Pre-surgical planning using patient-specific 3D printed anatomical models for women with uterine fibroids

Objectives To evaluate the effect of using patient-specific 3D-printed anatomical models in pre-surgical planning for patients with uterine fibroids. Methods Gynecologic surgeons completed a questionnaire documenting their surgical plan, perceived surgical difficulty, and confidence in surgical approach before and after receiving a patient-specific 3D-printed model derived from pelvic MRI. 3D models had uterine fibroids printed in opaque magenta, endometrium in cyan, and non-neoplastic anatomy (myometrium and cervix) printed as clear resin to maximize visualisation of underlying lesions. A post-operative questionnaire rated the surgeons’ experience using the 3D models. Results Five surgeries (4 open myomectomy; 1 laparoscopic hysterectomy) were completed. One staff surgeon and one/two surgical fellow(s) participated in each case (N=11). After viewing the models, perceived surgical difficulty changed in 6/11 surgeon responses. Average allotted surgical time changed by 50mins and anticipated blood loss by 120cc. Anticipated intra-operative complications and planned hemostatic techniques changed in 7/11 plans. Increased confidence in planned approach was reported in 7/11 surgeon responses. Intra-operative reference changed the operative course in 3/5 surgeries. On average, surgeons rated their experience 8.3/10 for pre-surgical planning and 8.0/10 for intra-operative reference. 3D models were perceived to have a positive impact on surgical outcomes in 7/11 surgeon responses. Conclusions By increasing their understanding of complex anatomy, the use of patient-specific 3D-printed models altered the surgeons’ perception of surgical difficulty, perceived risk for surgical complications, and planned hemostatic techniques when creating their pre-operative plan. Surgeons reported greater confidence in their pre-operative plan, thus optimizing surgical decision making and improving patient outcomes.