Manufacturing method of 3D printing liver cancer resection operation guide plate

Abstract

The invention relates to the field of medicine, and discloses a manufacturing method of a 3D printing liver cancer resection operation guide plate, which comprises the following steps: CT data acquisition: performing liver enhanced scanning to obtain multi-stage DICOM format data; a liver resection range is planned and a surgical section is determined by applying 3D visualization software on the basis of a portal vein 4-level branch drainage basin; 3-matic Medial and other engineering software are applied, and the liver surface and parenchyma inner operation guide plate is designed based on the operation section; a 3D printer is used for printing the digital operation guide plate into a physical model for operation positioning and navigation. Traditional liver cancer operation planning is established on the basis of a standard liver segmentation method and is lack of individuation. At present, the problems of complicated operation, low success rate, poor repeatability and the like exist when a liver pedicle blocking method and a dye injection method are mainly applied to surgical path navigation. The invention relates to a manufacturing method of a 3D printing liver cancer resection operation guide plate. Scientific planning and accurate navigation of an operation are realized through a 3D digital technology. Through the technical method, the radical treatment and safety of an operation are improved, and the liver cancer treatment effect is improved.

Description

Technical Field

[0001] The present invention relates to the field of medicine, and particularly to a manufacturing method of a 3D printed liver cancer resection guide plate. Background Art

[0002] Surgical resection is currently the preferred treatment measure for liver cancer. Liver surgery depends on the mastery of the liver's anatomical structure. Various traditional liver segmentation methods are based on population anatomy, but in fact, there are huge differences in the distribution and course of the intrahepatic vascular system among different individuals. Moreover, due to the mass effect of tumors and the often co-existing lesions such as liver cirrhosis in liver cancer patients, the liver volume, shape, and internal structure will also change. Performing liver surgery according to standardized segmentation is difficult to avoid damaging the vascular structures of the remaining liver tissue, thereby increasing the incidence of surgical complications such as liver failure, bleeding, and bile leakage. Moreover, liver cancer cells mostly spread and metastasize along the portal vein system, and the residue of the tumor-bearing liver segment may increase the chance of tumor recurrence.

[0003] Since the 1980s, anatomical hepatectomy has been recognized by more and more scholars. Its specific concept is to perform relatively precise sub-segmental, segmental, and combined segmental resection and other surgical methods, hoping to achieve good therapeutic effects while retaining sufficient remaining liver volume. At present, the intraoperative navigation methods for liver cancer resection mainly include the hepatic pedicle occlusion method and the dye injection method. Takasaki proposed the hepatic pedicle transection method, that is, occluding the hepatic pedicle of the liver segment to be resected in the porta hepatis area, and positioning the resection margin according to the ischemic range on the liver surface. This method requires dissection of the porta hepatis area, increasing the surgical difficulty and corresponding complications. Moreover, sometimes due to anatomical variations of the hepatic pedicle and its deep location, ligation or occlusion cannot be performed, often resulting in operation failure. Makuuchi conducted in-depth research on the portal vein dye injection method. This method is guided by intraoperative ultrasound, puncturing the portal vein branch of the liver segment to be resected, injecting dye, and then positioning the incision surface according to the discolored range of the liver. However, the dye injection method depends on intraoperative ultrasound and is complex to operate. Moreover, due to anatomical variations or the lack of a main trunk in the portal vein of the liver segment, the probability of puncture failure is relatively high. In recent years, tumor or incision surface localization using fluorescent dyes has been widely applied. The fluorescence imaging efficiency is higher, but it still has similar problems to ordinary dye injection, and the repeatability of this method is poor, which also limits its clinical application. So far, there is still a lack of an ideal method for precise positioning and navigation in liver resection surgery.

