Effect of navigation endoscopy combined with threedimensional printing technology in the treatment of orbital blowout fractures

●AIM:To explore the combined application of surgical navigation nasal endoscopy(NNE)and three-dimensional printing technology(3DPT)for the adjunctive treatment of orbital blowout fractures(OBF).●METHODS:Retrospective analysis was conducted on the data of patients with OBF who underwent surgical treatment at the Affiliated Eye Hospital of Nanchang University between July 2012 and November 2022.The control group consisted of patients who received traditional surgical treatment(n=43),while the new surgical group(n=52)consisted of patients who received NNE with 3DPT.The difference in therapeutic effects between the two groups was evaluated by comparing the duration of the operation,best corrected visual acuity(BCVA),enophthalmos difference,recovery rate of eye movement disorder,recovery rate of diplopia,and incidence of postoperative complications.●RESULTS:The study included 95 cases(95 eyes),with 63 men and 32 women.The patients’age ranged from 5 to 67y(35.21±15.75y).The new surgical group and the control group exhibited no statistically significant differences in the duration of the operation,BCVA and enophthalmos difference.The recovery rates of diplopia in the new surgical group were significantly higher than those in the control group at 1mo[OR=0.03,95%CI(0.01–0.15),P<0.0000]and 3mo[OR=0.11,95%CI(0.03–0.36),P<0.0000]postoperation.Additionally,the recovery rates of eye movement disorders at 1 and 3mo after surgery were OR=0.08,95%CI(0.03–0.24),P<0.0000;and OR=0.01,95%CI(0.00–0.18),P<0.0000.The incidence of postoperative complications was lower in the new surgical group compared to the control group[OR=4.86,95%CI(0.95–24.78),P<0.05].●CONCLUSION:The combination of NNE and 3DPT can shorten the recovery time of diplopia and eye movement disorder in patients with OBF.

Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation

BACKGROUND Prior studies have shown that preserving the left colic artery(LCA)during laparo-scopic radical resection for rectal cancer(RC)can reduce the occurrence of anasto-motic leakage(AL),without compromising oncological outcomes.However,anatomical variations in the branches of the inferior mesenteric artery(IMA)and LCA present significant surgical challenges.In this study,we present our novel three dimensional(3D)printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.AIM To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.METHODS We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital.Patients were divided into the 3D printing and control groups for sta-tistical analysis of perioperative characteristics.RESULTS The 3D printing observation group comprised of 72 patients,while the control group comprised 68 patients.The operation time(174.5±38.2 minutes vs 198.5±49.6 minutes,P=0.002),intraoperative blood loss(43.9±31.3 mL vs 58.2±30.8 mL,P=0.005),duration of hospitalization(13.1±3.1 days vs 15.9±5.6 days,P<0.001),postoperative recovery time(8.6±2.6 days vs 10.5±4.9 days,P=0.007),and the postoperative complication rate(P<0.05)were all significantly lower in the observation group.CONCLUSION Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively,thereby reducing intraoperative bleeding and shortening operating time,demonstrating better clinical application potential.

In-situ defect passivation assisted three-step printing of efficient and stable formamidine-lead bromide solar cells

Perovskite solar cells(PSCs)emerge as the most promising photovoltaics(PV)for their high performance and potential convenient cost-effective production routes comparing to the sophomore PV technologies.The printed PSCs with simplified device architecture and fabrication procedures could further enhance the competitive strength of PSC technology.In this work,we present an in-situ defect passivation(ISDP)assisted full-printing of high performance formamidine-lead bromide(FAPbBr_(3))PSCs.Only three rapid printing steps are involved for electron transporting layer(ETL),perovskite and carbon to form a complete solar cell on the low-cost fluorine-doped tin oxide(FTO)substrate.Long-chain polymer monomethyl ether polyethylene glycol is particularly utilized as the ISDP passivator,leading to conformal coating on the rough FTO and defect passivation for both ETL and perovskite during printing.A high efficiency of 10.85%(certified 10.14%)and a high V_(oc)up to 1.57 V are achieved for the printed device.The unencapsulated PSCs maintain above 90%of the initial efficiency after continuously heating at 85℃for 1000 h and over 80%of the efficiency after the maximum power point tracking for 3500 h.The fully printed semitransparent PSCs with carbon grids(CGs)show average visible light transmittance over 33%and an efficiency of 8.81%.

