Surgery of the Future
Surgeons Using Printers to make 3-D Patient Models
By Michael Lasalandra
Beth Israel Deaconess Medical Center correspondent
Two surgeons who specialize in minimally invasive operations at Beth Israel Deaconess Medical Center have won a grant to use 3-D printers to build models of patient body parts containing particular pathologies, such as tumors or aneurysms, that one day may be used to better educate patients about their illnesses and what will happen during their surgeries.
The 3-D models will also be able to be used in the training of surgeons and may eventually serve to help surgeons better prepare for tricky operations by practicing first on the models.
"We are laying the groundwork and testing the waters," says Dr. Robert Andrews, who, along with Dr. Daniel Jones, received the $40,000 grant from the William F. Milton Fund of Harvard Medical School. The pair is working with Dr. Justin Kung, a radiologist, and Theodore Korelitz, a volunteer with an engineering background, to see just where the 3-D models might take surgery in the future.
The models are created out of polymers using 3-D printers made by Objet Geometries Ltd. The printers work by taking a 3-D computer file, in these cases usually from a CT scan, and constructing from it a series of cross-sectional slices. Each slice is then printed, one on top of the other, to create the 3-D model.
The models, for example, could be of a breast containing a tumor, or a liver with several tumors. Different polymers are used for different types of body tissues. The models are designed not unlike those created by architects designing buildings, for example.
"We're very lucky to have this grant," Dr. Andrews says. "Otherwise, we would not be making these models. They are very expensive."
Each model takes about 15 man hours of work to create.
Right now, the team is creating models from patient CT scans that are not identified by name since they are only being used for learning and testing the process, not in patient care.
Eventually, Dr. Andrews says, the models — which are uniquely created to be patient-specific — would be able to be shown to the patients in question to help explain to them what is going on inside their bodies and what will happen during their surgeries.
"They can be used for better doctor-patient communication and in the informed consent process," he says.
Down the line, the models would likely be used in the training of doctors and one day by surgeons in the preparation of the operations to be performed on the patients who have been modeled. For example, if a surgeon needs to remove a tumor from a patient but there is a significant chance that he or she might hit a nerve or artery in doing so, the surgeon could create a model of the tumor from the patient's CT scans using the 3-D printer. The surgeon could then practice on the model before working on the patient.
"When we go in there, we often find surprises," says Dr. Andrews. "Arteries and bile ducts, for example, in an operation as common as a gallbladder removal, can be highly variable from patient to patient. If we could model them in advance, it might very well help in knowing what steps or precautions to take in advance to avoid problems."
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Posted March 2013