The Value of Using Patient-Specific 3D-Printed Anatomical Models in Surgical Planning for Patients With Complex Multifibroid Uteri

Teresa E Flaxman; Carly M Cooke; Olivier X Miguel; Adnan Sheikh; Matthew McInnes; Shauna Duigenan; Sukhbir Sony Singh

doi:10.1016/j.jogc.2024.102435

The Value of Using Patient-Specific 3D-Printed Anatomical Models in Surgical Planning for Patients With Complex Multifibroid Uteri

J Obstet Gynaecol Can. 2024 Mar 6;46(6):102435. doi: 10.1016/j.jogc.2024.102435. Online ahead of print.

Authors

Teresa E Flaxman¹, Carly M Cooke², Olivier X Miguel³, Adnan Sheikh⁴, Matthew McInnes⁵, Shauna Duigenan⁶, Sukhbir Sony Singh⁷

Affiliations

¹ Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON.
² University of Ottawa, Faculty of Medicine, Department of Obstetrics and Gynecology, Ottawa, ON.
³ Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON.
⁴ University of British Columbia, Faculty of Medicine, Department of Radiology, Vancouver, BC.
⁵ Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON; The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON.
⁶ University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON; The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON.
⁷ Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Obstetrics and Gynecology, Ottawa, ON; The Ottawa Hospital, Department of Obstetrics, Gynecology and Newborn Care, Ottawa, ON. Electronic address: susingh@toh.ca.

PMID: 38458270
DOI: 10.1016/j.jogc.2024.102435

Abstract

Objectives: To compare surgeon responses regarding their surgical plan before and after receiving a patient-specific three-dimensional (3D)-printed model of a patient's multifibroid uterus created from their magnetic resonance imaging.

Methods: 3D-printed models were derived from standard-of-care pelvic magnetic resonance images of patients scheduled for surgical intervention for multifibroid uterus. Relevant anatomical structures were printed using a combination of transparent and opaque resin types. 3D models were used for 7 surgical cases (5 myomectomies, 2 hysterectomies). A staff surgeon and 1 or 2 surgical fellow(s) were present for each case. Surgeons completed a questionnaire before and after receiving the model documenting surgical approach, perceived difficulty, and confidence in surgical plan. A postoperative questionnaire was used to assess surgeon experience using 3D models.

Results: Two staff surgeons and 3 clinical fellows participated in this study. A total of 15 surgeon responses were collected across the 7 cases. After viewing the models, an increase in perceived surgical difficulty and confidence in surgical plan was reported in 12/15 and 7/15 responses, respectively. Anticipated surgical time had a mean ± SD absolute change of 44.0 ± 47.9 minutes and anticipated blood loss had an absolute change of 100 ± 103.5 cc. 2 of 15 responses report a change in pre-surgical approach. Intra-operative model reference was reported to change the dissection route in 8/15 surgeon responses. On average, surgeons rated their experience using 3D models 8.6/10 for pre-surgical planning and 8.1/10 for intra-operative reference.

Conclusions: Patient-specific 3D anatomical models may be a useful tool to increase a surgeon's understanding of complex gynaecologic anatomy and to improve their surgical plan. Future work is needed to evaluate the impact of 3D models on surgical outcomes in gynaecology.

Keywords: gynecology; magnetic resonance imaging; minimally invasive surgical procedures; patient care planning; printing; three-dimensional; uterine myomectomy.