Intellectual Output 1

Output Title: Production of Patient-Specific CT-Reconstructed 3D Printed Surgical Models with Using Patient/Cadaver Radiologic Data and Standard Cadaveric Surgical Models

Output Type: Learning / Teaching / Training Material – Audiovisual Material

Leading Organisation: Hacettepe University
Participating Organisations: Katholieke Universiteit Leuven

By 2023, medical 3D printing is expected to be one of the major trends in the global 3D printing market, largely down to the increasing adoption of 3D printing technology by medical professionals. 3D printing has been found to greatly aid and improve success rates in surgery, deliver better patient communication and outcomes, and give greater insight for medical students and junior doctors. Patient -specific models of diseased or cancerous organs could be constructed to help better plan for surgical procedures to improve efficiency, minimize blood loos and ultimately translate into better patient outcomes. However, 3D printing can also serve as an important teaching tool and training adjunct in medical education not only for medical students and residents, specialist (urologists, gynecologists etc.), but also in the counseling of patients and their families with regards to disease management and procedural description. This outcome of the project will create re-usable patient- specific CT/MRI reconstructed 3D printed surgical models based on frequent surgeries on functional urology for training purposes. However, we will also create the standard surgical procedures on fresh-frozen cadavers to compare the efficacy of the innovative model with standard one. Functional urological problems consist of the anatomical organs within pelvic region and nervous system basically. All functional organs within pelvic region will be reconstructed from DICOM series to STL (Standard Tesselation Language) files , and then printed as STL files with using different types of materials due to the organs (silicone, wax, polymers, hydrogel, PLA etc.). We will use compatible 3D modeling software for computer-aided design, converting data from 2D to 3D that should be needed for 3D printing process. We do prefer fused deposition modeling which is one of the most common printing methods.

Due to European Board of Urology Curriculum and International Continence Society (main authority on functional urology in the world) Expert Opinion, we determined the anatomy based surgical procedures that will be produced with 3D printing technology and fresh-frozen cadavers as surgical simulators at list below:

1- Male Sling (Transobturator/Retropubic) – David Castro Diaz- David Hernandez- Frank Van Der Aa
2- Intravesical Botox Application (Male/Female) Sherif Mourad- Elizabetta Costantini- Ester İliano
3- Sacral Neuromodulation (Male/Female) Emre Huri- Alex Digesu
4- Cystoscopy(Male/Female)Emre Huri- Sherif Mourad
5- Artificial Urinary Sphincter Implantation (Male) David Castro Diaz- David Hernández- Frank Van Der Aa
6- Transurethral Prostate Resection Sherif Mourad- Emre Huri
7-Adjustable Male Sling- David Hernandez, David Castro Diaz
8- Vaginal Sling (Transobturator/Retropubic) - İlker Selçuk- İlkan Tatar- Emre Huri
9- Mini-sling Surgery Elizabetta Costantini - Alex Diguse- Ester İliano
10-Vesicovaginal Fistula Repairment (basic method) Sherif Mourad
11-Anatomic Sacrocolpopoexy Elizabetta Costantini- Ester İliano
12- Vaginal POP Repair (SSLP included) Elizabetta Costantini- Ester İliano
13- Posterior tibial nerve stimulation (posterior tibial nerve model) Sherif Mourad
14- Bulking Injection – Sherif Mourad

The methodology of creation novel training models is innovative side of the project proposal, however, creation various surgical training models in functional urology, having an interdiciplinary methodology, transferability to the other medical eras and fields are strong side of the project proposal.

Tasks leading to the production of the intellectual output and the applied methodology:
Production of patient-specific CT-reconstructed 3D printed models will be done by Turkey with using patient/cadaver radiologic data and cadaveric surgical models will be prepared by Belgium ang Turkey.

The tasks leading to the production of the intellectual output are: to reconstruct computer based 3D anatomical models from standardized DICOM (Digital Communications on Medicine) images, firstly we'll use software packages such as MIMICS and OSIRIX for extracting adequate anatomical info to the model. We'll also apply additional software for rendering, texturing processes to create realistic human organ models. We will use these models for producing real 3D printed educational materials.