Nerve-sparing surgery is the standard approach used in radical prostatectomy to enhance functional outcomes, but secondary resection might be needed in case of uncertainty regarding the complete removal of the tumour. However, direct visual guidance for resecting positive surgical margins (PSMs) during secondary resection is lacking.

In a study published in BJU International, a 3D-printed prostate model was used to improve surgical precision of targeted secondary resection during nerve-sparing robot-assisted radical prostatectomy. Overall, 100 patients undergoing nerve-sparing robot-assisted radical prostatectomy were enrolled in this prospective, multicentre study. 3D models were derived from pelvic MRI to guide intraoperative secondary resection of PSMs. This approach led to a successful conversion of PSMs to negative surgical margins in 83% of patients, 95% of whom achieved undetectable PSA levels postoperatively. These results indicate that PSMs marked on a 3D model by the pathologist can improve communication between the pathologist and surgeon, ultimately improving accuracy of the secondary resection site identification. The authors acknowledged some limitations of this study, including the lack of a control group, but concluded that the integration of personalized 3D models in surgical practice could substantially optimize precision in prostate cancer secondary resection.

保留神经的手术是根治性前列腺切除术中用于增强功能结果的标准方法，但在不确定肿瘤是否完全切除的情况下，可能需要二次切除。然而，在二次切除期间缺乏切除阳性手术切缘 （PSM） 的直接视觉指导。

在发表在 BJU International 上的一项研究中，在保留神经的机器人辅助根治性前列腺切除术中，使用 3D 打印的前列腺模型来提高靶向二次切除的手术精度。总体而言，100 名接受保留神经的机器人辅助根治性前列腺切除术的患者被纳入这项前瞻性、多中心研究。3D 模型源自盆腔 MRI，用于指导 PSM 的术中二次切除。这种方法导致 83% 的患者成功将 PSM 转化为阴性手术切缘，其中 95% 的患者在术后达到检测不到的 PSA 水平。这些结果表明，病理学家在 3D 模型上标记的 PSM 可以改善病理学家和外科医生之间的沟通，最终提高二次切除部位识别的准确性。作者承认这项研究存在一些局限性，包括缺乏对照组，但得出结论，在手术实践中整合个性化 3D 模型可以显着优化前列腺癌二次切除的精度。