| The Surgical Technologist | JUNE 2022 274 nature of surgical robots [287]. Medical devices, such as blood collectors, are examples of versatile tools used for both clinical research and health monitoring [289], and some can be produced in space using 3DP. Another possibility is to produce medication in space, although little is known regarding their pharmacodynamics and pharmacokinetics in microgravity. More research is also required to identify ways of safely sterilizing and recycling 3D printed medical devices, robotics [6], and tools (Figure 12). Space surgery is still in its infancy; however, it is ripe for innovation and could benefit particularly by combining with the rise and expansion of frontier technologies like artificial intelligence and augmented reality [290]. 5. Conclusion and Future Insights 3DP is a manufacturing process that has ramped its participation into industry as it offers unique characteristics with the aim to produce objects in a digital fabrication workflow. It has been well-developed in recent years reflected in a variety of surgical specialties, such as head and neck surgery, neurosurgery, general surgery, cardiovascular surgery, urology, gynecology, and orthopaedics. The main impact of this tool is divided into 3 pillars: medical training, surgical planning, and patient education. Obtaining anatomical models of the pathology of interest allows better comprehension and permits an accurate surgical approach. The applications are classified into three different categories: (1) presurgical tool, (2) intrasurgical tool, and (3) implant or replacement. The main manufacturing techniques are fused deposition modeling (FDM), stereo-lithography (SLA), selective laser sintering (SLS), selective laser melting (SLM), electron beam melting (EBM), and direct energy deposition (DED). The exponential innovations of this technology are having high expectations that will provide a major benefit in the future. In turn, the research and development of this technology have a potential impact with the integration of augmented, mixed, and virtual reality. Besides, other important applications are medical devices and tools for space surgery in order to bring better patient management during spaceflight (diagnosis and treatment). Finally, there is an interesting growing field called “Endoscopic - Intracorporeal 3D Bioprinting,” which consists of creating tissues that help to regenerate damaged organs during a robotic surgery procedure. Conflicts of Interest The authors declare no conflicts of interest. Acknowledgments The research has been managed and supervised by the Bioastronautics and Space Mechatronics Research Group—- BIO&SM (https://sites.google.com/view/bio-sm). The publication of the article was funded through the Universidad San Ignacio de Loyola. Also, special thanks to the Graduate Program in Biomedical Engineering of the Superior School of Engineering, Science and Technology at Universitat Internacional Valenciana, Spain. References [1] I. Gibson, D. Rosen, and B. Stucker, “Applications for additive manufacture,” in Additive Manufacturing Technologies, pp. 451–474, Springer, New York, NY, 2015. [2] M. H. Abedin-Nasab, Handbook of Robotic and ImageGuided Surgery, Elsevier, 2019. [3] J. Cornejo, J. A. Cornejo-Aguilar, and J. P. Perales-Villarroel, “Innovaciones internacionales en robótica médica para mejorar el manejo del paciente en Perú,” Revista de la Facultad de Medicina Humana, vol. 19, no. 4, pp. 105–113, 2019. [4] J. P. Desai, Encyclopedia Of Medical Robotics, The (In 4 Volumes), World Scientific, 2018. [5] J. Cornejo, J. A. Cornejo-Aguilar, and R. Palomares, “Biomedik surgeon: surgical robotic system for training and simulation by medical students in Peru,” in 2019 International Conference on Control of Dynamical and Aerospace Systems (XPOTRON), pp. 1–4, Arequipa, Peru, 2019. [6] J. Cornejo, J. A. Cornejo-Aguilar, R. Sebastian et al., “Mechanical design of a novel surgical laparoscopic simulator for telemedicine assistance and physician training during aerospace applications,” in2021 IEEE 3rd Eurasia Conference on Biomedical Engineering, Healthcare and Sustainability (ECBIOS), pp. 53–56, Tainan, Taiwan, 