[0004] Three-dimensional visualization technology has been gradually applied to liver cancer surgical planning. However, 3D images are still displayed on a 2D screen and the spatial structure needs to be judged by rotating the images, which still cannot meet the clinical needs. 3D printing technology can realize the physicalization of 3D digital models, and the three-dimensional spatial effect it provides is significantly better than that of 3D visualization technology. At present, the application of 3D printing technology in liver surgery is mainly limited to surgical planning. Due to the lack of clear anatomical landmarks on the liver surface, the opacity of liver tissue, and the complexity of the vascular structure inside the liver, the surgically planned incision plane is difficult to accurately guide the surgery, resulting in a large error between the actual resection area and the planned resection range. 3D printed surgical guides are tools designed using reverse engineering principles for intraoperative positioning and navigation. At present, surgical guides have been applied to intraoperative positioning in surgeries such as orthopedics and oral and maxillofacial regions, but there is still a lack of mature applications in the field of liver surgery. Summary of the Invention

[0005] (1) Technical problems to be solved

[0006] In view of the deficiencies of the prior art, the present invention provides a manufacturing method for a 3D printed surgical guide for liver cancer resection to solve the above problems.

[0007] (2) Technical solutions

[0008] To achieve the above object, the present invention provides the following technical solutions: A manufacturing method for a 3D printed surgical guide for liver cancer resection, comprising the following steps:

[0009] CT data acquisition: Perform plain and contrast-enhanced scans of the liver to obtain multi-phase DICOM format data of the patient in the plain scan phase, arterial phase, portal vein phase, and equilibrium phase. Confirm that the CT scan parameters are appropriate and cover the entire liver area to obtain image data. Transmit the DICOM data to the United Imaging Intelligence 3D visualization software to reconstruct the three-dimensional stereo images of the liver, hepatic artery, portal vein, hepatic vein, inferior vena cava, and tumor.

[0010] Surgical planning: Apply the portal vein watershed analysis tool to analyze the watersheds of all 4th-level portal vein branches of the tumor, merge them into the proposed resected portal vein area, and determine the liver resection range and surgical incision plane.

[0011] Surgical guide design: Use the 3-matic Medical 13.0 software to design the digital thin slice model of the guide according to the shape of the liver surface in the resection area. Select the incision plane of the liver preservation area to design the digital model of the in-parenchyma positioning guide of the liver. Through the Geomagic Studio 2012 software, perform surface patch, grid, NURBS (Non-Uniform Rational B-Splines) surface, etc. processing to generate an ideal surface model. Apply SolidWorks to thicken the thin slice outward by 2 mm to obtain the 3D digital model of the guide.

[0012] Guide model fabrication: Import the guide STL data into the printer slicing software NormalTek.ThreeD-Printer.UI, and print the actual surgical guide using a color, multi-material 3D printer. The guide is sterilized and ready for use to ensure safety during surgery.

[0013] According to another aspect of an embodiment of the present invention, a method for positioning a liver surface tangent using a 3D printed guide plate is provided, comprising the following steps:

[0014] Preoperative preparation: A CT scan is performed to obtain high-resolution images of the liver's anatomy, clarifying the tumor's location and the anatomical relationship of the surrounding blood vessels. 3D visualization software is used for surgical planning, determining the liver resection area and surgical incision plane. A 3D printing technology is used to design and produce a liver surface tangent positioning guide.

[0015] Surgery execution: The patient is anesthetized, the surgical area is prepared, and the 3D-printed liver surface positioning guide is directly adapted to the liver surface to ensure good contact with the liver surface. The liver surface is marked along the edge of the guide to clearly locate the tangent line of the surface of the liver area to be resected.

[0016] According to another aspect of an embodiment of the present invention, an application of a 3D printed substantial internal section guide plate is also provided:

[0017] Preoperative preparation: The patient undergoes a CT or MRI scan to obtain detailed information about the liver's structure. Based on the imaging data, 3D visualization software is used to plan the surgery and determine the surgical section. 3D printing technology is used to design and produce a surgical guide for the intraparenchymal section of the liver.

