Faculty of Medicine

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    Optimizing Nephrectomy Outcomes through 3D-Printed Anatomical Replicas
    (Macedonian Medical Association, 2024-04)
    Arsenkov, Stefan
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    Arsenkov, Emilija
    The utilization of 3D-printed replicas of patient-specific anatomy represents a significant advancement in the field of surgical planning. This abstract discusses the methodology, benefits, and implications of employing 3D-printed models in the preoperative planning and intraoperative phases of complex surgeries. The process begins with acquiring high-resolution images using CT or MRI. These images are then converted into a digital 3D model, which is used to produce a detailed physical replica of the patient's anatomy using 3D printing. The primary advantage of this approach is the ability to enhance the surgeon's understanding of the tumor's size, location, and relationship with adjacent structures. By physically manipulating the 3D model, surgeons can strategize the most effective surgical approaches, anticipate challenges, and avoid complications. Furthermore, these replicas can be used for patient education, improving their understanding of the procedure and setting realistic expectations. Clinical outcomes have shown the use of 3D-printed models for surgery planning can lead to shorter operation times and reduced intraoperative blood loss. We present the case of a 58-year-old female patient requiring a nephrectomy due to a large tumor of the left kidney. A 3D-printed anatomical replica was used for preoperative planning with promising results. The postoperative histological examination revealed the renal mass was a clear cell carcinoma of the kidney. Additionally, 13 lymph nodes were extracted, none showing signs of metastatic alteration. This not only demonstrates the surgical team's thoroughness but also highlights the added value of the 3D model in enabling meticulous dissection and evaluation of surrounding lymphatic tissue. In conclusion, the integration of 3D-printed anatomical replicas into the surgical workflow for large kidney tumors offers a tangible improvement in preoperative planning, surgical precision, and patient outcomes. As this technology becomes more accessible, it is poised to become a standard tool in the surgical treatment of renal pathologies.
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    3D Printing for Preoperative Planning in Pancreatic Resection for Rare Metastasis from Ovarian Cancer: a case report
    (Research Square Platform LLC, 2024-04-02)
    Arsenkov, Stefan
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    Plavevski, Ognen
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    Arsenkov, Emilija
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    Secondary pancreatic malignancies are a rarely reported entity, limited to sporadic case reports in the medical literature. Most often, these secondary malignancies are of renal origin, followed by gastrointestinal tumors and lung cancer as the primary tumor sites. Metastatic tumors from ovarian origin are few and far between. In our understanding this is the first time 3D printing has been used in the preoperative planning of one such case. Case presentation We present the case of a 63 year old patient with a history for bilateral ovariectomy for ovarian tumor 5 years prior, with a 3D printed model of the patient’s anatomy used for preoperative planning as a novel approach. During regular check-ups, an elevated CA19-9 level prompted a CT scan showing a distal pancreatic mass entering the splenic hilum, and a PET scan showed FDG avid lesion considered malignant and no other lesions were detected. The location of the metastasis warranted a distal pancreatectomy with splenectomy. To aid in the preoperative planning a 1:1 replica of the patient’s anatomy was constructed based on the CT scan, and it was manufactured using 3D printing. After extirpation of the tumor, the histological analysis showed a pancreatic pseudocyst with an intraluminal neoplastic proliferation, and further immunohistochemistry analysis determined the immunophenotype suitable of an ovarian cystadenocarcinoma metastasizing to the pancreas. Conclusions The surgical team was unanimous in the impression that the 3D printed model facilitated a swift surgery without any complications. Not only the model helped the planning phase, it is useful as a tool for patient education and further education of students and residents.</jats:p>