2021. [7] J. Cornejo, J. P. Perales-Villarroel, R. Sebastian, and J. A. Cornejo-Aguilar, “Conceptual design of space biosurgeon for robotic surgery and aerospace medicine,” in 2020 IEEE ANDESCON, pp. 1–6, Quito, Ecuador, 2020. [8] J. Cornejo, J. A. Cornejo-Aguilar, C. Gonzalez, and R. Sebastian, “Mechanical and kinematic design of surgical mini robotic manipulator used into SP-LAP multi-DOF platform for training and simulation,” in 2021 IEEE XXVIII International Conference on Electronics, Electrical Engineering and Computing (INTERCON), pp. 1–4, Lima, Peru, 2021. [9] D. Mitsouras, P. Liacouras, A. Imanzadeh et al., “Medical 3D printing for the radiologist,” Radiographics, vol. 35, no. 7, pp. 1965–1988, 2015. [10] T. M. Bücking, E. R. Hill, J. L. Robertson, E. Maneas, A. A. Plumb, and D. I. Nikitichev, “From medical imaging data to 3D printed anatomical models,” PloS One, vol. 12, no. 5, article e0178540, 2017. [11] C.-Y. Liaw and M. Guvendiren, “Current and emerging applications of 3D printing in medicine,” Biofabrication, vol. 9, no. 2, article 024102, 2017. [12] A. Christensen and F. J. Rybicki, “Maintaining safety and efficacy for 3D printing in medicine,” 3D Printing in Medicine, vol. 3, no. 1, pp. 1–10, 2017. [13] C. G. Helguero, I. Kao, D. E. Komatsu et al., “Improving the accuracy of wide resection of bone tumors and enhancing implant fit: a cadaveric study,” Journal of Orthopaedics, vol. 12, Supplement 2, pp. S188–S194, 2015. [14] K. Valenzuela-Villela, P. García-Casillas, and C. Chapa-González, “Progreso de la Impresión 3D de Dispositivos Médicos,” Revista Mexicana de Ingeniería Biomédica, vol. 41, no. 1, pp. 151–166, 2020. [15] C. G. Helguero, E. A. Ramírez, and J. L. Amaya, “Engineering interface inside the operative room: design and simulation of a fracture-plate bending machine,” Procedia CIRP, vol. 79, pp. 655–660, 2019. [16] D. Hoang, D. Perrault, M. Stevanovic, and A. Ghiassi, “Surgical applications of three-dimensional printing: a review of the 18 BioMed Research International current literature & how to get started,” Annals of Translational Medicine, vol. 4, no. 23, 2016. [17] C. G. Helguero, V. M. Mustahsan, S. Parmar et al., “Biomechanical properties of 3D-printed bone scaffolds are improved by treatment with CRFP,” Journal of Orthopaedic Surgery and Research, vol. 12, no. 1, pp. 1–9, 2017. [18] D. H. Ballard, P. Mills, R. Duszak Jr., J. A. Weisman, F. J. Rybicki, and P. K. Woodard, “Medical 3D printing costsavings in orthopedic and maxillofa ial surgery: cost analysis of operating room time saved with 3D printed anatomic models and surgical guides,” Academic Radiology, vol. 27, no. 8, pp. 1103–1113, 2020. [19] S. Marconi, L. Pugliese, M. Botti et al., “Value of 3D printing for the comprehension of surgical anatomy,” Surgical Endoscopy, vol. 31, no. 10, pp. 4102–4110, 2017. [20] R. J. Morrison, K. N. Kashlan, C. L. Flanangan et al., “Regulatory considerations in the design and manufacturing of implantable 3D-printed medical devices,” Clinical and Translational Science, vol. 8, no. 5, pp. 594–600, 2015. [21] J. D. Sandt, M. Moudio, J. K. Clark et al., “Stretchable optomechanical fiber sensors for pressure determination in compressive medical textiles,” Advanced Healthcare Materials, vol. 7, no. 15, article 1800293, 2018. [22] I. Gibson and A. Srinath, “Simplifying medical additive manufacturing: making the surgeon the designer,” Procedia Technology, vol. 20, pp. 237–242, 2015. [23] R. R. Edelman, “The history of MR imaging as seen through the pages of radiology,” Radiology, vol. 273, no. 2S, pp. S181–S200, 2014. [24] A. M. Thomas and A. K. Banerjee, The History of Radiology, [33] D. Espalin, K. Arcaute and R. Wicker, “Fus specific polymethylme ing Journal, vol. 16, no [34] Q. Chen, J. D. Man Pokorski, and R. C. A polyurethane/poly (lac ites: anisotropic prope faces, vol. 9, no. 4, pp. [35] R. Velu, T. Calais, A. J hensive review on bio and feasibility studies additive manufacturin p. 92, 2020. [36] A. Koptyug, L.