Clinical Application Of 3D Printing Technique In Laparoscopic Giant Adrenalectomy Via Retroperitoneal Approach

Objective: Explore the clinical value of 3D printing technique to assist laparoscopic giant adrenalectomy via retroperitoneal approach.Methods: From january 2016 to august 2019,patients with giant adrenal tumors(diameter ≥6 cm)were selected from adrenal tumor patients admitted from the first affiliated hospital of Guangxi Medical University according to the study inclusion criteria.Finally,26 patients were included in the study.All patients planned to undergo retroperitoneal laparoscopic giant adrenalectomy.Patients included in the study were assigned to the 3D printout and control groups according to the principle of random allocation.Preoperative 3D print group patients received adrenal CT plain scan enhancement examination,extracted from the computer CT image data DICOM format file,based on the data 3D modeling guidance the 3D printing device was used to print,and the ratio of the adrenal tumor model to the actual adrenal tumor was 1:1.The 3D printing model was applied to the patient’s preoperative doctor-patient communication,preoperative surgical approach and surgical mode planning.Control patients preoperative communication,preoperative surgical approach and surgical approach planning basis CT imaging results.After the doctor-patient communication is completed,the questionnaire is filled out and scored when the consent of the doctor-patient communication object(patient or his family)is sought.The operation time,blood loss,drainage days,drainage flow,hospitalization days and postoperative complications were compared between the two groups.Results: There was no significant difference in age distribution,sex ratio,tumor diameter,tumor site(left/right),hypertension status,diabetes status and other indicators between the 3D printing group and the control group(P>0.05).The questionnaire scores of patients in the two groups were as follows :3D the difference between the print group and the control group was statistically significant(P<0.05).Comparison of drainage,drainage days,postoperative hospitalization days and complication rate between the two groups showed no significant difference(P>0.05).Surgery in the 3D printing group time,intraoperative blood loss were smaller than the control group,the difference was statistically significant(P<0.05).Conclusion: 1.3D printing model applied to the preoperative doctor-patient communication of laparoscopic giant adrenalectomy through the retroperitoneal approach can improve the patients and their families’ understanding of adrenal tumor disease,surgical methods and surgical risk,improve the overall satisfaction of the communication object,and establish a good doctor-patient relationship.2.Individualized 3D printed adrenal tumor model can accurately show the spatial relationship between the adrenal gland and adjacent tissues.Preoperative planning for adrenalectomy can help the surgeon to provide surgical ideas and establish safe surgical methods.3.3D print model reduces the spatial relationship between adrenal tumors and surrounding tissues,assisting the surgeon rapid and accurate separation and ligation of important blood vessels,to a certain extent to avoid damage to normal tissues,reduce the operation time and intraoperative blood loss of adrenal tumor resection,has clinical application value.