Utilizing patient-specific 3D printed kidney surgical guide with realistic phantom for partial nephrectomy.

Area of Science:

• Urology
• Surgical Technology
• Medical Imaging

Background:

• Partial nephrectomy preserves renal function better than radical nephrectomy for localized renal cell carcinoma (RCC).
• Accurate intraoperative localization of RCC is challenging, hindering precise tumor excision.
• Computed tomography (CT) aids in identifying RCC but lacks direct intraoperative guidance.

Purpose of the Study:

• To develop and evaluate a 3D-printed kidney surgical guide (3DP-KSG) for accurate RCC targeting.
• To assess the precision of catheter insertion guided by the 3DP-KSG in realistic kidney phantoms.
• To determine the feasibility of using 3DP-KSG for quantitative and immediate RCC marking during surgery.

Main Methods:

• Fabrication of realistic kidney phantoms with simulated RCC based on patient CT data.
• Design and 3D printing of a patient-specific surgical guide (3DP-KSG).
• Evaluation of catheter insertion accuracy (point and trajectory) using CT scans of phantoms with the 3DP-KSG.

Main Results:

• The 3DP-KSG demonstrated high accuracy in targeting simulated RCC, with minimal insertion point errors (1.597 ± 0.741 mm).
• Catheter trajectory analysis showed excellent precision with a cosine similarity of 0.990 ± 0.010.
• Insertion point errors along X, Y, and Z axes were 0.611 ± 0.855 mm, 0.028 ± 1.001 mm, and -0.510 ± 0.923 mm, respectively.
• No significant difference in accuracy was observed between operators.

Conclusions:

• The 3DP-KSG provides accurate, quantitative, and immediate intraoperative guidance for RCC localization.
• This technology facilitates precise tumor removal during partial nephrectomy, potentially improving renal function preservation.
• 3DP-KSG is a promising tool for enhancing surgical outcomes in RCC treatment.