[0018] Surgery Execution: The patient is given general anesthesia, and the surgical area is prepared. A 3D-printed intraparenchymal cutting guide is accurately placed within the surgical field. Using the guide's cutting direction, angle, and depth, the liver tissue is gradually resected from the surface to the deeper layers. During the resection, the shape of the model section is compared in real time to ensure that the surgical section aligns with the planned section.

[0019] (3) Beneficial effects

[0020] Compared with the prior art, the present invention provides a method for manufacturing a 3D-printed liver cancer resection surgical guide, which has the following beneficial effects:

[0021] The present invention conducts hepatectomy planning by performing 3D visual watershed analysis on the 4th-level branch watershed of the portal vein, which is more scientific and reasonable than traditional methods. Currently, 3D printing is mainly used to display the spatial relationship between liver cancer lesions and liver vasculature. It is impossible to apply the accurate and comprehensive information provided by 3D printed models to actual surgeries. The present invention uses 3D printing technology to produce liver models and surgical guides, precisely locate the surgical incisions on the liver surface and within the liver parenchyma, achieve precise surgical navigation, and improve surgical safety and efficacy. Detailed implementation mode

[0022] Data acquisition: Perform plain and contrast-enhanced scans of the liver to obtain multi-phase DICOM format data of the patient in the plain scan phase, arterial phase, portal vein phase, and equilibrium phase. Confirm that the CT scan parameters are appropriate and cover the entire liver area to obtain imaging data. Transmit the DICOM data to the United Imaging Intelligence 3D visualization software to reconstruct the three-dimensional stereoscopic images of the liver, hepatic artery, portal vein, hepatic vein, inferior vena cava, and tumor.

[0023] Surgical planning: Use the portal vein watershed analysis tool to analyze the watersheds of all 4th-level branch portal veins supplying blood to the tumor, merge them into the proposed resected portal vein area, and determine the liver resection range and surgical incision.

[0024] Surgical guide design: Use the 3-matic Medical 13.0 software to design a surgical positioning guide according to the shape of the liver surface in the proposed resected area and produce a digital thin slice model of the guide. Select the incision surface of the liver preservation area to design an in-liver-parenchyma positioning guide. Through the Geomagic Studio 2012 software, perform surface patch, grid, NURBS (Non-Uniform Rational B-Splines) surface, etc. processing to generate an ideal surface model. Use SolidWorks to thicken the thin slice outward by 2 mm to obtain the 3D digital model of the guide.

[0025] Production of the physical model of the guide: Import the stl data of the guide into the printer slicing software NormalTek.ThreeD-Printer.UI, and use a color multi-material 3D printer to print the physical surgical guide. Disinfect and prepare the guide to ensure its safety during surgery.

[0026] According to another aspect of the embodiments of the present invention, there is also provided a method for positioning the liver surface tangent line using a 3D printed guide, including the following steps:

[0027] Preoperative preparation: Perform a CT scan to obtain high-resolution images of the liver anatomical structure, clarify the location of the tumor and the anatomical relationship of the surrounding blood vessels. Conduct surgical planning through 3D visualization technology to determine the resected liver area and surgical incision. Design and produce a liver surface tangent line positioning guide through 3D printing technology.

[0028] Surgical execution: Anesthetize the patient, prepare the surgical area, directly fit the 3D-printed liver surface positioning guide plate onto the liver surface, ensure good contact with the liver surface, use an electric scalpel to mark along the edge of the guide plate on the liver surface, and clarify the tangent positioning of the surface of the liver area to be resected.

[0029] According to another aspect of the embodiments of the present invention, there is also provided an application of a 3D-printed parenchymal section guide plate:

[0030] Preoperative preparation: Perform a CT scan on the patient to obtain detailed liver structure information, clarify the location, size of the tumor, and the anatomical relationship of adjacent blood vessels. Based on the imaging data, formulate a detailed liver resection surgical plan, determine the resection area, section direction, and angle. Design and manufacture a parenchymal section surgical guide plate for the liver through 3D printing technology.