-E. Rän and P. Dérand, “Addit tions targeting practi Life Science and Medi 2013. [37] H. A. Zaharin, A. M. “Additive manufactur nents: a review,” IOP and Engineering, vol. 3 [38] F. P. Melchels, J. Feije stereolithography and neering,” Biomaterials [39] T. M. Wong, J. Jin, dimensional printing review,” Journal of Or [40] A. Mazzoli, “Selective BioMed Research International nature of surgical robots [287]. Medical devices, such as blood collectors, are examples of versatile tools used for both clinical research and health monitoring [289], and some can be produced in space using 3DP. Another possibility is to produce medication in space, although little is known regarding their pharmacodynamics and pharmacokinetics in microgravity. More research is also required to identify ways of safely sterilizing and recycling 3D printed medical devices, robotics [6], and tools (Figure 12). Space surgery is still in its infancy; however, it is ripe for innovation and could benefit particularly by combining with the rise and expansion of frontier technologies like artificial intelligence and augmented reality [290]. 5. Conclusion and Future Insights 3DP is a manufacturing process that has ramped its participation into industry as it offers unique characteristics with the aim to produce objects in a digital fabrication workflow. It has been well-developed in recent years reflected in a variety of surgical specialties, such as head and neck surgery, neurosurgery, general surgery, cardiovascular surgery, urology, gynecology, and orthopaedics. The main impact of this tool is divided into 3 pillars: medical training, surgical planning, and patient education. Obtaining anatomical models of the pathology of interest allows better comprehension and permits an accurate surgical approach. The applications are classified into three different categories: (1) presurgical tool, (2) intrasurgical tool, and (3) implant or replacement. The main manufacturing techniques are fused deposition modeling (FDM), stereo-lithography (SLA), selective laser sintering (SLS), selective laser melting (SLM), electron beam melting (EBM), and direct energy deposition (DED). The exponential innovations of this technology are having high expectations that will provide a major benefit in the future. In turn, the research and development of this technology have a potential impact with the integration of augmented, mixed, and virtual reality. Besides, other important applications are medical devices and tools for space surgery in order to bring better patient management during spaceflight (diagnosis and treatment). Finally, there is an interesting growing field called “Endoscopic - Intracorporeal 3D Bioprinting,” which consists of creating tissues that help to regenerate damaged organs during a robotic surgery procedure. Conflicts of Interest The authors declare no conflicts of interest. Acknowledgments The research has been managed and supervised by the Bioastronautics and Space Mechatronics Research Group—- BIO&SM (https://sites.google.com/view/bio-sm). The publication of the article was funded through the Universidad San Ignacio de Loyola. Also, special thanks to the Graduate Program in Biomedical Engineering of the Superior School of Engineering, Science and Technology at Universitat Internacional Valenciana, Spain. References [1] I. Gibson, D. Rosen, and B. Stucker, “Applications for additive manufacture,” in Additive Manufacturing Technologies, pp. 451–474, Springer, New York, NY, 2015. [2] M. H. Abedin-Nasab, Handbook of Robotic and ImageGuided Surgery, Elsevier, 2019. [3] J. Cornejo, J. A. Cornejo-Aguilar, and J. P. Perales-Villarroel, “Innovaciones internacionales en robótica médica para mejorar el manejo del paciente en Perú,” Revista de la Facultad de Medicina Humana, vol. 19, no. 4, pp. 105–113, 2019. [4] J. P. Desai, Encyclopedia Of Medical Robotics, The (In 4 Volumes), World Scientific, 2018. [5] J. Cornejo, J. A. Cornejo-Aguilar, and R. Palomares, “Biomedik surgeon: surgical robotic system for training and simulation by medical students in Peru,” in 2019 International Conference on Control of Dynamical and Aerospace Systems (XPOTRON), pp. 1–4, Arequipa, Peru, 2019. [6] J. Cornejo, J. A. Cornejo-Aguilar, R. Sebastian et al., “Mechanical design of a novel surgical laparoscopic simulator for telemedicine assistance and physician training during aerospace