An ad hoc three dimensionally printed tool facilitates intraesophageal suturing in experimental surgery.
J Surg Res
; 223: 87-93, 2018 03.
Article
em En
| MEDLINE
| ID: mdl-29433890
ABSTRACT
BACKGROUND:
Three-dimensional printing (3DP) has become popular for development of anatomic models, preoperative planning, and production of tailored implants. A novel laparoscopic, transgastric procedure for distal esophageal mucosectomy was developed. During this procedure, a space holder had to be introduced into the distal esophagus for exposure during suturing. The production process and evaluation of a 3DP space holder are described herein. MATERIALS ANDMETHODS:
Computer-aided design software was used to develop models printed from polylactic acid. The prototype was adapted after testing in a cadaveric model. Subsequently, the device was evaluated in a nonsurvival porcine model. A mucosal purse-string suture was placed as orally as possible in the esophagus, in the intervention group with and in the control group without use of the tool (n = 8 each). The distance of the stitches from the Z-line was measured. The variability of stitches indicated the suture quality.RESULTS:
The median maximum distance from the Z-line to purse-string suture was larger in the intervention group (5.0 [3.3-6.4] versus 2.4 [2.0-4.1] cm; P = 0.013). The time taken to place the sutures was shorter in the control group (P < 0.001). Stitch variance tended to be greater in the intervention group (2.3 [0.9-2.5] versus 0.7 [0.2-0.4] cm; P = 0.051). The time required for design and production of a tailored tool was less than 24 h.CONCLUSIONS:
3DP in experimental surgery enables rapid production, permits repeated adaptation until a tailored tool is obtained, and ensures independence from industrial partners. With the aid of the space holder more orally located esophageal lesions came within reach.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Técnicas de Sutura
/
Esôfago
/
Impressão Tridimensional
Limite:
Animals
Idioma:
En
Revista:
J Surg Res
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Suíça