Three-dimensional printing: review of application in medicine and hepatic surgery

Three-dimensional(3D) printing(3DP) is a rapid prototyping technology that has gained increasing recognition in many different fields. Inherent accuracy and low-cost property enable applicability of 3DP in many areas, such as manufacturing, aerospace,medical, and industrial design. Recently, 3DP has gained considerable attention in the medical field. The image data can be quickly turned into physical objects by using 3DP technology. These objects are being used across a variety of surgical specialties. The shortage of cadaver specimens is a major problem in medical education. However, this concern has been solved with the emergence of 3DP model. Custom-made items can be produced by using 3DP technology. This innovation allows 3DP use in preoperative planning and surgical training. Learning is difficult among medical students because of the complex anatomical structures of the liver. Thus, 3D visualization is a useful tool in anatomy teaching and hepatic surgical training. However,conventional models do not capture haptic qualities. 3DP can produce highly accurate and complex physical models. Many types of human or animal differentiated cells can be printed successfully with the development of 3D bio-printing technology. This progress represents a valuable breakthrough that exhibits many potential uses, such as research on drug metabolism or liver disease mechanism. This technology can also be used to solve shortage of organs for transplant in the future.

Role of three-dimensional printing and artificial intelligence in the management of hepatocellular carcinoma:Challenges and opportunities

Hepatocellular carcinoma(HCC)constitutes the fifth most frequent malignancy worldwide and the third most frequent cause of cancer-related deaths.Currently,treatment selection is based on the stage of the disease.Emerging fields such as three-dimensional(3D)printing,3D bioprinting,artificial intelligence(AI),and machine learning(ML)could lead to evidence-based,individualized management of HCC.In this review,we comprehensively report the current applications of 3D printing,3D bioprinting,and AI/ML-based models in HCC management;we outline the significant challenges to the broad use of these novel technologies in the clinical setting with the goal of identifying means to overcome them,and finally,we discuss the opportunities that arise from these applications.Notably,regarding 3D printing and bioprinting-related challenges,we elaborate on cost and cost-effectiveness,cell sourcing,cell viability,safety,accessibility,regulation,and legal and ethical concerns.Similarly,regarding AI/ML-related challenges,we elaborate on intellectual property,liability,intrinsic biases,data protection,cybersecurity,ethical challenges,and transparency.Our findings show that AI and 3D printing applications in HCC management and healthcare,in general,are steadily expanding;thus,these technologies will be integrated into the clinical setting sooner or later.Therefore,we believe that physicians need to become familiar with these technologies and prepare to engage with them constructively.

Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis

BACKGROUND With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in threedimensional(3D)printing,there has been an increased interest in the concept.It has been shown that 3D models allow surgeons to better visualise anatomy,aid in planning and performing complex surgery.It is however not clear how best to utilise the technique and whether this results in better outcomes.AIM To evaluate the effect of 3D printing used in pre-operative planning in orthopaedic trauma surgery on clinical outcomes.METHODS We performed a comprehensive systematic review of the literature and a metaanalysis.Medline,Ovid and Embase were searched from inception to February 8,2018.Randomised controlled trials,case-control studies,cohort studies and case series of five patients or more were included across any area of orthopaedic trauma.The primary outcomes were operation time,intra-operative blood loss and fluoroscopy used.RESULTS Seventeen studies(922 patients)met our inclusion criteria and were reviewed.The use of 3D printing across all specialties in orthopaedic trauma surgery demonstrated an overall reduction in operation time of 19.85%[95%confidence intervals(CI):(-22.99,-16.71)],intra-operative blood loss of 25.73%[95%CI:(-31.07,-20.40)],and number of times fluoroscopy was used by 23.80%[95%CI:(-38.49,-9.10)].CONCLUSION Our results suggest that the use of 3D printing in pre-operative planning in orthopaedic trauma reduces operative time,intraoperative blood loss and the number of times fluoroscopy is used.

