Construction of a three-dimensional complex renal stone print and kidney print for comprehensive surgical planning and patient information

Purpose: To investigate the possibilities and reliability of manufacturing the physical three-dimensional (3D)models of complex kidney stone and kidney from medical images with the purpose of patient informing, student education and to facilitate surgical planning and assessment. Methods: The 3D reconstructions of a kidney stone, kidney and hilar structures were made from standard computerized tomography (CT) imaging of a patient referred for a surgery. Reconstructions were made with the use of 3D Doctor4.0 and MeshMixer software. Models were 3D printed for complete perioperative use with the two devices: paper-based 3D printer Mcor IRIS and powder-based 3D printer Z310. After open surgical removal of the entire stone, it was optically scanned for digital comparison of accuracy against 3D printed stone, thus to examine diagnostic reliability of a volume-rendered CT-based imaging. Results: The 3D printed model helped the patient and surgical trainees with the understanding of the condition and the need for the surgery. It also helped the urologist with the surgical planning and the intraoperative orientation. The analysis of characteristics between the 3D models, 3D printed stone and actual stone showed negligible differences despite the complex shape. Complete reliance on 3D model print in clinical use was justified since it was equal to an extracted stone. Conclusions: The 3D kidney stone reconstructions and manufactured 3D print present a real image of the actual stone. The 3D printed models can be reasonably produced for every day practice and are a helpful tool of high fidelity that facilitates patient comprehension and surgical assessment.