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Video: For The First Time In The World, Pelvic Bones Were Restored Using A 3D Printer
2023 Author: Abraham Higgins | [email protected]. Last modified: 2023-11-27 23:16
For the first time in the world, pelvic bones were restored using a 3D printer
The patient, who lost the front wall of the pelvis due to cancer, was replaced with an individual titanium structure printed on a 3D printer. And in a few weeks the woman will be able to fully move around. An operation performed by an interdisciplinary team of surgeons of the I. M. Sechenov is unique - previously such a technique has not been used in world practice.
Photo: press service of the First Moscow State Medical University. Sechenov /
A patient who lost the anterior pelvic wall due to cancer was replaced with an individual titanium structure printed on a 3 D-printer. And in a few weeks, the woman will be able to fully move around. An operation performed by an interdisciplinary team of surgeons of the I. M. THEM. Sechenov is unique - previously such a technique has not been used in world practice.
The operation to reconstruct the pelvic ring was attended by the director of the Clinic of Coloproctology and Minimally Invasive Surgery Peter Tsarkov and the Director of the Clinic of Traumatology, Orthopedics and Joint Pathology Alexey Lychagin.
According to the press service of the Sechenov University, a 52-year-old woman from the Crimea developed a large defect in the anterior pelvis due to the removal of a massive tumor. Initially, the patient was diagnosed with cancer of the anal canal, for which she was operated on at the place of residence. But later there was a relapse, requiring the removal of the rectum, uterus, bladder, anterior wall of the small pelvis - evisceration - a major operation, atypical for anal cancer . And then the patient was transferred to the Clinic of Coloproctology and Minimally Invasive Surgery of the First Moscow State Medical University, which specializes in the treatment of the most severe patients. THEM. Sechenov.
“The relapse has occurred in the region of the bladder neck with invasion into the pubic bone. The tumor rapidly progressed, we were looking for a solution, - explained Professor Peter Tsarkov, who performed the operation of evisceration of the pelvic organs. "The only way out in this life-threatening situation is extensive resection, an operation to remove a tumor that destroys the integrity of the pelvic ring." Previously, such patients were doomed to a painful death, since surgeons, not knowing how to restore the pelvic ring, were afraid to perform such an extensive bone resection.
The Clinic for Coloproctology and Minimally Invasive Surgery decided on an operation, having previously agreed with traumatologists, in order to subsequently solve the problem of destruction of the pelvic ring
The fact is that the evisceration of the pelvis itself is associated with a number of problems: the remaining organs of the pelvis are not protected by bones and can be damaged by any mechanical impact. In addition, the continuity of the pelvic ring is disrupted, and the entire load from the left lower limb is transferred only to the sacroiliac joint, causing pain, and if it is damaged, dangerous instability of the pelvis can develop.
It was impossible to reconstruct the anterior pelvis simultaneously with the operation to remove the tumor: in such complex cases, the volume of the resection is determined during the operation, and the size of the prosthesis is determined after the operation. It was decided that coloproctologists do their part of the work - evisceration of the pelvic organs with resection of the pubic bone, into which the tumor had grown, and postoperative images. And traumatologists have their own - the exact measurement of the volume required to replace the removed bone tissue, and the reconstruction of the pelvic ring.
The volume turned out to be so large that the use of conventional technologies, such as osteosynthesis, did not solve the problem. An original solution was required, and it was found: the use of 3 D technologies
“In medical science, there are cases of replacement of the entire complex, together with the hip joint, using 3D structures. Cases of replacement of the branches of the pubic and ischial bones together with the pubic articulation have not been described in world practice. We have used a new anatomical area to implement 3D technologies,”said Professor Alexey Lychagin. During the operation, the anterior pelvic semicircle was restored and the load was distributed from the left sacroiliac joint to the anterior parts of the pelvis, which would allow the patient to move fully. The entire surface of the individually printed titanium implant in contact with the bone is porous and designed for further ingrowth.
A successfully completed operation opens a new direction in orthopedics, and the capabilities of the Clinic of Traumatology, Orthopedics and Joint Pathology at Sechenov University will provide a difficult patient with high-quality postoperative rehabilitation. “We work with each patient for recovery, and, going through this, sometimes very long, path, we do not give him any doubts about it. A personalized approach is important in all areas of medicine, since the subject of a doctor's work is the patient's health and needs,”Alexey Lychagin is convinced.
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