Three-dimensional printed surgical guides for keratoma removal in horses using computed tomography or magnetic resonance imaging-based segmentation.
Abstract: To report the technique, surgical approach, and postoperative features in horses treated via a 3-dimensional (3D) printed guide-assisted keratoma resection created using computed tomography (CT) or magnetic resonance imaging (MRI)-based segmentation. Methods: Five client-owned horses. Methods: Short case series. Methods: Horses were placed under general anesthesia for imaging (CT and MRI) and underwent a second anesthesia for surgery. Two horses had guides created from CT-based imaging, 3 horses had guides created from MRI. Various sized nonarbored hole saws were used to create accurate and precise portals for keratoma removal. Surgical sites were managed until keratinized granulation tissue had formed and the defect was sealed with an artificial hoof wall patch. Results: All keratomas were successfully removed as a single piece either intact with the hoof wall or easily extracted after the hoof wall portal was created in a surgical time between 20 and 90 min. All CT created guides fitted without issue; MRI-created guides required minor adjustments with a rotary device for proper fit. All cases had minor debridement adjacent to P3 and circumferential lamellar tissue. All horses returned to previous level of performance 2 to 4 months postoperatively. Conclusions: Use of 3D printed guides led to accurate targeting of keratomas with small surgical portals and short surgical times. Due to challenges with MRI-based segmentation, CT is preferred.
© 2022 American College of Veterinary Surgeons.
Publication Date: 2022-02-28 PubMed ID: 35225367DOI: 10.1111/vsu.13786Google Scholar: Lookup
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Summary
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This research outlines a new technique towards keratoma removal in horses using three-dimensional (3D) printed surgical guides, based on either computed tomography (CT) or magnetic resonance imaging (MRI). The study suggests that this approach offers a precise and more effective way to tackle the keratoma resection while reducing surgical time. However, the paper establishes CT as a preferred imaging method due to some limitations presented by MRI-based procedure.
Methodology
- This study consisted of five horses that underwent the new procedure for keratoma removal.
- Each horse was placed under general anesthesia two times, initially for imaging using CT or MRI and later for surgery.
- For two horses, CT-based imaging was used for creating guides while for three horses, MRI was used.
- The surgical guides were created using nonarbored hole saws of different sizes to create accurate portals to access the keratoma.
- After the surgery, the surgical sites were managed until the keratinized granulation tissue formed and the resultant defect was sealed with an artificial hoof wall patch.
Results
- The results showed that all the keratomas were successfully removed as a single piece either attached with the hoof wall or could be easily extracted once the portal in the hoof wall was created. The surgical time varied between 20 and 90 minutes.
- All the guides created using CT fitted perfectly whereas the MRI-created guides required minor adjustments with a rotary device for proper fit.
- Post-surgery, each case required minor debridement adjacent to P3, the furthest joint in the hoof, and circumferential lamellar tissue, a layer of cells that help attach the hoof wall to the rest of the foot.
- All horses returned to their previous level of performance within 2 to 4 months post-surgery.
Conclusions
- The use of 3D printed guides led to accurate targeting of keratomas with small surgical portals, significantly reducing surgical times.
- Due to challenges observed with guides produced by MRI-based segmentation, the research concludes that CT is the preferred imaging method for creating surgical guides for keratoma removal in horses.
Cite This Article
APA
Biedrzycki AH, Morton AJ, Perez-Jimenez EE, Elane GL, Roe HA, Trolinger-Meadows KD.
(2022).
Three-dimensional printed surgical guides for keratoma removal in horses using computed tomography or magnetic resonance imaging-based segmentation.
Vet Surg, 51 Suppl 1, O43-O52.
https://doi.org/10.1111/vsu.13786 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
MeSH Terms
- Animals
- Hoof and Claw
- Horse Diseases / diagnostic imaging
- Horse Diseases / pathology
- Horse Diseases / surgery
- Horses
- Imaging, Three-Dimensional
- Keratosis / pathology
- Keratosis / surgery
- Keratosis / veterinary
- Magnetic Resonance Imaging / methods
- Magnetic Resonance Imaging / veterinary
- Tomography, X-Ray Computed / veterinary
References
This article includes 13 references
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