Poster Presentation Advances in Neuroblastoma Research Congress 2016

Creating Three-Dimensional full size model based on preoperative CT images for laparoscopic adrenalectomy and liver biopsy in a case demonstrating adrenal neuroblastoma with liver metastasis   (#334)

Ryota Souzaki 1 , Yoshiaki KINOSHITA 1 , Naonori KAWAKUBO 1 , Minori Ishii 1 , Takahiro JIMBO 1 , Satoshi OBATA 1 , Yuhki KOGA 2 , Makoto HASHIZUME 3 , Tomoaki TAGUCHI 1
  1. Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, FUKUOKA, Japan
  2. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, FUKUOKA, Japan
  3. Department of Advance Medicine and Innovative Technology, Kyushu University Hospital, FUKUOKA, Japan

<Background>A 3-dimensional (3D) printing model based on preoperative computerized tomography (CT) images facilitates the visualization of complex structures, such as vessels and tumors, and it is also useful for understanding the anatomy of various organs preoperatively. We made a full size 3D model using a 3D printer for a case with adrenal neuroblastoma and liver metastasis. We compared the findings between the laparoscopic view of a 3D Model based on preoperative CT images and the real laparoscopic view during laparoscopic adrenalectomy and liver biopsy.

<Materials and Methods> Multi-detector CT images were transferred to a 3D workstation and then 3D volume data were obtained by reconstructing the sections. The adrenal tumor and tumor vessels, liver with multiple metastases, kidney, renal vein and artery, inferior vena cava, aorta and outer body were fabricated using different color resins to create a 3D printed model. Pneumoperitoneum, the insertion of trocars through the outer body and a laparoscopic view were all attainable using this model.

<Results> A 1-year-old girl was diagnosed with right adrenal neuroblastoma with multiple liver metastases. After administering neoadjuvant chemotherapy, both the primary tumor and liver metastases decreased. We thereafter performed laparoscopic adrenalectomy and a liver biopsy.

The laparoscopic view in the 3D model for the retroperitoneum organs, such as the adrenal tumor and tumor vessels closely matched the real laparoscopic view during surgery. However, regarding the metastatic liver mass, the laparoscopic view in the 3D model did not accurately match the real laparoscopic view during surgery. This difference was due to liver deformation caused by pneumoperitoneum pressure during surgery.

<Conclusion> 3D printing models based on preoperative CT images are useful for simulating laparoscopic surgery for adrenal and retroperitoneum neuroblastoma and is useful for understanding the patient’s anatomy.