the way we produce all sort of objects, having also included medical applications. We embarked in a pilot study to assess the value of patient-specific 3-D physical manufacturing of spleno-pancreatic anatomy in helping during patient's counseling and for preoperative planning.
  
  
  METHODS
  Twelve patients scheduled for a laparoscopic splenectomy underwent contrast CT and subsequent post-processing to create virtual 3-D models of the target anatomy, and 3-D printing of the relative solid objects. The printing process, its cost and encountered problems were monitored and recorded. Patients were asked to rate the value of 3-D objects on a 1-5 scale in facilitating their understanding of the proposed procedure. Also 10 surgical residents were required to evaluate the perceived extra value of 3-D printing in the preoperative planning process.
  
  
  RESULTS
  The post-processing analysis required an average of 2; 20 h was needed to physically print each model and 4 additional hours to finalize each object. The cost for the material employed for each object was around 300 euros. Ten patients gave a score of 5, two a score of 4. Six residents gave a score of 5, four a score of 4.
  
  
  CONCLUSIONS
  Three-dimensional printing is helpful in understanding complex anatomy for educational purposes at all levels. Cost and working time to produce good quality objects are still considerable.
authors.affiliation: Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. a.pietrabissa@smatteo.pv.it.|Chirurgia Generale Seconda, Dipartimento di Chirurgia, Università degli Studi di Pavia, Piazzale Golgi, 9, 27100, Pavia, Italy. a.pietrabissa@smatteo.pv.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pietrabissa
authors.affiliation: Dipartimento di Ingegneria Civile ed Architettura, Università degli Studi di Pavia, Pavia, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Marconi
authors.affiliation: Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Peri
authors.affiliation: Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pugliese
authors.affiliation: Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Cavazzi
authors.affiliation: Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Vinci
authors.affiliation: Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Botti
authors.affiliation: Dipartimento di Ingegneria Civile ed Architettura, Università degli Studi di Pavia, Pavia, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Auricchio
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010865:Pilot Projects; D011300:Preoperative Care; D066330:Printing, Three-Dimensional; D013154:Spleen / Q000000981:diagnostic imaging*; D013156:Splenectomy
keywords: 3D printing; CT of the spleen; Computing; Intraoperative navigation; Laparoscopic splenectomy; Surgical education