Mar 8, 2017 | By David

The impact of 3D technology developments on healthcare in recent years has been undeniable, and a recent breakthrough by researchers in Poland suggests that the medical profession is poised to benefit even further from what 3D printing has to offer. A 3D printed model of a liver was produced, at a much lower cost than previously thought possible, and the model was used successfully as a surgical guide for a crucial operation to remove a potentially fatal tumour.

3D printed surgical guides have been used before for a number of different operations, but the costs involved in their production, as well as the necessity for a high level of expertise, tend to prohibit widespread implementation of the technology in hospitals. Jan Witowski, of the Jagiellonian University Medical College in Krakow, recognized these limitations and sought to test a cheaper, easier alternative that would hopefully encourage more surgeons to use 3D printed models in their pre-operative planning.

Whereas 3D printed surgical guides for liver operations had previously only modelled small areas or single blood vessels, due to the high cost of the SLS (selective laser sintering) or SLA (stereolithography apparatus) techniques used, Witowski’s innovation was to use the much cheaper FDM (fused deposition modelling) technique. This allowed him to produce an accurate model of the whole liver, at a relatively low cost.

Using CT scans of the patient’s liver, Witowski created separate 3D images for the various parts of the organ, including the blood vessels and the tumour that was to be removed. These were then 3D printed in bright, easily visible colors, and assembled. A "parenchyma scaffold," shaped like the outer structure of the liver, was filled with transparent silicon which was allowed to set, and the scaffold was removed. The silicon allowed the texture of the real organ to be modelled, at the same time as allowing the internal structure of the organ to be visible. The surgeon making use of the 3D model was therefore able to plan the operation in an extremely high level of detail, and the operation to remove the tumour was a great success.

In a paper outlining his work, entitled "Cost-effective, personalized, 3D-printed liver model for preoperative planning before laparoscopic liver hemihepatectomy for colorectal cancer metastases," Witowski highlighted the advantages of using these 3D surgical guides for operations. Compared to traditional 2D imaging techniques or virtual 3D renderings, the models allow for a more accurate visualization of the body part in question, particularly one as complex as the liver. 

'‘3D printed models offer great visualization of a patient’s anatomy and spatial relationships," said Witowski. '‘It is easier to realize the size of a tumor and its proximity to surrounding vessels and liver margins." He also pointed out the advantages of the surgeon being able to physically touch the organ. This was particularly beneficial for his test case, laparoscopic liver surgery, in which the surgeon doesn’t have direct contact with the organ itself. Giving the surgeons a clearer picture of what they are operating on reduces blood loss from surgery, as well as drastically speeding up the operating time.

Witowski reported the cost of his technique at around $150. This is a huge reduction, compared to an average cost of around $1000 for standard 3D printed surgical guides for a liver operation. He also reported that the training period required for physicians to learn the new 3D printing technique would be relatively short. According to Witowski, if this FDM 3D printing technique was standardized across the industry, healthcare providers worldwide would be more than justified in implementing 3D printing in clinical situations.

Despite what he recognizes as the relatively slow speed of the process limiting potential applications for emergency surgery, the low cost and efficiency of Witowski’s technique will hopefully mean that the results of his research are taken seriously across the medical world. It will be encouraging to see more and more cases of 3D printing being used for crucial operations such as this, and the technology contributing to more lives being saved.



Posted in 3D Printing Application



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