Three-Dimensional Printing of Surgical Clips: An in Vitro Pilot Study and Trial of Efficacy

Noah E. Canvasser, Shuvro De, Ersin Koseoglu, Aaron H. Lay, Igor Sorokin, Raul Fernandez, Jeffrey A Cadeddu

Research output: Contribution to journalArticle

Abstract

Introduction and Objective: Three-dimensional (3D) printing applications have increased over the past decade. Our objective was to test rapid prototyping of a 3D printed surgical clip for intraoperative use. Materials and Methods: Our prototype was modeled after the 10 mm Weck® Hem-o-lok® polymer clip (Teleflex, Inc., Wayne, PA). A 3D computer-aided design model of the Hem-o-lok clip was reverse engineered using commercial microscopy and printing was done using an Objet Connex500 multijetting system (Stratasys, Eden Prairie, MN). The initial polymer was Objet VeroWhitePlus RGD835; the addition of Objet TangoBlackPlus FLX980 during the design process improved hinge flexibility. The 3D printed clips were then pressure tested on rubber Penrose tubing and compared in vitro versus commercial Hem-o-lok clips. Results: Initial 3D printed clips were not functional as they split at the hinge upon closure of the clip jaws. Design changes were made to add Objet TangoBlackPlus FLX980 at the hinge to improve flexibility. Additional modifications were made to allow for clips to be compatible with the Hem-o-lok endoscopic clip applier. A total of 50 clips were tested. Fracture rate for the printed clips using a clip applier was 54% (n = 27), whereas none of the commercial Hem-o-lok clips broke upon closure. Of the 23 printed clips that closed, mean leak was at 20.7 κPa (range 4.8-42.7). In contrast, none of the commercial clips leaked, and fill continued until Penrose rupture at mean 46.2 κPa (44.8-47.6). Conclusions: This pilot study demonstrates feasibility of 3D printing functional surgical clips. However, the performance of our first generation clips is poor compared with commercial grade product. Refinement in printers and materials available may allow for customization of such printed surgical instruments that could be economically competitive to purchasing and stocking product.

Original languageEnglish (US)
Pages (from-to)930-933
Number of pages4
JournalJournal of Endourology
Volume31
Issue number9
DOIs
StatePublished - Sep 1 2017

Fingerprint

Surgical Instruments
Three Dimensional Printing
In Vitro Techniques
Polymers
Computer-Aided Design
Printing
Rubber
Jaw

Keywords

  • 3D printing
  • instrumentation
  • laparoscopy
  • robotics

ASJC Scopus subject areas

  • Urology

Cite this

Three-Dimensional Printing of Surgical Clips : An in Vitro Pilot Study and Trial of Efficacy. / Canvasser, Noah E.; De, Shuvro; Koseoglu, Ersin; Lay, Aaron H.; Sorokin, Igor; Fernandez, Raul; Cadeddu, Jeffrey A.

In: Journal of Endourology, Vol. 31, No. 9, 01.09.2017, p. 930-933.

Research output: Contribution to journalArticle

Canvasser, NE, De, S, Koseoglu, E, Lay, AH, Sorokin, I, Fernandez, R & Cadeddu, JA 2017, 'Three-Dimensional Printing of Surgical Clips: An in Vitro Pilot Study and Trial of Efficacy', Journal of Endourology, vol. 31, no. 9, pp. 930-933. https://doi.org/10.1089/end.2017.0221
Canvasser NE, De S, Koseoglu E, Lay AH, Sorokin I, Fernandez R et al. Three-Dimensional Printing of Surgical Clips: An in Vitro Pilot Study and Trial of Efficacy. Journal of Endourology. 2017 Sep 1;31(9):930-933. https://doi.org/10.1089/end.2017.0221
Canvasser, Noah E. ; De, Shuvro ; Koseoglu, Ersin ; Lay, Aaron H. ; Sorokin, Igor ; Fernandez, Raul ; Cadeddu, Jeffrey A. / Three-Dimensional Printing of Surgical Clips : An in Vitro Pilot Study and Trial of Efficacy. In: Journal of Endourology. 2017 ; Vol. 31, No. 9. pp. 930-933.
@article{44dc3b3eb0b54ada810336f329058412,
title = "Three-Dimensional Printing of Surgical Clips: An in Vitro Pilot Study and Trial of Efficacy",
abstract = "Introduction and Objective: Three-dimensional (3D) printing applications have increased over the past decade. Our objective was to test rapid prototyping of a 3D printed surgical clip for intraoperative use. Materials and Methods: Our prototype was modeled after the 10 mm Weck{\circledR} Hem-o-lok{\circledR} polymer clip (Teleflex, Inc., Wayne, PA). A 3D computer-aided design model of the Hem-o-lok clip was reverse engineered using commercial microscopy and printing was done using an Objet Connex500 multijetting system (Stratasys, Eden Prairie, MN). The initial polymer was Objet VeroWhitePlus RGD835; the addition of Objet TangoBlackPlus FLX980 during the design process improved hinge flexibility. The 3D printed clips were then pressure tested on rubber Penrose tubing and compared in vitro versus commercial Hem-o-lok clips. Results: Initial 3D printed clips were not functional as they split at the hinge upon closure of the clip jaws. Design changes were made to add Objet TangoBlackPlus FLX980 at the hinge to improve flexibility. Additional modifications were made to allow for clips to be compatible with the Hem-o-lok endoscopic clip applier. A total of 50 clips were tested. Fracture rate for the printed clips using a clip applier was 54{\%} (n = 27), whereas none of the commercial Hem-o-lok clips broke upon closure. Of the 23 printed clips that closed, mean leak was at 20.7 κPa (range 4.8-42.7). In contrast, none of the commercial clips leaked, and fill continued until Penrose rupture at mean 46.2 κPa (44.8-47.6). Conclusions: This pilot study demonstrates feasibility of 3D printing functional surgical clips. However, the performance of our first generation clips is poor compared with commercial grade product. Refinement in printers and materials available may allow for customization of such printed surgical instruments that could be economically competitive to purchasing and stocking product.",
keywords = "3D printing, instrumentation, laparoscopy, robotics",
author = "Canvasser, {Noah E.} and Shuvro De and Ersin Koseoglu and Lay, {Aaron H.} and Igor Sorokin and Raul Fernandez and Cadeddu, {Jeffrey A}",
year = "2017",
month = "9",
day = "1",
doi = "10.1089/end.2017.0221",
language = "English (US)",
volume = "31",
pages = "930--933",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "9",

