Robotic-assisted partial nephrectomy: initial experience with 3D printing

Authors

DOI:

https://doi.org/10.48193/revistamexicanadeurologa.v81i1.714

Keywords:

Three-dimensional, Partial Nephrectomy, Augmented Reality

Abstract

Introduction: The creation of 3D printed silicone models has several purposes, one of which is to provide augmented reality (AR), thanks to the imaging and visualization methods that serve as aids in “surgical planning”. They enable precise analysis of the anatomy at the site to be treated and can influence surgical strategy change or decision-making. 

Materials and methods: The present case report describes the surgical planning carried out with a 3D printed model, in a 40-year-old patient incidentally diagnosed with a T2aN0M0 CS I left kidney tumor, measuring 20 mm, that was slightly exophytic, with a RENAL Score of 4a.

Results: Total surgery duration was 180 min, with a console time of 120 min, blood loss of 50cc, and warm ischemia time of 12 min. No drain was placed, hospital stay was 2 days, and there were no complications.

Discussion: Visualizing the anatomic characteristics on the model enabled surgical programming to be carried out, along with guided dissection and selective clamping that did not involve the entire renal hilum. Three-dimensional models are based on multi-slice digital tomography images that are converted to real scale and then printed with different materials, achieving an anatomic representation of the organ to be treated.   

Conclusions: That type of planning favors better understanding of the surgical anatomy of the tumor and improved decision-making. Case series on different anatomic variations, as well as other organs, should be carried out. 

Author Biography

  • Víctor Enrique Corona-Montes, Hospital San Angel Inn Universidad / Hospital General de México. "Dr. Eduardo Liceaga" / Centro Médico A.B.C. Observatorio

    Dr. Víctor Enrique Corona Montes is a passionate surgeon specialized in oncological urology. Expert in diagnosis and treatments with minimally invasive surgery for prostate cancer, kidney cancer, bladder cancer and other urological conditions.

    He obtained the title of Doctor (UMSNH) and immediately completed a specialization in Urological Surgery (UNAM). In 2011, he travels to France to learn from the best Master in the field of minimally invasive urological surgery, Professor Richard Gaston, in Bordeaux, France. Dr. Corona performed around 800 robotic surgeries with his Master Gastón and returned to Mexico to open the first Robotic Surgery program in Mexico City in 2013 with a radical robot-assisted prostatectomy 8 years ago in Mexico.

    In 2015, he completed a second clinical fellowship in Oncological Urology (High Specialty) at the Fundació Puigvert in Barcelona, ​​Spain, this time under the tutelage of Professor Joan Palou Redorta, current director of the Fundació Puigvert.

    Currently, Dr. Corona is Deputy Director of Surgical Specialties at the General Hospital of Mexico, Founder and Head of the High Specialty Program in Laparoscopic and Robotic Surgery in Urology for UNAM (National Autonomous University of Mexico) and for Mexico, as well as member of the Academic Committee of Urology, of the same University.

    Ex-Coordinator of the Laparoscopy and Endourology Section of the Mexican Society of Urology (S.M.U.) between 2013-2016 and Ex- Coordinator of Urological Tumors of the Mexican Society of Oncology for the 2017-2019 cycle (SMeO)

    Author of numerous national and international scientific publications (articles, book chapters), as well as lecturer, trainer (IRCAD France and Brazil), speaker at the international level. He is constantly updated after taking Oncology courses at the Universities of Tampa and Chicago, as well as an active participant in the Oncology Urology Symposia at Mont Sinai Hospital in New York.

    In addition to sharing experiences with their students and their classmates. He has 3 master's degrees, one in Administration of Health Institutions, (U. Anáhuac), one in History of Medicine from the Descartes University of Paris and a Master's in Education from the Tecnológica University. He also has a specialty in Corporate Health and Wellness (U. Anáhuac) and a Doctorate in Senior Management (CEPEM).

    He is fluent in 5 languages ​​and is currently studying one more.

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Published

2021-03-05

Issue

Vol. 81 No. 1 (2021): January-February

Section

Review articles