applications,” in2021 IEEE 3rd Eurasia Conference on Biomedical Engineering, Healthcare and Sustainability (ECBIOS), pp. 53–56, Tainan, Taiwan, 2021. [7] J. Cornejo, J. P. Perales-Villarroel, R. Sebastian, and J. A. Cornejo-Aguilar, “Conceptual design of space biosurgeon for robotic surgery and aerospace medicine,” in 2020 IEEE ANDESCON, pp. 1–6, Quito, Ecuador, 2020. [8] J. Cornejo, J. A. Cornejo-Aguilar, C. Gonzalez, and R. Sebastian, “Mechanical and kinematic design of surgical mini robotic manipulator used into SP-LAP multi-DOF platform for training and simulation,” in 2021 IEEE XXVIII International Conference on Electronics, Electrical Engineering and Computing (INTERCON), pp. 1–4, Lima, Peru, 2021. [9] D. Mitsouras, P. Liacouras, A. Imanzadeh et al., “Medical 3D printing for the radiologist,” Radiographics, vol. 35, no. 7, pp. 1965–1988, 2015. [10] T. M. Bücking, E. R. Hill, J. L. Robertson, E. Maneas, A. A. Plumb, and D. I. Nikitichev, “From medical imaging data to 3D printed anatomical models,” PloS One, vol. 12, no. 5, article e0178540, 2017. [11] C.-Y. Liaw and M. Guvendiren, “Current and emerging applications of 3D printing in medicine,” Biofabrication, vol. 9, no. 2, article 024102, 2017. [12] A. Christensen and F. J. Rybicki, “Maintaining safety and efficacy for 3D printin in medici e,” 3D Printing in Medici e, vol. 3, no. 1, pp. 1–10, 2017. [13] C. G. Helguero, I. Kao, D. E. Kom tsu et al., “Improving the accuracy of wide resection of bone tumors and enhancing implant fit: a cadaveric study,” Journal of Orthopaedics, vol. 12, Supplement 2, pp. S188–S194, 2015. [14] K. Valenzuela-Villela, P. García-Casillas, and C. Chapa-González, “Progreso de la Impresión 3D de Dispositivos Médicos,” Revista Mexicana de Ingeniería Biomédica, vol. 41, no. 1, pp. 151–166, 2020. [15] C. G. Helguero, E. A. Ramírez, and J. L. Amaya, “Engineerin interface inside the operative room: design and simulation of a fracture-plate bending machine,” Procedia CIRP, vol. 79, pp. 655–660, 2019. [16] D. Hoang, D. Perrault, M. Stevanovic, and A. Ghiassi, “Surgical applications of three-dimensional printing: a review of the 18 BioMed Research International nature of surgical robots [287]. Medical devices, such as blood collectors, are examples of versatile tools used for both clinical research and health monitori g [289], and some can be produced in space using 3DP. Another possibility is to roduce medication in space, although litt e is known regarding their pharmacodynamics and pharmacokinetics in microgravity. More research is also required to identify ways of safely sterilizing and recycling 3D printed medical devices, obotics [6], and to ls (Fig re 12). Space surger is still in its infanc ; however, it is ripe for innovation and could benefit particularly by combining with the rise and expansion of frontier technologies like artificial intelligence and augm nt d reality [290]. 5. Conclusion and Future Insights 3DP is a manufacturing process that has ramped its participation into industry as it offers unique characteristics with the aim to produce objects in a digital fabrication workflow. It has been well-developed in recent years reflected in a variety of surgical specialties, such as head and neck surgery, neurosurgery, general surgery, cardiovascular surgery, urology, gynecology, and orthopaedics. The main impact of this tool is div ded into 3 pillars: medic l training, surgical planning, and patient education. Obt ining anatomical models of the pathology of interest allows better comprehension and permits an accurate surgical approach. The applications are classified into three different categories: (1) presurgical tool, (2) intrasurgical tool, and (3) implant or eplacement. The main manufacturing techniques are fused deposition modeling (FDM), stereo-lithography (SLA), selective laser sintering (SLS), selective laser melting (SLM), electron beam melting (EBM), and direct energy deposition (DED). The exponential innovations of this technology are having high expectations that will provide a major benefit i the future. In turn, the research and development of this technology have a potential impact with the integration of augmented, mixed, and