| The Surgical Technologist | JUNE 2022 254 Correspondence should be addressed to José Cornejo; [email protected] Received 2 December 2021; Revised 16 February 2022; Accepted 24 February 2022; Published 24 March 2022 Academic Editor: Chuan Ye Copyright © 2022 José Cornejo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients’ needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions. 1. Introduction Additive manufacturing (AM), also called threedimensional printing (3DP), is a manufacturing process that has ramped its participation into industry as it offers unique characteristics in order to produce objects in a digital fabrication workflow. For several years, AM has paved its path into medical industry by creating useful and innovative solutions to daily common problems. These solutions are mainly group into three different categories: (1) AM used as presurgical tool, (2) AM used as intrasurgical tool, and (3) AM used as an implant or replacement [1]. Each one of these categories has posed and solved challenges for engineers and medical doctors, and, in this process, commercial solutions have been created and added to medical industry which is commonly used for design and construction of surgical mechatronic systems and anatomical training simulation procedures [2–8]. As a presurgical tool, AM has introduced a simple yet powerful tool for medical doctors and surgeons: physical 3D-printed models [9]. Created based on reverseengineering of 3D medical data acquisition procedures, a virtual model with precise detail can be obtained [10]. Surgeons will use these models for procedure planning as they will have in their hands a replica of what they will find when they expose their patients during surgery [11]. Better outcomes, more reliable surgeries, costs saving, and shorter postoperatory procedures are among the benefits of using 3D-printed anatomical models [12]. As an intrasurgical tool, AM has helped doctors and engineers to create tools and devices that assists surgeons during medical procedures in the operating room (OR). One of the more developed devices is the 3D-printed surgical guide [13]. Guides are tools created by using a similar procedure as compared to anatomical models, however, they mimic an organ’s complex surface to obtain a jig that will allow the surgeon to perform a cut, drill, or resection in a more precise and clean procedure. These guides have proved to more effective in resection as compared to typical free hand cutting techniques [13]. Other medical devices that use the potential of AM previously depicted in this article are also being developed, such as hearing aids, dental aligners, and frames for glasses [14, 15]. Finally, the application that is currently in the focus of researchers is how AM can be used as a functional implant and, in the future, as a fabrication technique for fully operative organs [16]. Being able to obtain anatomical models from medical images has open the discussion of whether these replicas might evolve into utile organs [9]. The scientific community has started to design and 3D-print scaffolds with intricate shapes that have proved to serve as a favorable medium to promote cellular activity and differentiation [17]. In the meantime, AM is currently being used to successfully create implants with complex shapes and topologies for orthopaedic and maxillofacial surgeries among others [18]. AM is not new, however, its introduction to the medical field was just in the last decade, and applications are still being developed with an increased demand from patients, hospitals, and insurance companies that have embraced Anatomical Engineering as a useful and high exponential growth field [19]. This article is the focus in surgery, which presents a clear and comprehensive view to some of the most interesting and promising applications of AM and the use of its potential to solve complex problems and, ultimately, increases the quality of life of patients [20, 21]. Since the beginning of the use of 3D printing in the medical field in the 1990s, there has been an exponential development in the different areas of surgery, which was initially to educate patients and surgeons; additionally, its use is being applied in the creation of new organs. Thereby, the following question was raised: what are the advances and the outcomes in the applications of 3D printing in surgery at the presurgical, intrasurgical, and postsurgical settings in each group of surgical subspecialties? The main objective of this work is to have a better knowledge of this developing technology and thus, with this highly specialized group of surgeons and engineers, be able to develop new 3D technologies and promote their concomitant use with high-resolution 2 BioMed Research International
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