Three-Dimensional Printing for Chest Wall Reconstruction in Thoracic Surgery: Building on Experience

Thorac Cardiovasc Surg. 2020 Jun;68(4):352-356. doi: 10.1055/s-0039-1678611. Epub 2019 Feb 8.

Abstract

Objectives: Patients undergoing surgery for locally advanced lung cancer involving the chest wall require anatomical lung with extensive en-bloc chest wall resection and appropriate reconstruction.In this proof-of-concept study, we aimed to produce personalized three-dimensional (3D)-printed chest wall prosthesis for a patient undergoing chest wall resection and reconstruction using clinically obtained computed tomography (CT) data.

Methods: Preoperative CT scans of three patients undergoing chest wall resection were analyzed and the areas of resection segmented. This was then used to produce a 3D print of the chest wall and a silicone mold was created from the model. This mold was sterilized and used to produce methyl methacrylate prostheses which were then implanted into the patients.

Results: Three patients had their chest wall reconstructed using this technique to produce a patient specific prosthesis. There were no early complications or deaths.

Conclusions: It is possible to use 3D printing to produce a patient specific chest wall reconstruction for patients undergoing chest wall resection for malignancy that is cost-effective. This chest wall is thought to provide stability in the form of prosthetic ribs as well compliance in the form of an expanded polytetrafluoroethylene patch. Further research is required to measure chest wall compliance during the respiratory cycle and long-term follow-up from this method.

MeSH terms

  • Aged
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Methylmethacrylate*
  • Middle Aged
  • Neoplasm Invasiveness
  • Patient-Specific Modeling
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / instrumentation*
  • Printing, Three-Dimensional*
  • Proof of Concept Study
  • Prosthesis Design*
  • Thoracic Surgical Procedures / adverse effects
  • Thoracic Surgical Procedures / instrumentation*
  • Thoracic Wall / diagnostic imaging
  • Thoracic Wall / pathology
  • Thoracic Wall / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Methylmethacrylate