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

A Correction to this article was published on 20 January 2020

This article has been updated

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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Author information

Affiliations

Authors

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.

Ethics declarations

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.

Informed consent

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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Keywords

  • 3D printing
  • High fidelity
  • Partial nephrectomy
  • Mechanical testing
  • Simulation
  • Inanimate model
  • Perfused kidney model