virtual reality. Besides, other important applications are medical devices and tools for space surgery in order to bring bett r pati nt management during spaceflight (diagn sis and treatment). Finally, there is an interesting growing field called “Endoscopic - Intracorporeal 3D Bioprinting,” which consists of creating tissu s hat help to regenerate damaged organs during a robotic surgery procedure. Conflicts of Interest The authors declare no conflicts of interest. Acknowledgments Th research ha been managed and supervised by the Bioastronautics and Space Mechatronics Research Group—- BIO&SM (https://sites.google.com/view/bio-sm). The publication of the article was funded through the Universidad San Ignacio de Loyola. Also, special thanks to the Graduate Program in Biomedical Engineering of the Superior School of Eng eering, Science nd Techn logy at Universitat Internacional Valenciana, Spain. eferences [1] I. Gibs , . Rosen, a d B. Stucker, “Applications for additive manufacture,” in Additive Manufacturing Technologies, pp. 451–474, Springer, New York, NY, 2015. [2] M. H. Abedin-Nasab, Handbook of Robotic and ImageGuided Surgery, Elsevier, 2019. [3] J. Cornejo, J. A. Cornejo-Aguilar, and J. P. Perales-Villarroel, “Innovaciones internacionales n robótica médica para mejorar el manejo del paciente en Perú,” Revista de la Facultad de Medicina Humana, vol. 19, no. 4, pp. 105–113, 2019. [4] J. P. Desai, Encyclopedia Of Medical Robotics, The (In 4 Volumes), World Scientific, 2018. [5] J. Cornejo, J. A. Cornejo-Ag ilar, and R. Palomares, “Biomedik surgeon: surgical robotic system for training and simulation by medical students in Peru,” in 2019 International Conference on Control of Dynamical and Aerospace Systems (XPOTRON), pp. 1–4, Arequipa, Peru, 2019. [6] J. Cornejo, J. A. Cornejo-Aguilar, R. Sebastian et al., “Mechanical design of a novel surgical laparoscopic simulator for telemedicine assistance and physician traini g during aerospace applications,” in2021 IEEE 3rd Eurasi Conference on Biomedical Engineering, Healthcare and Sustainability (ECBIOS), pp. 53–56, Tainan, Taiwan, 2021. [7] J. rnejo, J. P. Perales-Villar oel, R. Sebastian, and J. A. Cornejo-Aguilar, “Conceptual design of space biosurgeon for robotic surgery and aerospace medicine,” in 2020 IEEE ANDESCON, pp. 1–6, Quito, Ecuador, 2020. [8] J. Cornejo, J. A. Cornejo-Aguilar, C. Gonzalez, and R. Sebastian, “Mechanical and kinematic design of surgical mini robotic manipulator used into SP-LAP multi-DOF platform for training and simulation,” in 2021 IEEE XXVIII Inter ati nal Conference on Electronics, Electrical Engineering and Computing (INTERCON), pp. 1–4, Lima, Peru, 2021. [9] D. Mitsouras, P. Liacouras, A. Imanz deh t al., “Medical 3D printing for the radiologist,” Radiographics, vol. 35, no. 7, pp. 1965–1988, 2015. [10] T. M. Bücking, E. R. Hill, J. L. Robertson, E. Maneas, A. A. Plumb, and D. I. Nikitichev, “From medical imag ng data to 3D printed anatomical models,” PloS One, vol. 12, no. 5, article e0178540, 2017. [11] C.-Y. Liaw and M. Guvendiren, “Current and emerging applications of 3D printing in medicine,” Biofabrication, vol. 9, no. 2, article 024102, 2017. [12] A. Christensen and F. J. Rybicki, “Maintaining safety and efficacy for 3D printing in medicine,” 3D Printing in Medicine, vol. 3, no. 1, pp. 1–10, 2017. [13] C. G. Helguero, I. Kao, D. E. Komatsu et al., “Improving the accuracy of wide resection of bone tumors and enhancing implant fit: a cadaveric study,” Journal of Orthopaedics, vol. 12, Supplement 2, pp. S188–S194, 2015. [14] K. Valenzuela-Villela, P. Gar ía-Casillas, and C. Chapa-González, “Progreso de la Impresión 3D de Dispositivos Médicos,” Revista Mexicana de Ingeniería Biomédica, vol. 41, no. 1, pp. 51–166, 202 . [15] C. G. Helguero, E. A. Ramírez, and J. L. Amaya, “Engineering interface inside the operative room: design and simulation of a fracture-plate bending machine,” Procedia CIRP, vol. 79, pp. 655–660, 2019. [16] D. Hoang, D. Perrault, M. Stevanovic, and A. Ghiassi, “Surgical applications of three-dimensional printing: a review of the 18 BioMed Research International
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