3D Printing: A Stepping StoneTowards Personalised Surgery
3D printing lends itself to improving quality and safety by aidingthe visualisation of complex anatomy. We seek to highlight thecurrent surgical applications of 3D printing, and attest to the easewith which it can be adopted by health services.
1.Bernhard J, Isotani S, Matsugasumi T, Duddalwar V, Hung A, Suer E et al. Personalized 3Dprinted model of kidney and tumor anatomy: a useful tool for patient education. World J Urol.2015;34(3):337-345.
2.Igami T, Nakamura Y, Hirose T, Ebata T, Yokoyama Y, Sugawara G et al. Application of aThree-dimensional Print of a Liver in Hepatectomy for Small Tumors Invisible byIntraoperative Ultrasonography: Preliminary Experience. World J Surg. 2014;38(12):3163-3166.
3.Biglino G, Capelli C, Wray J, Schievano S, Leaver L, Khambadkone S et al. 3D-manufactured patient-specific models of congenital heart defects for communication inclinical practice: feasibility and acceptability. BMJ Open. 2015;5(4):e007165-e007165.
4.Zhang Y, Ge H, Li N, Yu C, Guo H, Jin S et al. Evaluation of three-dimensional printing forlaparoscopic partial nephrectomy of renal tumors: a preliminary report. World J Urol.2015;34(4):533-537.
5.1. Berens A, Newman S, Bhrany A, Murakami C, Sie K, Zopf D. Computer-Aided Design and3D Printing to Produce a Costal Cartilage Model for Simulation of Auricular Reconstruction.Otolaryngology-Head and Neck Surgery. 2016;155(2):356-359.
6.2. Bizzotto N, Sandri A, Regis D, Romani D, Tami I, Magnan B. Three-Dimensional Printing ofBone Fractures. Surgical Innovation. 2015;22(5):548-551.
7.Qiao F, Li D, Jin Z, Hao D, Liao Y, Gong S. A novel combination of computer-assistedreduction technique and three dimensional printed patient-specific external fixator fortreatment of tibial fractures. International Orthopaedics (SICOT). 2015;40(4):835-841.
3. Pre-surgical planning and simulation
3D printed models printed specific to each individual patient’s anatomyare a beneficial advancement for surgical planning, in particular forcomplex cases, and in the training of surgical trainees.4 3D printing alsoallows for the creation of inexpensive, realistic models for the purposesof simulation and trainee education.5
Jasamine Coles-Black1,2, Gordon Chen1, Michael Jiang1,Jason Chuen1,2
1.Austin Health 3D Medical Printing Laboratory, Austin Health,The University of Melbourne
2.Department of Vascular Surgery, Austin Health, The Universityof Melbourne
There has been an explosion of interest in 3D printing in surgery.We seek to demonstrate the contributions to patient-centred care,quality and safety 3D printing brings to current best practice, whilecomparing our centre’s experiences with other labs internationally.
We performed a literature search using Ovid MEDLINE, OvidEMBASE and PubMed. The search terms used were “Printing,Three-Dimensional” AND “Surgery”. 392 articles resulted, whichwere read in full to identify relevant studies. The findings fromthese studies were then compared against our own centre’sexperiences as an early adopter of the technology.
We present the four main ways 3D printing is improving qualityand safety in surgery:
1.Improved patient and carer understanding
Personalised 3D printed models are of great benefit in thetherapeutic relationship. 3D models improve patient and carerunderstanding of basic anatomy, physiology, pathology, theplanned surgical procedure1, and are invaluable in gaininginformed consent. 3D printed models greatly aid patientunderstanding of the spatial relationships between anatomicalstructures.2
4. Improved patient safety
In accordance with the findings in our lab, 3D printed models are ofgreatest use in the preoperative planning of complex cases.6 3Dprinted models are associated with reduced time underanaesthesia, reduction in operation time, reduced postoperativerecovery times, and a reduction in blood loss intraoperatively.7
2. Improved patient satisfaction and engagement
For example, in one study, patients and their carers rated the 3D modelsas “very useful” and requested to keep the model at the end of the study.The study also observed better patient engagement when compared toother media.3
Figure 1a. 3D printed renal cell carcinoma model for patient education.
1b. Type A aortic dissection 3D printed for presurgical planning.
1c. 3D printed model for planning of a complex total hip arthroplasty.
1d. Bilateral 3D printed models for planning carotid body tumour resections.