Hunan Cancer Hospital uses 3D printed guide to remove primary liver cancer
Release date: 2016-09-12
Cut and cut is not clean, cut too much and is afraid of affecting metabolic function. In the past, primary liver cancer surgery has such a dilemma. Recently, the Department of Hepatobiliary Surgery of Hunan Cancer Hospital used 3D printing technology to design a 3D model-guided hepatic resection guide—3D printed liver cutting plate. In just two hours, the table tennis-sized tumor on the liver was perfectly removed. The amount of bleeding is only 100ml, and the dilemma is successfully solved. At present, the 3D printing liver cutting plate technology has successfully applied for a patent.
The dilemma of patients with cirrhosis of primary liver cancer is more obvious
China is a high-incidence area of ​​primary liver cancer, and nearly 50% of new cases of liver cancer occur in China every year. Hepatitis B and hepatitis C virus infection are the most common risk factors for primary liver cancer in China. Studies have shown that in China, about 90% of patients with primary liver cancer have a background of hepatitis virus infection; about 60% of them have different degrees of cirrhosis.
The compensatory capacity of normal liver is quite powerful. It is considered to be quite safe to remove about 70% of the liver. The remaining 30% of the liver can meet the metabolic needs of the body. For patients with cirrhosis, the liver function reserve is greatly reduced. Therefore, there is such a contradiction in the surgical treatment of primary liver cancer: on the one hand, doctors hope to expand the scope of resection, complete resection of liver tumors and proximity On the other hand, doctors also hope to retain normal liver tissue as much as possible to facilitate postoperative recovery and reduce the risk of liver failure.
Studies have shown that when the surgical margin of primary liver cancer reaches 1cm, the probability of negative margin is about 90%, and when the margin is 2cm, the negative margin is close to 100%. However, because it is difficult to determine the distance between the margin and the tumor on the surface of the liver, it is usually judged by the surgeon's experience in the operation. Such judgments often have certain deviations, especially for tumors located deep in the liver parenchyma. In the operation of the tumor and the location of the tumor, intraoperative B-ultrasound as a two-dimensional imaging examination, it is difficult to provide accurate pre-cutting line, therefore, patients often find a small lesion infiltration in the liver cutting edge in the postoperative pathological examination, and Blind expansion of the scope of surgery may lead to serious consequences of liver failure after surgery.
3D printing + new patent cracking problem
On the basis of the previous 3D model reconstruction and 3D printing technology, the Department of Hepatobiliary Surgery of Hunan Cancer Hospital designed a 3D model-guided hepatic resection guide—3D printed liver section. At present, the 3D printing liver cutting plate technology has successfully applied for a patent.
Wu Feiyue, director of the hospital's hepatobiliary and intestinal surgery, introduced that the principle of patented technology is to reconstruct the 3D model of the liver through detailed and accurate imaging examination before surgery, and carefully analyze the location of the tumor and the adjacent relationship with the surrounding blood vessels on the model. Simulated surgery was performed on a computer to design a cutting edge. The liver specimens that have been surgically removed are extracted separately, and according to the liver shape of the part of the specimen, a liver resection guide that can completely conform to the liver surface is designed. Based on the guide plate, the guide plate is printed with the high temperature sterilizable synthetic material. The 3D printed liver section was dissected, and the 3D printed liver section was placed on the surface of the liver during the operation to make a pre-cut line consistent with the simulated operation, thereby determining the surgical resection path.
Under the premise of complete resection of the liver tumor and ensuring the surgical margin, the remaining liver tissue was protected to the utmost extent, and a very satisfactory effect was obtained. Surgical bleeding was significantly reduced, postoperative liver function recovered well, and the margin was satisfactory.
Hepatobiliary and intestinal surgery has carried out nearly 100 cases of 3D printing model liver surgery, pancreatic surgery, biliary surgery, duodenal surgery and other operations. After using 3D printing technology, the operation is very precise, and the normal tissue is preserved to the maximum extent, which is conducive to rehabilitation. There is almost no blood transfusion and complications are reduced during the operation. The safety is greatly improved. The Department of Science and Education of the hospital said that the hospital will support the project by assisting in the application of relevant research projects and research centers in Hunan Province, so that the technology can be further researched and promoted, and the application can be more extensive. More departments and doctors can use this technology. It is hoped that the application of 3D printing technology in surgery can benefit more patients.
Source: Tiangongshe
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