Anterior mediastinal tumour: 3D modelling changed the surgical strategy
Dr. Ezequiel Muiño Aguilar
Hospital Interzonal Pedro Fiorito - Buenos Aires, Argentina
✔ More information on the structures involved
✔ Redesign of the surgical plan drawn up before looking at the model
✔ Reduction of surgical times
✔ Reduced bleeding
✔ Guidance in the surgical approach in the operating theatre
✔ Collaborates in the training of medical residents
✔ Significant changes in the patient's postoperative period
A 56-year-old woman, with no previous history, presented with dyspnoea and asthenia. She was examined by pneumonology and a computed tomography scan was ordered.
The images showed an anterior mediastinal formation. With the suspicion of thymoma, it was necessary to continue with studies that subsequently ruled out a relationship with the neuromuscular disease Myasthenia Gravis associated with negative ACRA (Anti Acetylcholine Receptor Antibodies). It was therefore decided to proceed with surgery to remove the tumour. Ruling out the possibility of myasthenia gravis would not have prevented the operation, but it would have required certain precautions to be taken.
3D anatomical model
◾ Technology: FDM
◾ Material: PLA
◾ Resolution: 0.2 mm
◾ Finish: Two color
Surgical plan and results in operating room
For resection of the pathological formation, the surgical plan was a right lateral thoracotomy followed by removal of the anterior mediastinal tumour. Initially, a transsternal approach was planned, but this strategy was later replaced by a right thoracic approach on visualisation of the 3D model. With this lateral approach, the tumour was resected taking into consideration the relationship with the right ventricle and vena cava.
The biomodel allowed them to rethink the surgical approach, allowing for better control of complex vascular structures, improving surgical times and patient post-operative outcomes.
In addition, it was very useful in explaining the chosen procedure to the trainee doctors, giving them a better understanding of the procedure.
Finally, the patient was discharged from the hospital 72 hours after the operation and showed a very favourable evolution at her first check-up one week after surgery.
"Excellent experience. We were able to plan tactics and technique correctly, allowing us to improve results."
Would you like to know more about other applications in the thorax?: "Thorax surgery - Bochdalek diaphragmatic hernia". At Clinica La Luz in Peru, Dr. Carlos Fernandez Crisosto used a 3D model to favour the compression of the case and optimise the surgical strategy.