title: Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review.
abstract: Three-dimensional (3D) printing is becoming increasingly important in medicine and especially in surgery. The aim of the present work was to identify the advantages and disadvantages of 3D printing applied in surgery.
  
  
  
  We conducted a systematic review of articles on 3D printing applications in surgery published between 2005 and 2015 and identified using a PubMed and EMBASE search. Studies dealing with bioprinting, dentistry, and limb prosthesis or those not conducted in a hospital setting were excluded.
  
  
  
  A total of 158 studies met the inclusion criteria. Three-dimensional printing was used to produce anatomic models (n = 113, 71.5%), surgical guides and templates (n = 40, 25.3%), implants (n = 15, 9.5%) and molds (n = 10, 6.3%), and primarily in maxillofacial (n = 79, 50.0%) and orthopedic (n = 39, 24.7%) operations. The main advantages reported were the possibilities for preoperative planning (n = 77, 48.7%), the accuracy of the process used (n = 53, 33.5%), and the time saved in the operating room (n = 52, 32.9%); 34 studies (21.5%) stressed that the accuracy was not satisfactory. The time needed to prepare the object (n = 31, 19.6%) and the additional costs (n = 30, 19.0%) were also seen as important limitations for routine use of 3D printing.
  
  
  
  The additional cost and the time needed to produce devices by current 3D technology still limit its widespread use in hospitals. The development of guidelines to improve the reporting of experience with 3D printing in surgery is highly desirable.
authors.affiliation: Pharmacy Department, Georges Pompidou European Hospital, Paris, France; University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France. Electronic address: nicolas.martelli@aphp.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Martelli
authors.affiliation: Pharmacy Department, Georges Pompidou European Hospital, Paris, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Serrano
authors.affiliation: University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: van den Brink
authors.affiliation: Pharmacy Department, Georges Pompidou European Hospital, Paris, France.
authors.forename: Judith
authors.initials: J
authors.lastname: Pineau
authors.affiliation: Pharmacy Department, Georges Pompidou European Hospital, Paris, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Prognon
authors.affiliation: University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France; Department of Health Economics, Gustave Roussy Institute, Villejuif, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Borget
authors.affiliation: Department of Cardiac and Vascular Surgery, Georges Pompidou European Hospital, Paris, France; URDIA - Unité de Recherche en Développement, Imagerie et Anatomie - EA 4465, Université Paris Descartes, Paris, France.
authors.forename: Salma
authors.initials: S
authors.lastname: El Batti
mesh_terms: D006801:Humans; D008953:Models, Anatomic; D066330:Printing, Three-Dimensional; D019736:Prostheses and Implants; D013514:Surgical Procedures, Operative