3D Printing Can Help Guide Urological Surgeries

By Will Boggs MD

June 18, 2019

NEW YORK (Reuters Health) - Prior to urological surgery, 3-dimensional printing can help guide the identification of lesions and their relationships with surrounding structures, among other uses, researchers report.

In a paper online May 18 in European Urology, Dr. Giovanni E. Cacciamani of the University of Southern California, Los Angeles, and colleagues review the impact of 3D printing for surgical planning, education, and patient counseling in the urological field.

They identified 52 papers: two reporting the use of 3D printing modeling for adrenal cancer; 24 for kidney transplantation and renal cancer; 15 for prostate cancer, seven for pelvicalyceal system procedures; three for ureteral stents; and three for 3D-printed biological scaffold development.

More than half the studies (29 papers) involved the use of 3D printing for preoperative and intraoperative surgical planning. The next most common use of 3D printing was for education and training (22 studies).

Other studies (10 papers) found 3D printing to be beneficial in communicating with patients, including pediatric patients, regarding their diagnosis and the surgical plan.

In the 19 studies that reported them, costs ranged from $460-$1,000 for kidney models, $40-$100 for prostate models, and $100 for pelvicalyceal system stones. In one study, a silicone kidney replica cost only $14.40, and in another, $3.90.

"Three-dimensional printing showed revolutionary potentials for patient counseling, pre- and intraoperative surgical planning, and education in urology," the researchers conclude. "Together with 'patient-tailored' presurgical planning, it (forms) the basis for 3D-bioprinting technology."

"Although costs and 'production times' remain the major concerns, this kind of technology represents a step forward to meet patients' and surgeons' expectations," they note. "Further investigation comparing three-dimensional printing with three-dimensional virtual reality are needed."

Dr. Nicole Wake, director of 3D imaging at Montefiore Medical Center, Albert Einstein College of Medicine, in New York, has researched various aspects of 3D printing. She told Reuters Health by email, "I'm a firm believer that 3D-printing technology can aid in any complex case. Seeing and holding a physical 3D printed model is much more powerful than simply visualizing medical imaging data on a 2D screen."

"With the advancement of 3D printing technologies, I think we'll continue to see more 3D printed anatomical models which closely mimic human tissue properties and allow for the surgical procedure to be performed prior to the actual surgery, and we will see more applications of bioprinting," she said.

"Large multi-center trials must be completed in order to determine the actual impact these models can make in patient care and to see which case types actually benefit the most from these models," she added.

"In the US, there is currently no reimbursement for 3D-printed models," added Dr. Wake, who was not involved in the review. "However, AMA Category 3 CPT codes are coming out on July 1, 2019. These Category 3 CPT codes are temporary and exist for emerging technologies, services, and procedures, and are created for data collection, assessment, and in certain circumstances for payment of new services and procedures that do not meet the criteria for a Category I CPT code."

Dr. Cacciamani did not respond to a request for comments.

SOURCE: https://bit.ly/2XJuyZK

Eur Urol 2019.