Surgical Simulation with a Soft Three-dimensional-printed Airway Model for Segmental Resection and Telescopic Anastomosis of the Bronchus Intermedius in a Patient with a Carcinoid Tumor

Abstract

Introduction: Surgery is the preferred treatment for bronchial carcinoid, often involving resection of the affected bronchi with or without lobectomy. Proper bronchial transection and anastomosis are critical and require careful, case-by-case planning.

Technical Report: The patient was a 52-year-old woman with intermittent bloody sputum. A chest computed tomography scan revealed a nodule obstructing the bronchus intermedius, while bronchoscopy identified a polypoid tumor near the upper lobar bronchus. The tumor was excised at its narrow base using a high-frequency snare, and pathology confirmed a typical carcinoid diagnosis. Concern about residual tumor at the margin necessitated surgical resection.

Preoperative planning involved creating a three-dimensional-printed bronchial model from computed tomography scan images to simulate sleeve resection. The model revealed a caliber mismatch between the proximal and distal bronchus intermedius after resection. This mismatch was addressed with a telescopic anastomosis technique. During surgery, the planned procedure was replicated, successfully resecting the lesion and achieving satisfactory anastomosis.

Conclusions: A definite diagnosis of a typical carcinoid was obtained via high-frequency snare resection. Moreover, the extent of resection and differences in the caliber of the anastomosis were determined in advance through preoperative simulation with a three-dimensional-printed bronchial model. Sleeve resection of the bronchus intermedius was successfully performed.