Personalised 3D planning for oncology patient with a horseshoe kidney
Dr. Alberto Jurado
Hospital Italiano de Buenos Aires - Ciudad de Buenos Aires, Argentina
✔ Improve understanding of anatomical structures.
✔ Optimise surgical strategy
✔ Visualise the plan to follow
✔ Guiding the approach during surgery
✔ Achieving a less invasive resection
A 75-year-old female patient, whose kidneys are fused from the upper to the lower pole (forming a horseshoe kidney), had a tumour lesion on the right side measuring 35.1 x 30.6 mm. Underneath, in relation to the longitudinal axis, a simple renal cyst was also located in the CT images.
Given the complexity of the case, Dr. Alberto Jurado requested a patient-specific 3D model to plan the surgery.
3D anatomical model
◾ FDM Technology
◾ Material: PLA
◾ Resolution: 0.2 mm
◾ Finish: Two-colour
Surgical planning and outcomes in the operating room
The anatomical model was used to define from different angles the exact relationship between the blood vessels and the tumour, allowing him to choose the most appropriate approach.
The surgical planning was a laparoscopic partial nephrectomy with a transperitoneal approach. Given the location of the tumour it was decided to use medial trocars and a lateral accessory trocar.
In the operating room, Dr. Jurado positioned the physical biomodel on the patient to get a better idea of what he would encounter during the operation and to create a mental image of the procedure.
Surgery time was 3h 30min with an estimated bleeding of 250ml. It was performed satisfactorily with no intraoperative or postoperative complications. The patient was discharged 3 days after surgery.
Histopathology revealed that the tumour lesion was a stage T1b chromophobe cell renal carcinoma.
Reflections by Dr. Alberto Jurado on his experience with 3D biomodels:
Surgical planning is oriented towards personalised surgery, greatly reducing the risk of unexpected situations.
It facilitates the integration of pre-surgical information.
It allows an adequate resection.
It avoids excessive haemostasis, improving the functional results of surgery.
Video of the surgery
Do you want to know new cases in urology? "3D Reconstruction in Urology: Saving and changing the surgical plan". At the Hospital General de Vic (Barcelona, Spain) Dr. Bellido Petti used a virtual anatomical 3D model to plan his surgery and thus reduce ischaemia time and intraoperative bleeding.