|
1
|
Agrawal H, Tanwar H, Gupta N. Revolutionizing hepatobiliary surgery: Impact of three-dimensional imaging and virtual surgical planning on precision, complications, and patient outcomes. Artif Intell Gastroenterol 2025; 6:106746. [DOI: 10.35712/aig.v6.i1.106746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Revised: 04/01/2025] [Accepted: 04/11/2025] [Indexed: 06/06/2025] Open
Abstract
BACKGROUND Hepatobiliary surgery is complex and requires a thorough understanding of the liver’s anatomy, biliary system, and vasculature. Traditional imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), although helpful, fail to provide three-dimensional (3D) relationships of these structures, which are critical for planning and executing complicated surgeries.
AIM To explore the use of 3D imaging and virtual surgical planning (VSP) technologies to improve surgical accuracy, reduce complications, and enhance patient recovery in hepatobiliary surgeries.
METHODS A comprehensive review of studies published between 2017 and 2024 was conducted through PubMed, Scopus, Google Scholar, and Web of Science. Studies selected focused on 3D imaging and VSP applications in hepatobiliary surgery, assessing surgical precision, complications, and patient outcomes. Thirty studies, including randomized controlled trials, cohort studies, and case reports, were included in the final analysis.
RESULTS Various 3D imaging modalities, including multidetector CT, MRI, and 3D rotational angiography, provide high-resolution views of the liver’s vascular and biliary anatomy. VSP allows surgeons to simulate complex surgeries, improving preoperative planning and reducing complications like bleeding and bile leaks. Several studies have demonstrated improved surgical precision, reduced complications, and faster recovery times when 3D imaging and VSP were used in complex surgeries.
CONCLUSION 3D imaging and VSP technologies significantly enhance the accuracy and outcomes of hepatobiliary surgeries by providing individualized preoperative planning. While promising, further research, particularly randomized controlled trials, is needed to standardize protocols and evaluate long-term efficacy.
Collapse
Affiliation(s)
- Himanshu Agrawal
- Department of Surgery, University College of Medical Sciences, University of Delhi, GTB Hospital, Delhi 110095, India
| | - Himanshu Tanwar
- Department of Surgery, University College of Medical Sciences, University of Delhi, GTB Hospital, Delhi 110095, India
| | - Nikhil Gupta
- Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
| |
Collapse
|
|
2
|
Han HR. Antibiotic Action, Drug Delivery, Biodegradability, and Wound Regeneration Characteristics of Surgical Sutures and Cutting-Edge Surgical Suture Manufacturing Technologies. J Funct Biomater 2025; 16:135. [PMID: 40278243 PMCID: PMC12028033 DOI: 10.3390/jfb16040135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Revised: 03/04/2025] [Accepted: 04/02/2025] [Indexed: 04/26/2025] Open
Abstract
(1) Background: With the emergence of various super bacteria, interest in antibacterial properties, drug delivery, and wound regeneration is increasing in the field of surgical materials. There are many studies on surgical sutures, but not many recent ones that have studied structurally subdivided functions. Accordingly, various studies on surgical sutures were classified based on the main functions that are considered important, and studies were conducted by categorizing the latest production technology into 3D printing and electrospinning. (2) Methods: Data from the literature (n = 1077) were collected from databases such as PubMed, Harvard.edu, MDPI, Google Scholar, Web of Science, ACS, Nature, and IOP Publishing. The selected 103 papers were divided into two main groups: cutting-edge characteristics of surgical sutures and the latest technologies for manufacturing surgical sutures. (3) Results: Cutting-edge characteristics of surgical sutures were divided into four major categories: antibacterial, drug delivery, biodegradability, and wound regeneration, and examined in depth. In addition, the final technologies for manufacturing surgical sutures were divided into electrospinning and 3D printing. (4) Conclusions: The results of this study can contribute to the development of multifunctional surgical sutures that promote wound regeneration through antibacterial properties, drug elution, and biodegradability.