The Controlled-releasing Drug Implant based on the Three Dimensional Printing Technology: Fabrication and Properties of Drug Releasing in vivo

Three dimensional （3D） printing technology was utilized to fabricate a new type of drug implant with complicated architectures, employing levofloxacin （LVFX） and rifampicine （RFP） as model drugs. The prepared drug implant prototype consists of a doublelayer structure, of which the upper region is a reservoir system containing RFP and the lower region is a matrix one containing LVFX. The release test in vivo revealed that LVFX was released in the early stage; no RFP was detected until 8th day; both of them continuously released more than 6 weeks. Therefore, 3D printing technology provides a precise and feasible method to fabricate a controlled-releasing drug implant with complicated architectures and this drug implant may present a new strategy for the prophylaxis and treatment of bone diseases such as combined bone infections and bone tuberculosis in the near future.

Three-dimensional printing for the accurate orthopedics:clinical cases analysis

As an emerging technology to promote the combination of medicine and industry,the three-dimensional(3D)printing has developed rapidly in the fields of orthopedics,while its unique advantages in improving precise treatment still need to be further popularized.In this report,our team have exhibited several classic cases of integrating 3D printing into orthopedic clinical application,thereby further elaborating thoughts and opinions on the significance of 3D printing in the orthopedic clinical application,technical advantages,existing main problems and coping strategies.

An erratum on “Application of three-dimensional printing in interventional medicine” [J Interv Med(February 2020) 1–16]

After the publication of this work,1 the authors noticed and confirmed that the Funding Information was mistakenly omitted from the article.The statement“This study was supported by grants from the National Natural Science Foundation of China,grant no.81370041,81471760,81671655,the Outstanding Clinical Discipline Project of Shanghai Pudong,grant no.PWYgy2018-04.The authors declare that they have no conflicts of interest.”should be included in the Funding information section of the paper which is missing.We apologize for the error.

Three-dimensional(3D) Printing Technology Assisted by Minimally Invasive Surgery for Pubic Rami Fractures

The feasibility of three-dimensional (3D) printing technology cgmbined with minimally invasive surgery in the treatment of pubic rami fractures was explored.From August 2015 to October 2017,a series of 30 patients who underwent surgical stabilization of their anterior pelvic ring (all utilizing the 3D printing technology)by one surgeon at a single hospital were studied.The minimally invasive incisions were made through anterior inferior cilia spine and pubic nodule.Data collected included the operative duration,the blood loss,the damage of the important tissue,the biographic union and therecovery of the function after the operation.Measurements on inlet and outlet pelvic cardiograph were made immediately post-operation and at all follow-up clinic visits.The scores of reduction and function were measured during follow-up.Results showed that the wounds of 30 patients were healed in the first stage,and there was no injury of important structures such as blood vessels and nerves.According to the Matta criteria,excellent effectiveness was obtained in 22 cases and good in 8 cases.According to the functional evaluation criteria of Majeed,excellent effectiveness was obtained in 21 cases and good in 9 cases.It was suggested that the 3D printing technology assisted by minimally invasive surgery can better evaluate the pelvic fracture before operation,which was helpful in plate modeling, and can shorten surgery duration and reduce intraoperative blood loss and complications. The positioning accuracy was improved,and better surgical result was finally achieved.

