Development of 3D printed tissue-mimicking materials: Combining fiber reinforcement and fluid content for improved surgical rehearsal

Abstract

The prevalence of medical errors during surgical procedures has led to a higher emphasis on improving surgical outcomes, by improving surgical planning and training. Anatomical models have become valuable tools for pre-operative planning and current 3D printed models strive to better match real soft biological tissues. This study aimed to develop novel 3D printed material composites with controllable mechanical properties that mimic soft tissue. Concepts of microstructuring, fiber reinforcement and fluid infill in extrusion-based 3D printing are combined to design tunable materials towards target tissues of porcine muscle and liver. Material characterization was performed in triangular wave cyclic experiments under uniaxial tension with increasing displacements. Hereby, initial EI and final EII elastic moduli were evaluated. Further, the viscous response was characterized by the dissipated energy ratio UD and suture retention strength (SRS) was determined by single tensile pull-out tests Elastic moduli of printed materials were successfully tuned to 510 ± 10 kPa, closely resembling porcine muscle with 580 ± 150 kPa. The dissipated energy ratio UD of the silicone was increased from 0.09 ± 0.01 to 0.46 ± 0.17 by addition of gyroid infill and viscous fluid. Suture retention strength (SRS) for porcine liver tissue was 1.64 ± 0.42 N, while that of 3D printed silicone showed a mean SRS of 5.1 ± 0.6 N. Although the exact properties of porcine muscle and liver tissue require finer tuning, this study established techniques for refinement of 3D printed tissue-mimicking materials, ultimately enabling more accurate models for surgical rehearsal.