Collapse
Affiliation(s)
- Hye-Ree Han
- Department of Beauty Art Care, Dongguk University, Seoul 04620, Republic of Korea
| |
Collapse
|
|
3
|
Borselle D, Więckowski A, Patkowski D. Evaluating suturing skill improvement for pediatric minimally invasive esophageal anastomosis model: an observational cohort study based on simulator training. Sci Rep 2025; 15:7692. [PMID: 40044784 PMCID: PMC11882792 DOI: 10.1038/s41598-025-91307-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 02/19/2025] [Indexed: 03/09/2025] Open
Abstract
The study aimed to evaluate the enhancement of minimally invasive surgery (MIS) suturing skills through intensive simulator training, to compare various experimentally measured movement parameters with the established scoring system and to identify movement parameters that may be crucial for achieving proficiency. 55 participants of the intensive practical course of endoscopic surgery in children were included. Training commenced with daily single surgical knot practice, progressed to executing on the final day an anastomosis resembling those performed in esophageal atresia repair. The training effectiveness was gauged by the successful completion of anastomosis. Skills were evaluated by simulator equipped with specialized sensors, which converted data into a set of instrument movement parameters. Additionally, two researchers assessed skills using recorded videos and the objective structured assessment of technical skills (OSATS) questionnaire. Significant improvements in single surgical knot proficiency were noted each day, specifically in metrics: time, movement economy, smoothness, acceleration, instrument activity, and overall score. Strong correlation was observed between automated and human assessments. 48/55 participants attempted anastomosis on the final day, among whom 70% (34/48) attained success (median score 5.1/10, only 16.7% scored above 7/10). Movement economy and instrument distance covered emerged as the most relevant predictors of the anastomosis success. Intensive simulation training significantly enhances endoscopic suturing skills.
Collapse
Affiliation(s)
- Dominika Borselle
- Department of Pediatric Surgery and Urology, Wroclaw Medical University and Hospital, Borowska 213, 50-556, Wroclaw, Poland.
| | - Andrzej Więckowski
- Department of Theoretical Physics, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370, Wroclaw, Poland
| | - Dariusz Patkowski
- Department of Pediatric Surgery and Urology, Wroclaw Medical University and Hospital, Borowska 213, 50-556, Wroclaw, Poland
| |
Collapse
|
|
4
|
Zhu Z, Amadi SM, Mao J, Zhou M, Xia M, Parikh NJ, Hu J, Wang Z. A randomized cohort study on the use of 3D printed models to enhance surgical training in suturing techniques. Sci Rep 2025; 15:636. [PMID: 39753693 PMCID: PMC11699156 DOI: 10.1038/s41598-024-84887-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 12/27/2024] [Indexed: 01/06/2025] Open
Abstract
Three-dimensional (3D) printed surgical models provide an excellent surgical training option to closely mimic real operations to teach medical students who currently rely largely on visual learning aided with simple suturing pads. There is an unmet need to create simple to complex surgical training programs suitable for medical students. A prospective cohort study was conducted on a group of 16 6th year students. They were randomly divided into two groups for suture training on a basic training pad or on unique 3D-printed intestinal anastomosis models. After 4 weeks of open and laparoscopic surgical training, exams were performed on the standardized 3D-printed model at the end of each stage to assess surgical performance including surgical time and scores. Both groups had similar skills before the start of each stage. In stage 1, both groups showed comparable learning performance, but the 3D model group performed better in Exam 1. In stage 2, the 3D model group took more time but showed significant improvements and outperformed the pad group in Exam 2 in both performance scores and time. Post-training questionnaires indicated increased interest in surgery and technical training among students using 3D models. Realistic 3D-printed models benefit surgical training, expected to become integral in teaching operative skills and techniques to medical students.
