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94Chapter5Table2Resultsofthesurveyamong7pediatricsurgeonsAnatomicalstructureScoreMedian(IQR)MRI /CT3DPrintARHologramTumor407(362–415)467(414–471)471(426–475)Arteries362(343–393)454(432–471)483(464–486)Veins346(339–362)450(439–468)483(471–486)Urinarycollectingstructures276(242–300)386(364–439)400(393–458)3DKIDNEYMODELFORNEPHRON-SPARINGSURGERYIn9of10patientsthe3DprintandtheARmodelwerecreatedforresearchpurposesandevaluatedafterthetreatmenthadbeenadministeredForpatient2the3Dmodelwasprinted1weekbeforesurgerybecausetherewasabilateraltumorin ahorseshoekidney Thepediatric surgeonsused themodel as an assistingtoolbecauseoftheabnormalanatomicalvasculatureAsurgicalassistantheldthe3Dprintedmodelforreal-timeguidanceduringsurgery(Figure3)DISCUSSIONPreoperativeimagingisparamountinachievinggoodresultsduringoncologicsurgeryInnephronsparingsurgeryforWT,theriskofpositiveresectionmarginsishigh619;thereforeitisnecessarytoimprovethepresentprocedureAsopposedtobilateralWT,nephron-sparingsurgeryinunilateralWTisstilldebatablebutsurgeonsrecentlyshowedahigherinterestinitsuseforunilateralWTtopreservelong-termrenalfunction67However,theuseofnephron-sparingsurgeryisreportedtoleadtoincompletetumorresectionin30%ofunilateralcaseswhichresultsinreoperationandadditionalradiotherapy6Thenovel3DvisualizationtechniquespresentedheremaybeausefuladdedtoolwhenplanningnephronsparingsurgeryinunilateralandbilateralWT.Inthisstudyweconstructedpersonalizedhigh-qualityphysicalandAR3Dmodelsofpediatricunilateralandbilateral WTtocreatepracticeobjectsforpreoperativeplanningToourknowledgewewerethefirsttoreconstructMRIsand/orCTimagesofkidneysof10patientswithWTsinboth3DprintsandARhologramsWefoundareported added value ofboth of our 3Dmodels in association with thepreoperativeassessmentbysurgeonsofthe4anatomicalstructures(tumor,arteriesveinsandurinarycollectingstructure) Thesedataareconsistentwithpreviousstudiesthatused3Dprintsinadultswithrenalcellcarcinoma2021