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Published on: October 15, 2021
Puncture and Drainage Surgery for Intracerebral Hemorrhage Guided by 3D Printing Puncture Guide Plate
Shengyu Kang1, Chengle Zhao2, Yifeng Fan1
1School of Medical Imaging, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Insights
A novel 3D printing puncture guide plate improves intracerebral hemorrhage surgery by enabling precise hematoma localization and efficient drainage. This 3D-guided technique offers accurate placement and high clearance rates, enhancing patient outcomes.
Area of Science:
- Neurosurgery
- Medical Device Technology
- Biomedical Engineering
Background:
- Intracerebral hemorrhage (ICH) treatment relies on accurate puncture for effective drainage.
- Current CT-guided techniques face challenges with 2D imaging limitations and surgeon expertise requirements.
- Inaccurate positioning can compromise surgical outcomes and increase risks.
Purpose of the Study:
- To evaluate the efficacy of a 3D printing puncture guide plate for guiding ICH surgery.
- To assess the accuracy and efficiency of 3D-guided puncture and drainage in ICH patients.
- To determine the hematoma clearance rate using this novel surgical approach.
Main Methods:
- 3D models of the head and hematoma were reconstructed from CT images using 3D Slicer software.
- A patient-specific 3D printing puncture guide plate was designed and fabricated.
- The guide plate was used to precisely position the drainage tube in the hematoma center during surgery.
Main Results:
- Eight patients with ICH underwent successful surgery using the 3D printing guide plate.
- The average operation time was 17.63 minutes.
- Drainage tube placement accuracy averaged 2.10±0.32 mm, with a mean hematoma clearance rate of 85.14±6.71%.
Conclusions:
- 3D printing puncture guide plates facilitate rapid and accurate localization of intracerebral hematomas.
- This technique achieves satisfactory hematoma clearance rates in ICH patients.
- The 3D-guided approach enhances precision and efficiency in ICH drainage surgery.
Objectives:
Accurate puncture is the key to ensure the effect of puncture and drainage surgery for intracerebral hemorrhage. It usually uses CT to guide the drainage tube to reach the center of the hematoma cavity, which has the problems of inaccurate positioning using 2D images and high requirements for surgeon's experience in brain anatomy and imaging diagnosis. The aim of this study was to use a 3D printing puncture guide plate to guide the puncture and drainage surgery for intracerebral hemorrhage.
Methods:
The CT images were imported into 3D Slicer software to reconstruct 3D models of the head skin and intracerebral hematoma. The target was set in the center of the hematoma and the puncture path from the target to the entry point was designed, the 3D model of puncture guide plate was constructed and saved as stereolithography format file, which was imported into 3D printer to print. During surgery, the drainage tube was placed in the center of the hematoma guided by the 3D printing puncture guide plate, and the blood clot was extracted by the suction syringe.
Results:
Eight patients with hypertensive intracerebral hemorrhage were treated with puncture and drainage surgery guided by 3D printing puncture guide plate. The average operation time of the 8 surgeries was 17.63 minutes. The drainage tubes were all precisely placed in the center of the hematoma, and the blood clots were all successfully extracted. The positioning errors of the 8 drainage tubes were between 1.76 mm and 2.68 mm, and the mean value was 2.10±0.32 mm. The hematoma clearance rate of the 8 patients was between 74.18% and 96.73%, and the mean value was 85.14±6.71%.
Conclusions:
The puncture and drainage surgery for intracerebral hemorrhage guided by 3D printing puncture guide plate helps to quickly and effortlessly localize intracerebral hematoma and achieves satisfactory hematoma clearance rate.
