University of Twente Student Theses


Improvement of patient satisfaction after diep flap surgery by applying 3D techniques

Kuipers, T van (2022) Improvement of patient satisfaction after diep flap surgery by applying 3D techniques.

Full text not available from this repository.

Full Text Status:Access to this publication is restricted
Embargo date:31 December 2024
Abstract:Introduction: Breast cancer is the most common cancer in women worldwide. One in seven women in the Netherlands is diagnosed with breast cancer every year. Factors such as a higher survival rate and more knowledge about hereditary genes increase the demand for (autologous) breast reconstruction. Autologous reconstruction methods are preferred over silicone prosthesis. In most hospitals worldwide, the gold standard is the deep inferior epigastric perforator (DIEP) flap procedure. In this technique, the skin, perforators and subcutaneous fat are transplanted to shape a breast during a 5 - 8 hour operation. Approximately 20% of the DIEP flap patients undergo a secondary correction at the contralateral side to create symmetrical breasts. To improve patient satisfaction and clinical outcome, new techniques including 3D stereophotogrammetry (3D photography) and 3D printing are upcoming in surgical planning. This research aims to improve patient satisfaction by applying 3D techniques. Objectives were to validate the application of these techniques by validating the process from 3D photo to 3D print with breast phantoms and custom-made breast moulds on volunteers. For further validation of the breast moulds after DIEP flap and gaining more insight in breast symmetry, the possibilities to develop an objective breast symmetry algorithm were explored. Method: Breast phantoms (four foam hemispheres and one female torso) were photographed on a Vectra XT system to validate the process from 3D photo to 3D print. Following the capture, the breasts were segmented and the 3D models were printed. Anatomical landmarks have been applied to measure landmark distances between each step in the process. In a clinical study, these landmarks and distance differences have been evaluated on human subjects (healthy volunteers and DIEP flap surgery patients). A distance error of 10 mm was considered acceptable for clinical application. Furthermore, it is described how an algorithm should work and what variables could be used to assess breast symmetry. To demonstrate this, clinical 3D photos of 25 patients were obtained and breast symmetry was scored by plastic surgeons and experienced observers. Results: In the study with breast phantoms, the mean differences found were mostly < 3 mm and < 1%. The maximum mean deviation found was -3.4 mm ±3.1 mm (1.9% ±1.7%) in the comparison between phantom and 3D print. The clinical study on volunteers showed a maximum mean deviation of 2.0 mm ±0.6 mm (-1.3% ±0.7%) in the lateral to medial distance. Most results showed difference of < 2 mm and < 1.5%. Before the developed can be used in clinic, it should be optimized in symmetry calculation. For optimizing the algorithm, a valid database as the gold standard should be developed to validate the algorithm. In the algorithm chapter, (new) analysis methods and parameters are described for further development. Further research should focus on further development of the algorithm, validation database v and application in the clinic. Discussion/Conclusion: Accurate 3D printed breast moulds can be fabricated from 3D photos with small errors found, mostly less than 2 mm. Further research should be performed to use the moulds as an intervention during DIEP flap surgery whether the use of a mould improves patients satisfaction. An objective algorithm should be used in such a study to calculate symmetry. This research provided the framework to develop such an algorithm.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:
Export this item as:BibTeX
HTML Citation
Reference Manager


Repository Staff Only: item control page