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Mechanical and functional validation of a perfused, robot-assisted partial nephrectomy simulation platform using a combination of 3D printing and hydrogel casting

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World Journal of Urology Aims and scope Submit manuscript

A Correction to this article was published on 20 January 2020

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Abstract

Introduction and objectives

There is a scarcity of high-fidelity, life-like, standardized and anatomically correct polymer-based kidney models for robot-assisted partial nephrectomy (RAPN) simulation training. The purpose of this technical report is to present mechanical and functional testing data as evidence for utilizing a perfused hydrogel kidney model created utilizing 3D printed injection casts for RAPN simulation and training.

Methods

Anatomically correct, tumor-laden kidney models were created from 3D-printed casts designed from a patient's CT scan and injected with poly-vinyl alcohol (PVA). A variety of testing methods quantified Young’s modulus in addition to comparing the functional effects of bleeding and suturing among fresh porcine kidneys and various formulations of PVA kidneys.

Results

7% PVA at three freeze–thaw cycles (7%-3FT) was found to be the formula that best replicates the mechanical properties of fresh porcine kidney tissue, where mean(± SD) values of Young’s modulus of porcine tissue vs 7%-3FT samples were calculated to be 85.97(± 35) kPa vs 80.97(± 9.05) kPa, 15.7(± 1.6) kPa vs 74.56(± 10) kPa and 87.46(± 2.97) kPa vs 83.4(± 0.7) kPa for unconfined compression, indentation and elastography testing, respectively. No significant difference was seen in mean suture tension during renorrhaphy necessary to achieve observable hemostasis and capsular violation during a simulated perfusion at 120 mmHg.

Conclusions

This is the first study to utilize extensive material testing analyses to determine the mechanical and functional properties of a perfused, inanimate simulation platform for RAPN, fabricated using a combination of image segmentation, 3D printing and PVA casting.

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Change history

  • 20 January 2020

    The Eqs. 1, 2 and 3 come under the section “Kidney cortex testing” as per the original manuscript, but they have been incorrectly moved and separated into different sections in the original publication of the article.

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Authors and Affiliations

  1. Department of Urology, Simulation Innovation Laboratory, Univeristy of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA

    Rachel Melnyk, Elizabeth Belfast, Patrick Saba & Ahmed Ghazi

  2. School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA

    Shamroz Farooq & Timothy Campbell

  3. Department of Biomedical Engineering, Hajim School of Engineering, University of Rochester, 500 Joseph C. Wilson Blvd, Rochester, NY, 14611, USA

    Bahie Ezzat, Stephen McAleavey & Mark Buckley

Authors
  1. Rachel Melnyk
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  2. Bahie Ezzat
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  3. Elizabeth Belfast
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  4. Patrick Saba
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  5. Shamroz Farooq
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  6. Timothy Campbell
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  7. Stephen McAleavey
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  8. Mark Buckley
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  9. Ahmed Ghazi
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Contributions

Protocol/project development: RM, SM, MB, AG. Data collection or management: BE, EB, PS, SF, RM, AG. Data analysis: BE, EB, PS, SF, RM, AG. Manuscript writing/editing: RM, AG, TC.

Corresponding author

Correspondence to Ahmed Ghazi.

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Conflict of interest

RMelnyk: none. B Ezzat: none. E Belfast: none. P Saba: none. S Farooq: none. S McAleavey: none. M Buckley: none. A Ghazi: Intuitive Surgical: Research grant, Olympus America: Consultant.

Research involving human participants and/or animals

This research was conducted utilizing porcine kidneys. Fresh porcine kidneys were acquired through the University of Rochester veterinary research facilities.

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No informed consent was required for this study.

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The original version of this article was revised: The Eqs. (1), (2), (3) have been incorrectly moved, and separated into different sections. Now, it has been corrected.

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Melnyk, R., Ezzat, B., Belfast, E. et al. Mechanical and functional validation of a perfused, robot-assisted partial nephrectomy simulation platform using a combination of 3D printing and hydrogel casting. World J Urol 38, 1631–1641 (2020). https://doi.org/10.1007/s00345-019-02989-z

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  • DOI: https://doi.org/10.1007/s00345-019-02989-z

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