Preoperative surgical simulation of laparoscopic adrenalectomy for neuroblastoma using a three-dimensional printed model based on preoperative CT images.

BACKGROUND: Three-dimensional (3D) printed models based on computed tomography (CT) images facilitate the visualization of complex structures and are useful for understanding the surgical anatomy preoperatively. We developed a preoperative surgical simulation method using a 3D printed model based on CT images obtained prior to laparoscopic adrenalectomy for adrenal neuroblastomas (NBs).

MATERIALS AND METHODS: The multi-detector CT images were transferred to a 3D workstation, and 3D volume data were obtained by reconstructing the sections. A model was made with a 3D printer using acrylic ultraviolet curable resin. The adrenal tumor, kidney, renal vein and artery, inferior vena cava, aorta, and outer body were fabricated. The pneumoperitoneum, insertion of trocars, and laparoscopic view were all attainable in this model. We used this model for three cases with adrenal NB.

RESULTS: We used this model to discuss the port layout before the operation and to simulate the laparoscopic view and range of forceps movement. All three cases with NB were completely resected without any surgical complications.

CONCLUSIONS: The surgical simulation using 3D printed models based on preoperative CT images for adrenal NB was very useful for understanding the patient's surgical anatomy and for planning the surgical procedures, especially for determining the optimal port layout.