Improving Surgical Planning for Patients with Deep Endometriosis Using Patient-Specific 3-Dimensional Anatomical...

To evaluate the clinical impact of incorporating patient-specific 3-dimensional (3D) printed anatomical models into gynaecologic practice for improving surgical planning and patient outcomes in patients with deep endometriosis.

A pilot prospective randomized controlled study using a repeated-measures, questionnaire-based design included patients who consented to surgical excision of endometriosis. Patients were randomized to have a 3D printed model or not (control). 3D models were rendered from T2-weighted magnetic resonance images. Gynaecologic surgeons completed questionnaires on surgical planning, surgical outcomes and surgeon experience before and after viewing the 3D printed models and postoperatively, and comparisons were made using paired t tests.

There were 5 patients included in the 3D printing group and 8 patients in the control group. In the 3D printing group, there was a change in 5/10 (50%) surgeon responses for perception of surgical level of difficulty, 5/10 (50%) surgeon responses for allotted surgical time, and 3/10 (30%) surgeon responses for estimated blood loss after viewing the 3D model. Eight of 10 (80%) surgeon responses indicated that the model was referenced intraoperatively. Allotted surgical time was significantly greater post-viewing compared to pre-viewing the model (256.4 ± 60.5 vs. 246.4 ± 56.6 minutes; d = -0.19, P = 0.044) and estimated blood loss significantly lower post-viewing compared to pre-viewing the model (177.3 ± 114.8 vs. 204.6 ± 154.1 mL; d = 0.293, P = 0.003). Compared to control cases, mean surgical time was significantly lower in the 3D model cases (271.7 ± 94.6 vs. 460 ± 225.2 minutes; P = 0.006).

3D printed models may help to optimize surgical planning and improve surgical performance, bettering the overall surgical outcomes in gynaecologic surgery for deep endometriosis.