Application of the Guiding Template Designed by Three-dimensional Printing Data for the Insertion of Sacroiliac Screws:a New Clinical Technique

This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws.A retrospective study of 7 cases (from July 2016 to December 2016),in which the guiding template printed by the three-dimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis,was performed.Totally,4 males and 3 females were included in template group,aged from 38to 65years old (mean 50.86±8.90).Of them,5 had sacral fractures (3 with Denis type Ⅰ and 2 with type Ⅱ)and 2 the separation of sacroiliac joint.Guiding templates were firstly made by the three-dimensional printing technique based on the pre-operative CT data. Surgical operations for the stabilization of pelvic ring by applying the guiding templates were carried out.A group of 8 patients with sacroiliac injuries treated by percutaneous sacroiliac screws were analyzed as a control group retrospectively.The time of each screw insertion,volume of intra-operative blood loss,and the exposure to X ray were analyzed and the Matta's radiological criteria were used to evaluate the reduction quality.The Majeed score was used to evaluate postoperative living quality.The visual analogue scale (VAS)was applied at different time points to judge pain relief of coccydynia.All the 7 patients in the template group were closely followed up radiographically and clinically for 14 to 20 months,mean (16.57±2.44)months.Totally 9 sacroiliac screws for the S 1 and S2 vertebra were inserted in the 7 patients.The time length for each screw insertion ranged from 450 to 870 s,mean (690.56±135.68)s,and the number of times of exposure to X ray were 4 to 8,mean (5.78±1.20).The intra-operative blood loss ranged from 45to 120 mL,mean (75±23.32)mL.According to Matta's radiology criteria,the fracture and dislocation reduction were excellent in 6cases and good in 1.The pre-operative VAS score ranged from 5.2 to 8.1,mean (7.13±1.00).The average one-week/six-month post-operative VAS was (5.33±0.78)and (1.33±0.66),respectively (P<0.05 when compared with pre-operative VAS).The 12-month post-operative Majeed score ranged from 86 to 92,mean (90.29±2.21).The three-dimensional printed guiding template for sacroiliac screw insertion,which could significantly shorten the operation time,provide a satisfied outcome of the stabilization of the pelvic ring,and protect doctors and patients from X-ray exposure,might be a practical and valuable new clinical technique.

Application of three-dimensional printing in interventional medicine

Introduction In recent years,three-dimensional printing(3DP),an additive manufacturing process,has gained widespread clinical application,and 3DP has been considered as the third industrial revolution.1 In its early introduction in the 1980s,3DP served as a software-controlled technology that converted computer-aided-design(CAD)data into a physical object via a single process.By depositing multiple two-dimensional cross-sections one above the other,3DP can now be used to build arbitrarily complex geometries and patient-specific constructs using the patient’s imaging data.Till date,computed tomography has been the main imaging data source for 3DP owing to its excellent spatial resolution.Furthermore,current 3D printers have enabled bedside on-demand fabrication of medical products in hospitals.New materials including polymers,ceramics,biomaterials,and metals have been developed for such applications over the last few decades.Medical fields that employ 3DP technologies have also expanded,such as tissue engineering,regenerative medicine,pharmaceutics,and medical models and devices.2 The market for additive manufacturing is expected to surpass$20 billion in the global industry by the end of the 2020.3 Although the use of 3DP technology in interventional medicine is still relatively new,advancements are occurring within this discipline at a rapid rate.Different 3DP technologies,materials,and clinical applications relevant to the interventional field are discussed in this article.