[0031] Surgical execution: General anesthesia is performed on the patient, and the surgical area is prepared. Accurately place the 3D-printed parenchymal section guide plate in the surgical field. Referring to the section direction, angle, and depth of the guide plate, gradually cut the liver tissue from the surface layer to the deep layer of the liver. During the resection process, compare the shape of the model section in real time to ensure that the surgical section is consistent with the planned section.

[0032] In summary, the present invention provides a manufacturing method of a 3D-printed surgical guide plate for liver cancer resection. Through 3D visualization watershed analysis technology for liver cancer surgical planning, an individualized liver segmentation method for liver cancer patients based on the fourth-level portal vein branch watershed is proposed, which is more scientific and reasonable than the traditional method. Design and manufacture a liver surgical positioning guide plate through computer-aided design and 3D printing technology to accurately position the liver surface and the surgical section in the liver parenchyma, and realize precise navigation of the surgery.

[0033] Although the embodiments of the present invention have been shown and described, it will be understood by those of ordinary skill in the art that various changes, modifications, substitutions, and variations can be made to these embodiments without departing from the principles and spirit of the present invention, and the scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A manufacturing method of a 3D printed liver cancer resection surgical guide plate, characterized in that, It includes the following steps: CT image data acquisition: Perform plain and contrast-enhanced CT scans of the liver to obtain multi-phase DICOM format data of the patient in the plain scan phase, arterial phase, portal vein phase, and equilibrium phase. Confirm that the CT scan parameters are appropriate and cover the entire liver area to obtain image data; Surgical planning: Use United Imaging Intelligence 3D visualization software to reconstruct the three-dimensional stereoscopic images of the liver, hepatic artery, portal vein, hepatic vein, inferior vena cava, and tumor; Apply United Imaging Intelligence 3D visualization software to analyze the blood supply of all 4th-level branch basins of the portal vein of the tumor. Based on the basin analysis and according to the surgical planning scheme designed by this research group, determine the liver resection range and surgical section; Surgical guide design: Use 3-matic Medical 13.0 software to select the digital thin slice model of the guide plate on the liver surface of the resection area, and select the digital model of the guide plate in the liver parenchyma for the remaining liver section; Through Geomagic Studio software, perform surface patch, grid, NURBS (Non-Uniform Rational B-Splines) surface, etc. processing to generate an ideal surface model; Apply SolidWorks to thicken the thin slice outward by 2 mm to generate the 3D digital model of the guide plate; Fabrication of the physical model of the guide plate: Import the stl data of the guide plate into the printer slicing software NormalTek.ThreeD-Printer.UI, and use a color multi-material 3D printer to print the physical surgical guide plate; Sterilize the guide plate and keep it in reserve.

2. A method for tangent line positioning of liver surface surgery using a 3D printing guide plate, characterized in that, It includes the following steps: Preoperative preparation: Perform a CT scan to obtain high-resolution images of the liver anatomy. Apply 3D visualization software for surgical planning to determine the liver resection range and surgical section. Design and fabricate a surgical tangent positioning guide plate on the liver surface; Surgical execution: Clean and disinfect the guide plate to ensure sterility; Anesthetize the patient and prepare the surgical area; Adapt the 3D printed liver surface positioning guide plate to the liver surface to ensure good contact with the liver surface. Mark along the edge of the guide plate on the liver surface for liver surface tangent positioning.

3. A method for a 3D printed liver parenchyma internal cutting plane guide plate, characterized in that, It includes the following steps: Preoperative preparation: Perform a CT scan for the patient to obtain detailed liver structure information. Apply 3D visualization software for surgical planning; Design and fabricate a 3D printed surgical section guide plate in the liver parenchyma; Surgical execution: General anesthesia is performed on the patient, and the surgical area is prepared; Place the guide plate in the liver parenchyma accurately in the surgical field; Refer to the section direction, angle, and depth of the guide plate, and gradually cut the liver tissue from the surface layer to the deep layer of the liver. During the resection process, compare the shape of the model section in real time to ensure that the surgical section is consistent with the planned section.