Collapse
Affiliation(s)
- Zhihao Zhu
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, China
| | - Sidney Moses Amadi
- International Education College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Jinlei Mao
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, China
| | - Menghui Zhou
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Minjun Xia
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | | | - Junfeng Hu
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, China.
| | - Zhifei Wang
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, China.
| |
Collapse
|
|
5
|
Yu S, Xu X, Ma L, Zhao F, Mao J, Zhang J, Wang Z. Versatile and Tunable Performance of PVA/PAM Tridimensional Hydrogel Models for Tissues and Organs: Augmenting Realism in Advanced Surgical Training. ACS APPLIED BIO MATERIALS 2024; 7:6261-6275. [PMID: 39194173 DOI: 10.1021/acsabm.4c00873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
The increasing complexity and difficulty of surgical procedures have led to a rise in medical errors within clinical settings in recent years. Gastrointestinal diseases, in particular, present significant medical challenges and impose substantial economic burdens, underscoring the urgent need for experiential, high-fidelity gastrointestinal surgical training tools. This study leverages patient-specific computed tomography (CT) and magnetic resonance imaging (MRI) data, combined with 3D printed manufacturing, to develop hydrogel organ models with tunable performance and tissue-mimicking softness. These properties are achieved by regulating the freeze-thaw cycles, cross-linking agents, and the concentration of incorporated antibacterial nanoparticles in DN hydrogels. Through the application of indirect 3D printing and the "sacrificial material method", we successfully fabricate organ tissues such as the stomach, intestines, and blood vessels with high precision. In ex vivo surgical training demonstrations, these tissue-like soft hydrogels provide an effective platform for preoperative simulation and surgical training in digestive surgery, accommodating various surgical procedures and accurately simulating intraoperative bleeding. The development of advanced bionic organ models with specific and tunable characteristics based on DN hydrogels is poised to significantly advance surgical training, medical device testing, and the reform of medical education.
Collapse
Affiliation(s)
- ShiJie Yu
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - XiaoDong Xu
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Liang Ma
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Fei Zhao
- Center for General Practice Medicine, Department of Gastroenterology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - JinLei Mao
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Jing Zhang
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - ZhiFei Wang
- General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| |
Collapse
|
|
6
|
Zhang Y, Wang MY, Wang LK, Zhang S, Sun H, Liu J. Preliminary study of 3D printing technology for extracorporeal positioning guide assisted ultrasound-guided microwave ablation of the liver. Expert Rev Med Devices 2023; 20:1227-1233. [PMID: 37897059 DOI: 10.1080/17434440.2023.2277233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND We designed a 3D-printed extracorporeal positioning guide for assisting ultrasound-guided microwave ablation of the liver and observed its effectiveness. RESEARCH DESIGN AND METHODS 13 patients with liver cancer were selected, and their CT data were obtained. The CT data is reconstructed in 3D by computer software Mimics to create a 3D model. The 3D-printed in vitro positioning guides were designed by 3-Matic and fabricated using 3D printing technology. Finally, it is applied to the clinic, and its effect is observed. RESULTS The preliminary design of a 3D printed extracorporeal positioning guide was applied to the clinic, and the efficiency of assisted ultrasound positioning was 76.92% (10/13), with three patients requiring repositioning. The efficiency of the 3D printed extracorporeal positioning guide technique was 76.92%, a CT examination was performed one month after surgery, and three patients had residual lesions. CONCLUSIONS 3D-printed extracorporeal positioning guides can assist ultrasound in localizing tumors during liver microwave ablation and reduce repeated punctures. It makes percutaneous microwave ablation of the liver more precise and safe. However, the current study sample is small, there are still apparent shortcomings, and long-term clinical studies are needed to prove its effectiveness.
Collapse
Affiliation(s)
- Yu Zhang
- Guizhou University Medical College, Guiyang, Guizhou Province, China
| | - Ming-Yue Wang
- Guizhou Medoll Company, Oriental Pearl Tower, Guizhou Province, China
| | - Li-Kui Wang
- Guizhou Medoll Company, Oriental Pearl Tower, Guizhou Province, China
| | - Sha Zhang
- Guizhou Medoll Company, Oriental Pearl Tower, Guizhou Province, China
| | - Hong Sun
- Guizhou Medoll Company, Oriental Pearl Tower, Guizhou Province, China
| | - Jun Liu
- Guizhou University Medical College, Guiyang, Guizhou Province, China
- Guizhou Provincial People's Hospital, Guiyang, Guizhou Province, China
| |
Collapse
|