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Updated: May 29, 2025
Multicolor 3D Printing of Complex Intracranial Tumors in Neurosurgery
Published on: January 11, 2020
Utility of Surgical Simulation for Tubular Retractor Surgery Using Three-Dimensional Printed Intraventricular Tumor
Ryo Omae1, Ryu Kimura1, Yoshihiro Otani1
1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Objective:
The utility of the tubular retractor for deep-seated tumors, including intraventricular tumors, has recently been reported. However, the surgical field's depth and narrowness can lead to blind spots, and it is crucial to prevent damage to the cortex and white matter fibers in eloquent areas. Therefore, preoperative simulation is critical for tubular retractor surgery. In this study, we investigated the benefits of threedimensional (3D)-printed intraventricular tumor models for tubular retractor surgery.
Methods:
Nine patients with intraventricular central neurocytoma who underwent tubular retractor surgery at our institution between March 2013 and August 2023 were retrospectively reviewed. Fusion images and 3D-printed intraventricular tumor models were developed from preoperative computed tomography (CT) and magnetic resonance imaging (MRI). The puncture points of the tubular retractor were simulated using fusion images and 3D-printed intraventricular tumor models by 11 neurosurgeons (3 experts in brain tumors, 2 experts in areas other than brain tumors, and 6 residents). The dispersion of puncture points among 8 neurosurgeons (excluding brain tumor experts) was compared in each simulation model.
Results:
These cases were categorized into two groups based on the dispersion of puncture points simulated by fusion images. Puncture point dispersion was markedly smaller in all cases when using 3D-printed intraventricular tumor models compared to simulations solely based on fusion images.
Conclusions:
In intraventricular tumor surgery using a tubular retractor, 3D-printed intraventricular tumor models proved more beneficial in preoperative simulation compared to fusion images.
Insights
Three-dimensional (3D)-printed intraventricular tumor models significantly improve preoperative simulation accuracy for tubular retractor surgery. These models reduce blind spots and enhance safety in complex neurosurgical procedures.
Area of Science:
- Neurosurgery
- Medical Imaging
- Biomedical Engineering
Background:
- Tubular retractors offer utility for deep-seated and intraventricular tumors.
- Challenges include surgical field depth, narrowness, potential blind spots, and risk to eloquent cortex/white matter fibers.
- Preoperative simulation is critical for optimizing tubular retractor surgery outcomes.
Purpose of the Study:
- To investigate the benefits of three-dimensional (3D)-printed intraventricular tumor models for preoperative simulation in tubular retractor surgery.
- To compare the efficacy of 3D-printed models versus traditional fusion images for surgical planning.
- To assess the impact on neurosurgeon accuracy in determining optimal retractor placement.
Main Methods:
- Retrospective review of nine patients with intraventricular central neurocytoma undergoing tubular retractor surgery.
- Development of 3D-printed tumor models and fusion images from preoperative CT and MRI scans.
- Simulation of tubular retractor puncture points by 11 neurosurgeons using both modalities, with analysis of puncture point dispersion.
Main Results:
- Puncture point dispersion was significantly smaller when using 3D-printed intraventricular tumor models compared to simulations based solely on fusion images.
- The 3D-printed models provided a more precise and consistent simulation of surgical access.
- This enhanced precision was observed across different levels of neurosurgical expertise.
Conclusions:
- Three-dimensional (3D)-printed intraventricular tumor models are more beneficial than fusion images for preoperative simulation in tubular retractor surgery.
- These models enhance surgical planning by providing a superior spatial understanding of the tumor and surrounding structures.
- The use of 3D-printed models can potentially improve surgical safety and efficacy for intraventricular tumors.
