An ad hoc three dimensionally printed tool facilitates intraesophageal suturing in experimental surgery

• Verfasst von: Steinemann, Daniel [VerfasserIn]
• Verfasst von: Müller, Philip C. [VerfasserIn]
• Verfasst von: Apitz, Martin [VerfasserIn]
• Verfasst von: Nickel, Felix [VerfasserIn]
• Verfasst von: Kenngott, Hannes Götz [VerfasserIn]
• Verfasst von: Müller, Beat P. [VerfasserIn]
• Verfasst von: Linke, Georg R. [VerfasserIn]
• Titel: An ad hoc three dimensionally printed tool facilitates intraesophageal suturing in experimental surgery
• Verf.angabe: Daniel C. Steinemann, Philip C. Müller, Martin Apitz, Felix Nickel, Hannes G. Kenngott, Beat P. Müller-Stich, Georg R. Linke
• E-Jahr: 2018
• Jahr: November 14, 2017
• Jahr des Originals: 2017
• Umfang: 7 S.
• Fussnoten: Gesehen am 14.04.2020
• Titel Quelle: Enthalten in: Journal of surgical research
• Ort Quelle: Orlando, Fla. : Academic Press, 1961
• Jahr Quelle: 2018
• Band/Heft Quelle: 223(2018), Seite 87-93
• ISSN Quelle: 1095-8673
• DOI: doi:10.1016/j.jss.2017.10.026
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1694418707

Abstract

Background: Three-dimensional printing (3DP) has become popular for development of anatomic models, preoperative planning, and production of tailored implants. A novel laparoscopic, transgastric procedure for distal esophageal mucosectomy was developed. During this procedure, a space holder had to be introduced into the distal esophagus for exposure during suturing. The production process and evaluation of a 3DP space holder are described herein. Materials and methods: Computer-aided design software was used to develop models printed from polylactic acid. The prototype was adapted after testing in a cadaveric model. Subsequently, the device was evaluated in a nonsurvival porcine model. A mucosal purse-string suture was placed as orally as possible in the esophagus, in the intervention group with and in the control group without use of the tool (<i>n</i> = 8 each). The distance of the stitches from the Z-line was measured. The variability of stitches indicated the suture quality Results: The median maximum distance from the Z-line to purse-string suture was larger in the intervention group (5.0 [3.3-6.4] <i>versus</i> 2.4 [2.0-4.1] cm; <i>P</i> = 0.013). The time taken to place the sutures was shorter in the control group (<i>P</i> < 0.001). Stitch variance tended to be greater in the intervention group (2.3 [0.9-2.5] <i>versus</i> 0.7 [0.2-0.4] cm; <i>P</i> = 0.051). The time required for design and production of a tailored tool was less than 24 h. Conclusions: 3DP in experimental surgery enables rapid production, permits repeated adaptation until a tailored tool is obtained, and ensures independence from industrial partners. With the aid of the space holder more orally located esophageal lesions came within reach.</p>