title: Use of 3D Prototypes for Complex Surgical Oncologic Cases.
abstract: BACKGROUND
  Physical 3D models known by the industry as rapid prototyping involve the creation of a physical model from a 3D computer version. In recent years, there has been an increasing number of reports on the use of 3D models in medicine. Printing such 3D models with different materials integrating the many components of human anatomy is technically challenging. In this article, we report our technological developments along with our clinical implementation experience using high-fidelity 3D prototypes of tumors encasing major vessels in anatomically sensitive areas.
  
  
  METHODS
  Three patients with tumors encasing major vessels that implied complex surgery were selected for surgical planning using 3D prototypes. 3D virtual models were obtained from routine CT and MRI images. The models, with all their anatomical relations, were created by an expert pediatric radiologist and a surgeon, image by image, along with a computerized-aided design engineer.
  
  
  RESULTS
  Surgeons had the opportunity to practice on the model before the surgery. This allowed questions regarding surgical approach; feasibility and potential complications to be raised in advance of the actual procedure. All patients then successfully underwent surgery as planned.
  
  
  CONCLUSIONS
  Having a tumor physically printed in its different main component parts with its anatomical relationships is technically feasible. Since a gross total resection is prognostic in a significant percentage of tumor types, refinements in planning may help achieve greater and safer resections therefore contributing to improve surgical management of complex tumors. In this early experience, 3D prototyping helped significantly in the many aspects of surgical oncology planning.
authors.affiliation: Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Barcelona, Spain. lkrauel@hsjdbcn.org.
authors.forename: Lucas
authors.initials: L
authors.lastname: Krauel
authors.affiliation: Fundació CIM, Department of Mechanical Engineering, ETSEIB, Universitat Politècnica de Catalunya, Diagonal 647, 08028, Barcelona, Spain. ffenollosa@fundaciocim.org.
authors.forename: Felip
authors.initials: F
authors.lastname: Fenollosa
authors.affiliation: Pediatric Radiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Barcelona, Spain. lriaza@hsjdbcn.org.
authors.forename: Lucía
authors.initials: L
authors.lastname: Riaza
authors.affiliation: Fundació CIM, Department of Mechanical Engineering, ETSEIB, Universitat Politècnica de Catalunya, Diagonal 647, 08028, Barcelona, Spain. martinpereztorrents@gmail.com.
authors.forename: Martín
authors.initials: M
authors.lastname: Pérez
authors.affiliation: Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Barcelona, Spain. xtarrado@hsjdbcn.org.
authors.forename: Xavier
authors.initials: X
authors.lastname: Tarrado
authors.affiliation: Pediatric Oncology and Hematology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Barcelona, Spain. amorales@hsjdbcn.org.
authors.forename: Andrés
authors.initials: A
authors.lastname: Morales
authors.affiliation: Fundació CIM, Department of Mechanical Engineering, ETSEIB, Universitat Politècnica de Catalunya, Diagonal 647, 08028, Barcelona, Spain. jgoma@fundaciocim.org.
authors.forename: Joan
authors.initials: J
authors.lastname: Gomà
authors.affiliation: Pediatric Oncology and Hematology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Barcelona, Spain. jmora@hsjdbcn.org.
authors.forename: Jaume
authors.initials: J
authors.lastname: Mora
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008953:Models, Anatomic; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D066330:Printing, Three-Dimensional; D013584:Sarcoma, Synovial / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed