Utility of patient-specific silicone renal models for planning and rehearsal of complex tumour resections prior to robot-assisted laparoscopic partial nephrectomy

BJU Int. 2017 Apr;119(4):598-604. doi: 10.1111/bju.13712. Epub 2016 Dec 10.


Objective: To describe our experience using patient-specific tissue-like kidney models created with advanced three-dimensional (3D)-printing technology for preoperative planning and surgical rehearsal prior to robot-assisted laparoscopic partial nephrectomy (RALPN).

Patients and methods: A feasibility study of 10 patients with solid renal masses who underwent RALPN after preoperative rehearsal using 3D-print kidney models. A single surgeon performed all surgical rehearsals and procedures. Using standard preoperative imaging and 3D reconstruction, we generated pre-surgical models using a silicone-based material. All surgical rehearsals were performed using the da Vinci® robotic system (Intuitive Surgical Inc., Sunnyvale, CA, USA) before the actual procedure. To determine construct validity, we compared resection times between the model and actual tumour in a patient-specific manner. Using 3D laser scanning in the operating room, we quantified and compared the shape and tumour volume resected for each model and patient tumour.

Results: We generated patient-specific models for 10 patients with complex tumour anatomy. R.E.N.A.L. nephrometry scores were between 7 and 11, with a mean maximal tumour diameter of 40.6 mm. The mean resection times between model and patient (6:58 vs 8:22 min, P = 0.162) and tumour volumes between the computer model, excised model, and excised tumour (38.88 vs 38.50 vs 41.79 mm3 , P = 0.98) were not significantly different.

Conclusions: We have developed a patient-specific pre-surgical simulation protocol for RALPN. We demonstrated construct validity and provided accurate representation of enucleation time and resected tissue volume. This simulation platform can assist in surgical decision-making, provide preoperative rehearsals, and improve surgical training.

Keywords: RALPN; #KCSM; #KidneyCancer; 3D printing; robotic partial nephrectomy; surgical simulation.

Publication types

  • Clinical Trial

MeSH terms

  • Carcinoma, Renal Cell / surgery*
  • Feasibility Studies
  • Humans
  • Kidney / pathology*
  • Kidney Neoplasms / surgery*
  • Laparoscopy / methods
  • Models, Anatomic*
  • Nephrectomy / methods
  • Nephrectomy / trends
  • Precision Medicine / methods*
  • Printing, Three-Dimensional*
  • Robotic Surgical Procedures / methods*
  • Silicones*


  • Silicones