The rise of 3D printing represents a huge advance in surgical planning by improving our understanding of anatomy.
One London hospital to recognize the potential of this promising technology is Charing Cross, which has an active surgical research laboratory.
James Duncan, clinical research fellow and the rest of the orthopaedic surgery team were faced with a tricky procedure: the reconstruction of an acetabular – or pelvic – fracture in a man who had had a motorbike accident. These fractures, mainly associated with extreme trauma, are extremely complex. Thus, in the preoperative planning stage and during the operation itself, surgeons usually rely on computed tomography images in conjunction with plain X-rays to work out how to repair them.
“The pelvic surgeon commonly has a CT scan on a screen and looks at a rotating image. What the pelvic surgeon is doing is very complex compared to other orthopaedic procedures. They rely on X-rays during the operation but it’s difficult to really know what you’re actually looking at,” Duncan told MedicalExpo.
The surgeon, who is now based at King’s College Hospital in a different part of London, explained that this method is not perfect, as it can be difficult to determine where to put all the individual plates and screws.
Printing a 3D Model of the Pelvis to Work On
So the team came up with the idea of printing a 3D model of the patient’s pelvis – based on detailed CT scans – to give the surgeons a more accurate version to work on. The tangible nature of an actual 3D model helps the surgeons to visualize the bone he or she is going to operate on and to work out more accurately the best way to approach the fracture. Duncan explained:
By having a 3D print of that individual patient’s pelvis in theatre with you, you can look at the print which will help you to appreciate the patient’s anatomy and will help you with screw and plate positioning.
To create the model, conventional CT scans were used and the files were then converted into a format so that they were compatible with the 3D printer. They were printed on an Objet Eden 250 printer utilising selective laser sintering – a standard 3D printing process – of nylon.