Three-dimensional printing technique assisted cognitive fusion in targeted prostate biopsy

Objective:To explore the effect of 3-dimensional(3D)printing-assisted cognitive fusion on improvement of the positive rate in prostate biopsy.Methods:From August to December 2014,16 patients with suspected prostatic lesions detected by multiparametric magnetic resonance imaging(MRI)were included.Targeted prostate biopsy was performed with the use of prostate 3D reconstruction modeling,computersimulated biopsy,3D printing,and cognitive fusion biopsy.All patients had received 3.0 T multiparametric MRI before biopsy.The DICOM MRI files were imported to medical imaging processing software for 3D reconstruction modeling to generate a printable.stl file for 3D printing with use of transparent resin as raw material.We further performed a targeted 2-to 3-core biopsy at suspected lesions spotted on MRI.Results:For the 16 patients in the present study,3D modeling with cognitive fusion-based targeted biopsy was successfully performed.For a single patient,1e2 lesions(average:1.1 lesions)were discovered,followed by 2-6 cores(average:2.4 cores)added as targeted biopsy.Systematic biopsies accounted for 192 cores in total,with a positive rate of 22.4%;targeted biopsies accounted for 39 cores in total,with a positive rate of 46.2%.Among these cases,10 patients(62.5%)were diagnosed with prostate adenocarcinoma,in which seven were discovered by both systematic and targeted biopsy,one was diagnosed by systematic biopsy only,and two were diagnosed by targeted biopsy only.For systematic biopsy,Gleason score ranged from 6 to 8(average:7),while that for targeted biopsy ranged from 6 to 9(average:7.67).Among the seven patients that were diagnosed by both systematic and targeted biopsy,three(42.8%)were reported with a higher Gleason score in targeted therapy than in systematic biopsy.Conclusion:3D printing-assisted cognitive fusion technique markedly promoted positive rate in prostate biopsy,and reduced missed detection in high-risk prostate cancer.

Design and Fabrication of Drug Delivery Devices with Complex Architectures Based on Three-dimensional Printing Technique

A new type of implantable drug delivery devices （ DDD ） with complicated architectures were fubricated by three-dimensional printing technique, employing levofloxacin （LVFX） as a model drug. Processing parameters were optimized in riew of the layer thickness, spucing between printed lines, flow rate of liquid binder and the fast axis speed. The prepared DDD prototype consists of a double-layer structure, of which the upper region is a reservoir system and the lower region is a matrix one. The in vitro release test revealed that LVFX was released in a dual-puse pattern. This DDD may present a new strategy for the prophylaxis and treatment of diseases such as bone infection in the near future.

Visual representation and characterization of three-dimensional hydrofracturing cracks within heterogeneous rock through 3D printing and transparent models

The heterogeneity of unconventional reservoir rock tremendously affects its hydrofracturing behavior. A visual representation and accurate characterization of the three-dimensional （3D） growth and distribution of hydrofracturing cracks within heterogeneous rocks is of particular use to the design and implementation of hydrofracturing stimulation of unconventional reservoirs. However, because of the difficulties involved in visually representing and quantitatively characterizing a 3D hydrofracturing crack-network, this issue remains a challenge. In this paper, a novel method is proposed for physically visualizing and quantitatively characterizing the 3D hydrofracturing crack-network distributed through a heterogeneous structure based on a natural glutenite sample. This method incorporates X-ray microfocus computed tomography （μCT）, 3D printing models and hydrofracturing triaxial tests to represent visually the heterogeneous structure, and the 3D crack growth and distribution within a transparent rock model during hydrofracturing. The coupled effects of material heterogeneity and confining geostress on the 3D crack initiation and propagation were analyzed. The results indicate that the breakdown pressure of a heterogeneous rock model is significantly affected by material heterogeneity and confining geostress. The measured breakdown pressures of heterogeneous models are apparently different from those predicted by traditional theories. This study helps to elucidate the quantitative visualization and characterization of the mechanism and influencing factors that determine the hydrofracturing crack initiation and propagation in heterogeneous reservoir rocks.

Three-dimensional printing for heart diseases: clinical application review

Heart diseases remain the top threat to human health,and the treatment of heart diseases changes with each passing day.Convincing evidence shows that three-dimensional(3D)printing allows for a more precise understanding of the complex anatomy associated with various heart diseases.In addition,3D-printed models of cardiac diseases may serve as effective educational tools and for hands-on simulation of surgical interventions.We introduce examples of the clinical applications of different types of 3D printing based on specific cases and clinical application scenarios of 3D printing in treating heart diseases.We also discuss the limitations and clinically unmet needs of 3D printing in this context.

