EN
TÜRKÇE
Poster - 59
3D printing in pediatric surgery: a systematic review and in vitro evaluation of 3D-printed Nuss implants
Alicija Šavareikaitė 1, Paulius Valatka 2, Sergejus Borodinas 3, Roma Puronaitė 4, Artūras Kilikevičius 5, Darius Vainorius 5, Linas Jonušauskas 6
1 Vilnius University Faculty of Medicine, Vilnius, Lithuania
2 Vilnius University Hospital Santariskiu Klinikos - Childrens Hospital, Vilnius, Lithuania
3 Vilnius Gediminas Technical University, Department of Applied Mechanics, Vilnius, Lithuania
4 Vilnius University Faculty of Mathematics and Informatics, Institute of Data Science and Digital Technologies, Vilnius, Lithuania
5 Vilnius Gediminas Technical University, Mechanical Science Institute, Vilnius, Lithuania
6 Lintrovert MB, Vilnius, Lithuania
This study aimed to conduct a systematic review of three-dimensional (3D) printing applications in pediatric populations, focusing on the thoracic cavity, and to design, fabricate, and evaluate 3D-printed Nuss implant models for treating Pectus Excavatum through in vitro mechanical testing.
A systematic literature search was conducted in accordance with PRISMA guidelines using the PubMed to identify studies published between January 2013 and February 2025. In the experimental phase, Nuss implant models were fabricated using a P1S 3D printer (BambuLab) with ASA, TPU, PETG, and PLA filaments. Mechanical testing used a Sauter FH 1K force gauge (range: 1000 N; tolerance: ±0.5%; resolution: 0.5 N) and a Sauter TVL displacement gauge (range: 200 mm; resolution: 10 µm). Parametric optimization via the Levenberg–Marquardt method identified virtual material properties based on experimental data, supporting model validation. Fatigue testing determined the maximum duty cycle of each material under dynamic loading.
Twenty studies involving 136 patients (mean age: 11.26 years) were included. 3D printing was primarily applied in diagnostic and preoperative planning, particularly for congenital respiratory anomalies (36.8%), Pectus Excavatum (31.6%), and spinal deformities (10.5%). Therapeutic applications most frequently addressed tracheobronchomalacia (88.9%) and spinal fractures (5.6%). In experimental study, 3D-printed implant models were subjected to compression testing with forces ranging from 0 to 250 N in 10 N increments. The TPU sample tolerated a progressive 1N force increase up to 18N before reaching the setup’s limit, yielding 18 data points. Maximum displacements for the remaining filaments were: TPU – 42.28 mm, ASA – 19.79 mm, PETG – 19.35 mm, and PLA – 11.96 mm.
Three-dimensional printing demonstrates potential for application in pediatric thoracic surgery. Among tested materials, TPU exhibited the highest deformation capacity, while PLA showed the least. These results support the feasibility of custom 3D-printed Nuss implants and warrant further clinical investigation.