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Three-Dimensional Scanning is a Novel Method of Documenting Hypospadias Anatomy
Christina P. Ho, MD, Emmanuele Delot, PhD, Daniel P. Casella, MD.
Children's National Health Systems, Washington, DC, USA.

Background: In the absence of a standardized classification system, current anatomic descriptions of hypospadias provide little objective anatomic data which surgeons can rely upon when planning a surgical approach or tracking outcomes. Handheld scanners capable of quickly generating a 3D computer model with sub-millimeter resolution have recently become commercially available. We hypothesized that the generation of three-dimensional computer models with handheld scanners would offer a novel, non-invasive approach to documenting individual patient's hypospadias anatomy.
Methods: To demonstrate the feasibility of this approach, an Artec3D Space Spider scanner was used to obtain 3D scans in 10 patients undergoing hypospadias repair at Children's National Medical Center. Scans were obtained after the placement of a glans traction suture and prior to creation of any incisions. A linear scale was attached to the glans suture to ensure that a standard force of 100 grams was applied to retract the phallus (figure 1). 3D models were generated with Artec Studio 13 software.
Results: 3D scans were successfully generated in 10 patients, including patients with proximal hypospadias (figures 2 and 3). There was an initial learning curve, however we quickly became proficient and were completing scans in under 5 minutes.
Conclusion: 3D scanning offers a rapid, reproducible and non-invasive method of documenting the individual anatomy of patients with hypospadias. In addition to standardizing measurements among surgeons, the application of 3D shape analysis algorithms may allow for the identification of novel anatomic features which are predictive of outcomes.
Figure 1: Setup in the OR with traction suture attached to linear spring scale.
Figure 2: 3D rendering of a distal hypospadias.
Figure 3: 3D model of patient with proximal hypospadias prior to second stage repair.


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