Low-cost and bendable patient-specific three-dimensional pulmonary vessel models for lung segmentectomy

BACKGROUND: Lung segmentectomy offers the advantages of preserving pulmonary function and improving patient survival, leading to its increased adoption. However, this procedure is technically demanding, especially when compared with lobectomy, owing to anatomical shifts from intraoperative lung collapse and manipulation. To support thoracic surgeons and enhance their surgical training, we developed a low-cost, patient-specific, and bendable three-dimensional (3D) pulmonary vessel model. This study describes the development, clinical application, and evaluation of this model. METHODS: A flexible 3D pulmonary vessel model was created using thermoplastic polyurethane (TPU) filaments. Preoperative thin-slice computed tomography images were processed using SYNAPSE VINCENT® (FUJIFILM, Japan) to annotate the pulmonary arteries, veins, bronchi, and tumors. Data were converted into stereolithography format using OsiriXMD (Pixmeo SARL, Switzerland) and printed using Adventure 5M Pro (FLASHFORGE JAPAN, Japan). These models were used for surgical planning, intraoperative navigation, and resident education. RESULTS: Between September 2024 and January 2025, 31 lung segmentectomies were performed with reference to TPU-based models. Cost of the TPU filament was approximately 1 per vessel, totaling approximately 2 per patient, and printing time was approximately 3 h per model. Compared with polylactic acid models, TPU models demonstrated superior flexibility in simulating vascular deformation caused by lung traction. Their use has improved anatomical understanding, facilitated intraoperative vessel recognition, and proved valuable in surgical training. CONCLUSION: Bendable TPU-based 3D pulmonary vessel models are cost-effective and anatomically accurate tools with broad potential for use in thoracic surgery, particularly in planning, navigation, and education.