title: Cost-effective, personalized, 3D-printed liver model for preoperative planning before laparoscopic liver hemihepatectomy for colorectal cancer metastases.
abstract: OBJECTIVE
  Three-dimensional (3D) printing for preoperative planning has been intensively developed in the recent years. However, the implementation of these solutions in hospitals is still difficult due to high costs, extremely expensive industrial-grade printers, and software that is difficult to obtain and learn along with a lack of a defined process. This paper presents a cost-effective technique of preparing 3D-printed liver models that preserves the shape and all of the structures, including the vessels and the tumor, which in the present case is colorectal liver metastasis.
  
  
  METHODS
  The patient's computed tomography scans were used for the separation and visualization of virtual 3D anatomical structures. Those elements were transformed into stereolithographic files and subsequently printed on a desktop 3D printer. The multipart structure was assembled and filled with silicone. The patient underwent subsequent laparoscopic right hemihepatectomy. The entire process is described step-by-step, and only free-to-use and mostly open-source software was used.
  
  
  RESULTS
  As a result, a transparent, full-sized liver model with visible vessels and colorectal metastasis was created for under $150, which-taking into account 3D printer prices-is much cheaper than models presented in previous research papers.
  
  
  CONCLUSIONS
  The increased accessibility of 3D models for physicians before complex laparoscopic surgical procedures such as hepatic resections could lead to beneficial breakthroughs in these sophisticated surgeries, as many reports show that these models reduce operative time and improve short term outcomes.
authors.affiliation: 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. jan.witowski@student.uj.edu.pl.
authors.forename: Jan Sylwester
authors.initials: JS
authors.lastname: Witowski
authors.affiliation: 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Pędziwiatr
authors.affiliation: 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Major
authors.affiliation: 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Budzyński
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000191:economics* / Q000379:methods; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D061646:Operative Time; D066330:Printing, Three-Dimensional; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: 3D printing; Colorectal metastases; Hemihepatectomy; Laparoscopic surgery; Preoperative planning