Preoperative planning and training often rely on anatomical models that deliver results as accurately and close to reality as possible. Traditional anatomical models made from foam or cadavers are expensive to obtain and not always an accurate representation of the patient’s anatomical part being studied.
A strong solution for development of anatomical models is 3D printing. With the ability to build complex and highly accurate parts from 3D CAD data, 3D printing technology delivers innovative ways to operate and develop procedure practices.
We’ve highlighted three customers who took advantage of 3D printing in their anatomical models below:
Dr. Saleem Abdulrauf, is a leading neurosurgeon and president of the Walter E. Dandy Neurosurgical Society, serving as Neurosurgeon-in-Chief at the St. Louis University Hospital. Dr. Abdulrauf works with the society and greater neurological community to improve patient outcomes during neurological surgery with cutting-edge practices. The St. Louis Department of Neurological Surgery partnered with the St. Louis School of Engineering to begin quantifying how 3D printing will enhance the training and surgical practice for neurosurgeons.
They launched a comparison study on the effectiveness of 3D printed models against traditional training methodologies such as cadavers or foam models. The study focused specifically on brain aneurysms and the highly specialized method of reaching an aneurysm at minimal effect to surrounding tissue. The brain simulations had to mimic the look and feel of brain matter, so that surgeons could use the same surgical tools on the model as they would on a patient. Additionally, the models had to be manufactured fast in order to accommodate the immediacy of aneurysm surgery.
Highly accurate scans of the patient’s brain and aneurysm were translated into 3D CAD models and delivered to Stratasys Direct Manufacturing for production. Together with the engineering and medical students at St. Louis University, Stratasys Direct Manufacturing 3D printed a patient’s individual aneurysm and skull with PolyJet technology and the brain tissue with specially formulated Urethane Casting material that cured around the PolyJet builds.
The preliminary surgeries using the 3D printed models provided valuable insight for Dr. Abdulrauf and his team. The model helped identify and overcome surgical challenges before the surgery even began.
Dr.’s Clayman, Landman and Kaler at the University of California Irvine specialize in patients with large burden urolithiasis (kidney stone disease) affecting one or both kidneys. As experts in the field of endourology, which encompasses minimally invasive treatment of urologic disease, they conducted a study to assess the impact of using personalized 3D printed kidney models on the surgeon’s ability to render the patient stone-free and on the patient’s understanding of the surgery planned to treat their complex stone disease.
Percutaneous nephrolithotomy (PCNL) is the standard treatment for large, complex kidney stones, where the stone is removed through a less than one inch incision. Preoperative planning, including the identification of the optimal nephrostomy tract, is essential for successful stone removal. Currently, surgeons use two-dimensional, computed tomography images to examine the kidney and stones and plan surgical stone removal. 3D printing offers a unique solution for three-dimensional modeling an individual patient’s kidney with its attendant stone.
The UCI surgeons conducted a study utilizing 3D printed models of individual stone-bearing kidneys to facilitate surgical planning and provide education for their patients. The pilot study assessed cost, logistics, feasibility and utility of using CT imaging translated into STL files to produce the 3D models.
Ten PolyJet models were produced from individual patient CT scans. In one build, kidney stones were printed in VeroMagenta while the rest of the kidney (i.e. the renal parenchyma) was printed in VeroClear. The transparency of VeroClear allowed the surgeon to observe the stone’s relation to each component of the kidney’s anatomy.
While assessment of improvement in surgical outcomes was limited by the pilot nature of the study, patients responded well to the models and reported that holding and seeing their kidneys in 3D facilitated their understanding of the extent of their stone disease and the planned procedure.
Intramedullary fixation is commonly used to fix larger bones like the femur (thigh) or tibia (shin), in which a special pin is placed inside the medullary canal of the bone to hold fragments in place during healing. The procedure is less invasive than plate fixation, using small incisions over the damaged bone. The intramedullary pin is inserted into the bone cavity, joining the bone halves together into proper alignment. Intramedullary fixation has proved to result in faster recovery and improved patient comfort than the traditional plate fixation procedure.
Sonoma Orthopedics Products, Inc. has developed a proprietary pin technique that allows for the expansion of intramedullary fixation to repair fractures in smaller bones like the wrist, ankle and clavicle. To test this technique and educate surgeons and others in the medical industry of their technology, they needed consistent and cost-effective bone fracture models.
Conventional bone models used to train practitioners on surgical procedures are usually cadavers and foam models. Cadavers are inconsistent in term of quality and cost. Foam models don’t cost-effectively deliver the unique canal geometries and characteristics of real bone. 3D printing offered a viable, cost-effective solution to recreate accurate models with repeatable bone fracture types for multiple training scenarios.
Stratasys Direct Manufacturing provided Sonoma Orthopedics with an ideal low volume production solution for training models at a fast delivery rate. Stereolithography was the ideal technology for the large, lightweight parts and the fine feature details of the bone models. Sonoma also used Stratasys Direct Manufacturing to prototype materials and processes to test for new training model capabilities.
Preoperative training and planning is being impacted by the unique design and customization abilities and cost-effective opportunities of 3D printed anatomical models. Surgical preparation and education are no longer restrained to the traditional methods of inconsistent cadavers and foam anatomical models. 3D printing’s solution for repeatable and accurate anatomical models is changing the landscape of surgical development.