Jul 21, 2016 | By Benedict

Dr. Jose Gurrola II, a doctor at the University of Virginia Health System, has been using 3D printed skulls at his otolaryngology clinic to teach students how to perform a nasal endoscopy: inserting a camera with a long scope down a patient’s nasal cavity.

When suffering from severe nasal problems—nosebleeds, chronic sinusitis, brain fluid leaks, and the like—patients often have to undergo an endoscopy. By inserting a long tube with a camera and light down a patient’s nasal cavity, doctors are able to closely examine a patient’s anatomy, giving them a better idea of what might be causing the problems. Unfortunately, this important procedure comes at a cost. With the camera sometimes going up to two inches into the nose, receiving an endoscopy can be an incredibly uncomfortable experience, especially if performed incorrectly. Because of this, it is essential that doctors are properly trained on how to conduct the procedure. This training, however, is often curtailed by the limited number of noses available to practice on.

Alongside otolaryngology resident Dr. Robert Reed and 3D printing expert Dwight Dart, Gurrola has come up with a clever way to train his students how to perform endoscopies. Using their combined experience, the three experts have used the UVA’s Rapid Prototyping 3D Printing Lab to create a number of 3D printed skulls on which medical students can practice the procedure and other rhinological surgical simulations.

Creating the 3D printed skulls takes time, because each is modeled on a CT or MRI scan taken of a patient’s skull. Using the data collected from these scans, the team is able to create a 3D printable model of the skull, which can then be printed on one of the UVA’s 3D printers. These models are cheap to produce, reusable, and available to members of the department whenever they are needed. “The models allow students, residents and doctors to see, feel and understand dimensions of real human geometry,” Dart said.

According to Gurrola, the 3D printed skulls represent a big improvement on the options available when he was a trainee. Back then, the students went through a much more painful ordeal in order to perfect the art of the endoscopy: “Students and residents in the same class would take turns ‘scoping each other,” Gurrola said. “You wanted to make sure you didn’t hurt the other person too much, because they were going to ’scope you right after.”

When it was Gurrola’s turn to teach students, he started off by letting them practice endoscopies on him. Unsurprisingly, the doctor was keen to embrace additive manufacturing in order to develop a more amiable solution both for him and for his students. Having some experience in 3D printing himself, the nose expert sketched some potential systems which used 3D printing to replicate the human anatomy. After Reed and Dart joined the project, it was not long before a fully fledged solution was in place.

For medical students like Michael Freeman, these new 3D printed skulls are providing the confidence needed to develop important surgical skills. “The idea that next July being thrown into situations where I have to perform endoscopies on awake patients who may be agitated or frustrated or even scared is a daunting prospect,” Freeman told Newsplex. “There is a definitive technique to how you perform this and provide a better opportunity for when you become a practicing physician.”

Gurrola hopes that the 3D printed skulls, as well as similar innovations, can help to transform surgical training into a more advanced and efficient practice. “For the most part, surgical training is still a process where trainees pass through a continuum that still looks a lot like the ‘see one, do one, teach one’ model of old,” he said. “Our hope is that with the continued development of simulations such as this, we can improve upon this model.”

According to Gurrola, Reed, and Dart, these 3D printed skulls are just the beginning. In future, the experts believe that such models could incorporate sensors and fluid flow lines which could allow the skulls to react in humanlike ways, giving trainees a more realistic and interactive experience as they learn to perfect surgical procedures. Until then, the 3D printed skulls are at least saving students from ‘scoping each other too often, while simultaneously enabling them to develop their skills to a higher level.

“One of the most rewarding experiences is to see the amazing smile that’s generated after we ask a patient who hasn’t breathed well for years to take a deep breath, and they realize they’re finally able to breathe well through their nose again,” Gurrola said. “From my perspective, providing world-class care for our patients while allowing our trainees to develop into tomorrow’s world-class physicians is a winning situation for all of us.”



Posted in 3D Printing Application



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