Magnetic resonance imaging-three-dimensional printing technology fabricates customized scaffolds for brain tissue engineering

Conventional fabrication methods lack the ability to control both macro- and micro-structures of generated scaffolds. Three-dimensional printing is a solid free-form fabrication method that provides novel ways to create customized scaffolds with high precision and accuracy. In this study, an electrically controlled cortical impactor was used to induce randomized brain tissue defects. The overall shape of scaffolds was designed using rat-specific anatomical data obtained from magnetic resonance imaging, and the internal structure was created by computer- aided design. As the result of limitations arising from insufficient resolution of the manufacturing process, we magnified the size of the cavity model prototype five-fold to successfully fabricate customized collagen-chitosan scaffolds using three-dimensional printing. Results demonstrated that scaffolds have three-dimensional porous structures, high porosity, highly specific surface areas, pore connectivity and good internal characteristics. Neural stem cells co-cultured with scaffolds showed good viability, indicating good biocompatibility and biodegradability. This technique may be a promising new strategy for regenerating complex damaged brain tissues, and helps pave the way toward personalized medicine.

Recent advances in meniscus-on-demand three-dimensional micro-and nano-printing for electronics and photonics

The continual demand for modern optoelectronics with a high integration degree and customized functions has increased requirements for nanofabrication methods with high resolution,freeform,and mask-free.Meniscus-on-demand three-dimensional(3D)printing is a high-resolution additive manufacturing technique that exploits the ink meniscus formed on a printer nozzle and is suitable for the fabrication of micro/nanoscale 3D architectures.This method can be used for solution-processed 3D patterning of materials at a resolution of up to100 nm,which provides an excellent platform for fundamental scientific studies and various practical applications.This review presents recent advances in meniscus-on-demand 3D printing,together with historical perspectives and theoretical background on meniscus formation and stability.Moreover,this review highlights the capabilities of meniscus-on-demand 3D printing in terms of printable materials and potential areas of application,such as electronics and photonics.

Treatment of Stanford type A aortic dissection with triple prefenestration, reduced diameter, and three-dimensional-printing techniques: A case report

BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.CASE SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA data.Then,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the surgery.The CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained unobstructed.CONCLUSION Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case.The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.

A combination of digital design and three-dimensional printing to assist treatment of thoracolumbar compression fractures using percutaneous kyphoplasty

Objective:To evaluate the clinical efficacy of the preoperative digita1 design combined with three dimensional(3D)printing models to assist percutaneous kyphoplasty(PKP)treatment for thoracolumbar compression frac tures.Methods:From January 2018 to August 2020,we obtained data of 99 patients diagnosed thoracolumbar compression fractures.These patients were divided into control group(n=50)underwent traditional PKP surgery,and observation group(n=49)underwent preoperative digital design combined with 3D printing model assisted PKP treatment.The clinical efficacy was evaluated with five parameters,including operation time,number of intraoperative radiographs,visual analogue scale(VAS)score,Cobb Angle change,and high compression rate of injured vertebrae.Results:There were statistically significant differences of operation time and number of intraoperative radio graphs between the two groups(P<0.05).For VAS score,Cobb Angle change and vertebral height compression rate,all of these three parameters were significantly improved when the patients accepted surgery teatment in two groups(P<0.05).However,there were no significant differences between control group and observation group for these three parameters either before or after surgery(P>0.05).Conclusions:Through the design of preoperative surgical guide plate and the application of 3D printing model to guide the operation,the precise design of preoperative surgical puncture site and puncture Angle of the injured vertebra was realized,the number of intraoperative radiographs was reduced,the operation time was shortened and the operation efficiency was improved.