}

TY - JOUR

T1 - Three-Dimensional Printing of Surgical Clips

T2 - An in Vitro Pilot Study and Trial of Efficacy

AU - Canvasser, Noah E.

AU - De, Shuvro

AU - Koseoglu, Ersin

AU - Lay, Aaron H.

AU - Sorokin, Igor

AU - Fernandez, Raul

AU - Cadeddu, Jeffrey A

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Introduction and Objective: Three-dimensional (3D) printing applications have increased over the past decade. Our objective was to test rapid prototyping of a 3D printed surgical clip for intraoperative use. Materials and Methods: Our prototype was modeled after the 10 mm Weck® Hem-o-lok® polymer clip (Teleflex, Inc., Wayne, PA). A 3D computer-aided design model of the Hem-o-lok clip was reverse engineered using commercial microscopy and printing was done using an Objet Connex500 multijetting system (Stratasys, Eden Prairie, MN). The initial polymer was Objet VeroWhitePlus RGD835; the addition of Objet TangoBlackPlus FLX980 during the design process improved hinge flexibility. The 3D printed clips were then pressure tested on rubber Penrose tubing and compared in vitro versus commercial Hem-o-lok clips. Results: Initial 3D printed clips were not functional as they split at the hinge upon closure of the clip jaws. Design changes were made to add Objet TangoBlackPlus FLX980 at the hinge to improve flexibility. Additional modifications were made to allow for clips to be compatible with the Hem-o-lok endoscopic clip applier. A total of 50 clips were tested. Fracture rate for the printed clips using a clip applier was 54% (n = 27), whereas none of the commercial Hem-o-lok clips broke upon closure. Of the 23 printed clips that closed, mean leak was at 20.7 κPa (range 4.8-42.7). In contrast, none of the commercial clips leaked, and fill continued until Penrose rupture at mean 46.2 κPa (44.8-47.6). Conclusions: This pilot study demonstrates feasibility of 3D printing functional surgical clips. However, the performance of our first generation clips is poor compared with commercial grade product. Refinement in printers and materials available may allow for customization of such printed surgical instruments that could be economically competitive to purchasing and stocking product.

AB - Introduction and Objective: Three-dimensional (3D) printing applications have increased over the past decade. Our objective was to test rapid prototyping of a 3D printed surgical clip for intraoperative use. Materials and Methods: Our prototype was modeled after the 10 mm Weck® Hem-o-lok® polymer clip (Teleflex, Inc., Wayne, PA). A 3D computer-aided design model of the Hem-o-lok clip was reverse engineered using commercial microscopy and printing was done using an Objet Connex500 multijetting system (Stratasys, Eden Prairie, MN). The initial polymer was Objet VeroWhitePlus RGD835; the addition of Objet TangoBlackPlus FLX980 during the design process improved hinge flexibility. The 3D printed clips were then pressure tested on rubber Penrose tubing and compared in vitro versus commercial Hem-o-lok clips. Results: Initial 3D printed clips were not functional as they split at the hinge upon closure of the clip jaws. Design changes were made to add Objet TangoBlackPlus FLX980 at the hinge to improve flexibility. Additional modifications were made to allow for clips to be compatible with the Hem-o-lok endoscopic clip applier. A total of 50 clips were tested. Fracture rate for the printed clips using a clip applier was 54% (n = 27), whereas none of the commercial Hem-o-lok clips broke upon closure. Of the 23 printed clips that closed, mean leak was at 20.7 κPa (range 4.8-42.7). In contrast, none of the commercial clips leaked, and fill continued until Penrose rupture at mean 46.2 κPa (44.8-47.6). Conclusions: This pilot study demonstrates feasibility of 3D printing functional surgical clips. However, the performance of our first generation clips is poor compared with commercial grade product. Refinement in printers and materials available may allow for customization of such printed surgical instruments that could be economically competitive to purchasing and stocking product.

KW - 3D printing

KW - instrumentation

KW - laparoscopy

KW - robotics

UR - http://www.scopus.com/inward/record.url?scp=85038610735&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038610735&partnerID=8YFLogxK

U2 - 10.1089/end.2017.0221

DO - 10.1089/end.2017.0221

M3 - Article

C2 - 28719986

AN - SCOPUS:85038610735

VL - 31

SP - 930

EP - 933

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 9

ER -