Impact of personalized three-dimensional -3D- printed pelvicalyceal system models on patient information in percutaneous nephrolithotripsy surgery: a pilot study.
OBJECTIVE
To investigate the impact of personalized three dimensional (3D) printed pelvicalyceal system models on patient information before percutaneous nephrolithotripsy surgery.


METHODS
Patients with unilateral complex renal stones with indicatation of percutaneous nephrolithotripsy surgery were selected. Usable data of patients were obtained from CT scans as Digital Imaging and Communications in Medicine (DICOM) format. Mimics software version 16.0 (Materialise, Belgium) was used for segmentation and extraction of pelvicalyceal systems. DICOM format were converted to Stereolithography file format. Finally, fused deposition modeling was used to create plasticine 3D models of pelvicalyceal systems. A questionnaire was designed for patients to assess personalized 3D models effect on patient's understanding their conditions before percutaneous nephrolithotripsy surgery (PCNL). The day before surgery, each patient was seen by a urologist to deliver information about surgery. Questionnaire forms were asked to patients complete before and after presentation of 3D models and the results of the questions were compared.


RESULTS
Five patient's anatomically accurate models of the human renal collecting system were successfully generated. After the 3D printed model presentation, patients demonstrated an improvement in their understanding of basic kidney anatomy by 60% (p=0.017), kidney stone position by 50% (p=0.02), the planned surgical procedure by 60% (p=0.017), and understanding the complications related to the surgery by 64% (p=0.015). In addition, overall satisfaction of conservation improvement was 50% (p=0.02).


CONCLUSIONS
Generating kidney models of PCSs using 3D printing technology is feasible, and understandings of the disease and the surgical procedure from patients were well appreciated with this novel technology.
Department of Urology, Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey.
Hasan Anil
HA
Atalay
Department of Urology, Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey.
H Lütfi
HL
Canat
Department of Urology, İzmir Tepecik Training and Research Hospital, Izmir, Istanbul, Turkey.
Volkan
V
Ülker
Department of Urology, Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey.
İlter
İ
Alkan
Department of Urology, Istanbul Medical School, Çapa, Istanbul, Turkey.
Ünsal
Ü
Özkuvanci
Department of Urology, Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey.
Fatih
F
Altunrende
D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007668:Kidney / Q000000981:diagnostic imaging*; D007669:Kidney Calculi / Q000000981:diagnostic imaging* / Q000601:surgery*; D008953:Models, Anatomic; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D010865:Pilot Projects; D066330:Printing, Three-Dimensional; D014057:Tomography, X-Ray Computed
Calculi; Lithotripsy; Technology