Clinical School (Austin Health) - Research Publications
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ItemInnovations in cardiac surgery: techniques and applications of 3D printing(Future Medicine, 2018)Aim: The 3D printing is a developing technology which has begun to flourish in felds where the ability to visualize complex anatomy in novel ways can aid interventions. This paper reviews the literature on 3D printing in cardiac surgery. Methods: We performed a literature search in three databases using appropriate search terms to capture publications pertaining to 3D printing in cardiac surgery. Results: Our search demonstrated a paucity of literature in this area, with 27 relevant publications identified since 1980. The majority of articles pertained to the utility of 3D printing in presurgical planning, but its application in other areas was largely unexplored. Conclusion: There is enormous potential for growth of 3D printing in cardiac surgery, which can drastically change the way, we practice medicine.
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ItemFrom ideas to long-term studies: 3D printing clinical trials review(SPRINGER HEIDELBERG, 2018-09-01)PURPOSE: Although high costs are often cited as the main limitation of 3D printing (3DP) in the medical field, current lack of clinical evidence is asserting itself as an impost as the field begins to mature. The aim is to review clinical trials in the field of 3DP, an area of research which has grown dramatically in recent years. METHODS: We surveyed clinical trials registered in 15 primary registries worldwide, including ClinicalTrials.gov. All trials which utilized 3DP in a clinical setting were included in this review. Our search was performed on December 15, 2017. Data regarding the purpose of the study, inclusion criteria, number of patients enrolled, primary outcomes, centers, start and estimated completion dates were extracted. RESULTS: A total of 92 clinical trials with [Formula: see text]252 patients matched the criteria and were included in the study. A total of 42 (45.65%) studies cited China as their location. Only 10 trials were multicenter and 2 were registered as international. The discipline that most commonly utilized 3DP was Orthopedic Surgery, with 25 (27.17%) registered trials. At the time of data extraction, 17 (18.48%) clinical trials were complete. CONCLUSIONS: After several years of case reports, feasibility studies and technical reports in the field, larger-scale studies are beginning to emerge. There are almost no international register entries. Although there are new emerging areas of study in disciplines that may benefit from 3DP, it is likely to remain limited to very specific applications.
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ItemUltrasound Guided Foam Sclerotherapy: Does Size Matter?(Association for Academic Surgery Academic Surgical Congress, 2018)
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ItemA Narrative Review of 3D Printing in Cardiac Surgery(Association for Academic Surgery, 2018)
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ItemUse Of 3d Printed Models For Pre Operative Rehearsal Prior To Complicated Aortic Surgery(Association for Academic Surgery Academic Surgical Congress, 2018-02-01)Introduction: We present a simple technique for the pre-operative planning and technical practice of complicated aortic surgery using 3D printed models. Methods: A 1040 slice CT of a complicated aortic case was imported into imaging processing software and a stereolithographic replica printed using Formlabs Clear Resin and polished with Dulux Dura-Max plastic primer and White Knight Crystal clear acrylic to improve resin transparency. The aortic model was suspended and secured in a plastic container filled with waterbeads and placed on an angiography suite table. Lengths of transparent polyvinyl tubing 6mm in diameter were aligned against and taped to the subclavian and external iliac arteries of the aortic model. A camera was placed on the gantry and video streamed to a monitor made visible to the operator The surgical procedure was then recreated, allowing the operator to practice cannulating the model through the polyvinyl tubing and feeding chimney stents into the coeliac axis, SMA and bilateral renal arteries of the model aorta. Results: Whilst CT imaging is capable of stereoscopic rendering to provide a 3D representation of the aorta; these images can only be viewed in 2D, which makes subtleties of complicated anatomy difficult to appreciate. We offer a simple and cheap model that we predict will improve preoperative planning through a better understanding of the anatomy, improve the operative times through practice of key steps involved in the surgery and reduce complication rates by early identification of issues prior to performing the real surgery. Conclusion: The use of 3D printing in medicine affords surgeons the unique ability to simulate complicated operations on anatomy matched to individual patients. We provide an example of how a simple printed model can be used to improve operative planning and reduce both complication rates and operative times.
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ItemLeft acute neovascular glaucoma after right carotid endarterectomy(ELSEVIER SCIENCE BV, 2018-06-01)Carotid endarterectomy is a commonly performed vascular surgical procedure with well-known complications, such as stroke and nerve injury. Neovascular glaucoma (NVG) is an exceedingly rare complication after carotid endarterectomy that can result in loss of vision. All previous reports of NVG after carotid endarterectomy have occurred on the same side as the carotid surgery; in this report, we present a case of left-sided NVG after right carotid endarterectomy for contralateral ocular ischemic syndrome. We aim to emphasize the importance of early recognition and treatment of this serious complication as rapid intervention has the potential to save sight.
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ItemThe academic tweet: Twitter as a tool to advance academic surgery(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2018-06-01)Social media, Twitter in particular, has emerged as an essential tool for surgeons. In the realm of academic surgery, it enables surgeons to advance the core values of academic surgery, as outlined by the Association for Academic Surgery: inclusion, leadership, innovation, scholarship, and mentorship. This article details the ways in which surgeons are using Twitter to embody these values and how the Twitter account for the Association of Academic Surgeons accomplishes its goal of inspiring and developing young academic surgeons.
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ItemThree dimensional models in uro-oncology: a future built with additive fabrication(SPRINGER, 2018-04-01)PURPOSE: Three-dimensional (3D) printing was invented in 1983 but has only just begun to influence medicine and surgery. Conversion of digital images into physical models demonstrates promise to revolutionize multiple domains of surgery. In the field of uro-oncology, researchers and clinicians have recognized the potential of this technology and are working towards making it an integral part of urological practice. We review current literature regarding 3D printing and other 3D technology in the field of urology. METHOD: A comprehensive assessment of contemporary literature was performed according to a modified PRISMA analysis for the purposes of this narrative review article. Medical databases that were searched included: Web of Science, EMBASE and Cochrane databases. Articles assessed were limited only to English-language peer-reviewed articles published between 1980 and 2017. The search terms used were "3D", "3-dimensional", "printing", "printing technology", "urology", "surgery". Acceptable articles were reviewed and incorporated for their merit and relevance with preference given for articles with high impact, original research and recent advances. RESULTS: Thirty-five publications were included in final analysis and discussion. CONCLUSIONS: The area of 3D printing in Urology shows promising results, but further research is required and cost reduction must occur before clinicians fully embrace its use. As costs continue to decline and diversity of materials continues to expand, research and clinical utilization will increase. Recent advances have demonstrated the potential of this technology in the realms of education and surgical optimization. The generation of personalized organs using 3D printing scaffolding remains the 'holy grail' of this technology.