Application of 3D Printing Technique in Radical Gastrectomy With Leonardo da Vinci Robot

Study Overview
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Brief Summary
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The incidence of gastric cancer is the highest in China, and surgery is one of the most effective treatment methods. Da Vinci robot radical gastrectomy for gastric cancer has the advantage of minimally invasive and fine operation. However, due to complicated perigastric anatomy, abundant blood supply and wide distribution of lymph nodes, it is widely used in clinical use of .Combine the 3D printing technique with imaging examination (digestive endoscopy,3Dct cta/ctv, etc.) ,making the 3D model of da Vinci robot assisted radical gastrectomy can fully show the anatomical relationship around gastric cancer, determine the flow and variation of splenic portal vessels, and the distribution of splenic hilar lymph nodes. In order to eliminate the imagination difference of spatial anatomical structure before operation, it is easier for surgeons to optimize the operation plan, to control the operation process and to improve the accuracy, and to adopt individualized operation suitable for the patients.

Detailed Description
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The investigators will work with general surgery, imaging department and 3D printing center to try to print gastric cancer model and guide the operation. After obtaining the approval of the Hospital Ethics Committee, 20 patients with gastric cancer were collected for imaging examination and evaluation, and the normal physical model of 70% normal volume was printed with Guang Min resin material.The investigators will analyse the anatomical relationship between the tumor and surrounding tissues,and determine the range of tumor excision and the feasibility and safety of radical gastrectomy with Leonardo da Vinci robot for gastric cancer.Through the assistance of the 3D model,The investigators will select the suitable operation path to determine the extent of tumor excision and lymph node dissection.Furthermore, 3D print model is used to provide real-time navigation for key steps of surgery. The purpose of this research is to observe the application value of 3D printing technique in gastric cancer laparoscopic surgery with Leonardo da Vinci robot radical gastrectomy, and to provide reference for the development of 3D printing model of other complicated digestive tract surgery.

Official Title
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Combined Application of 3D Printing Technology and Robotic Surgery in Radical Gastrectomy of Gastric Cancer

Conditions
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Stomach Neoplasms

Intervention / Treatment
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* Procedure: 3D printing model
* Procedure: non 3D printing model


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients without contraindications gastroscope，surgery and anesthesia; There is no history of abdominal surgery, no severe abdominal cavity adhesion; Not found the tumor metastasis; Normal coagulation function; There is no history of anticoagulant drugs, or who take aspirin, salvia miltiorrhiza, etc., should stop taking drugs for more than one week; Patients and their families volunteered choice the surgical procedure and signed informed consent. Exclusion Criteria: Patients with preoperative assessment of distant metastasis; Patients with preoperative radiation and chemotherapy or hormone therapy; Patients with acute obstruction, bleeding or perforation of the emergency surgery; Patients with a history of abdominal trauma or abdominal surgery; Patients with contraindications gastroscope，surgery and anesthesia.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 3D printing group<br>the radical gastrectomy for gastric cancer of Davinci robotic surgery with the assistance of 3D printing model | Procedure: 3D printing model<br>* Combine the 3D printing technique with imaging examination ,making the 3D model of da Vinci robot assisted radical gastrectomy<br>|
| Experimental: non 3D printing group<br>the radical gastrectomy for gastric cancer of Davinci robotic surgery without the assistance of 3D printing model | Procedure: non 3D printing model<br>* da Vinci robot assisted radical gastrectomy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| operation time | record in minutes,from the beginning of anesthesia to the end | 1 hours to 6 hours through the surgery completion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| blood loss | from the surgical record sheet | 1 hours to 6 hours through the surgery completion | 
| success rate | the time in bed to the postoperative patient | from two days to two weeks after surgery | 
| time in bed | the time in bed to the postoperative patient | from two days to two weeks after surgery | 
| time to take food | the time to eat to the postoperative patient | from two days to two weeks after surgery | 
| postoperative complication rate | including anastomotic stoma fistula,anastomotic stenosis,abdominal | from two weeks to one year after surgery | 
| tumor recurrence rate | periodic review the CT or MRI or endoscope | from one month to 2 years after surgery | 
| hospitalization expenses | total hospitalization expenses | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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3D printing technology