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    3D printing in gynecologic surgery planning

     

    What the future holds

    For select cases of deep infiltrating endometriosis affecting multiple organ systems (gynecologic, urinary, alimentary tracts), a multidisciplinary surgical team might find 3D modeling useful for patient-specific preoperative planning and for counseling a patient regarding the extent of surgical resection and need for stents or stoma, etc. Other potential applications for 3D printing in gynecologic surgery include myomectomies and surgery for certain Müllerian abnormalities. With tactile feedback a limitation of laparoscopic or robotic myomectomy, smaller fibroids might be inadvertently retained during these procedures. Three-dimensional models of the uterus with varying color and consistency might aid in a more thorough procedure. In addition, a tangible model in complex multiple myomectomy cases might inform the optimal location of hysterotomies, thereby limiting unnecessary and inefficient incisions. Women with Müllerian anomalies in whom a hysterectomy is indicated often undergo preoperative MRI as part of gynecologic and urologic system evaluation. Three-dimensional rendering of anomalies involving the lower uterine segment or cervix (didelphys, bicollis, complete septate uterus, cervical agenesis, etc.) might more precisely delineate the relationship of the uterine vasculature and ureters to the uterus.

    As enticing as it may be to use 3D printing for patient education, the current price of a model does not support that as the only indication for the technology. With continued innovation and evolution in the field of 3D printing, the cost of printers, and the process of image to model is expected to continue to decline to a more affordable level. As the paths of affordability and further research studies cross, clinical benefits of 3D printing in the field of gynecologic surgery may one day be clarified, making this exciting technology a new and permanent addition to the surgeon’s armamentarium.  

    Disclosures: The author reports no potential conflicts of interest with regard to this article.

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    Mobolaji Oluwaseun Ajao, MD
    Dr. Ajao is a Fellow in Minimally Invasive Gynecologic Surgery, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

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