by Adam Fairbourn, MBA, CNMT
Vizient Senior Portfolio Executive, Diagnostic Imaging
If you’ve never had an invasive medical procedure, just imagine going to an auto shop to have your vehicle repaired — something that you rely on for most aspects of your life and have no options for replacing. The mechanic uses jargon that sounds like a foreign language, and you’re anxious wondering if you’re making the right choice for your sole method of transportation. You might feel the urge to ask, “Can you show me what needs to be done?”
Obviously, there’s a lot more at stake than a vehicle when you’re faced with a medical procedure but think of the relief that comes with removing some of that uncertainty by reviewing a personalized model of how the plan will be carried out.
The ability to create three-dimensional models for patient education and consent is just one of the many ways 3D printing, also known as additive manufacturing, can improve patient care. Back in 1984, when Charles Hull first filed a patent for “an apparatus for production of three-dimensional [3D] objects,” he never dreamed it would have medical application. And initially, the technology was underutilized in medicine. For many years, investing in 3D printing meant the purchase of a large, complex and expensive piece of equipment, which created a barrier for budget- and space-conscious healthcare facilities. Now, however, feasible 3D printing applications exist that can be implemented across the continuum of care.
I recently had the opportunity to take part in a demonstration of one such application and learned that 3D printing has relevant functions for healthcare, including onsite production of surgical devices, medical device development, and enhanced education for clinicians and patients. Even more fascinating is the impact that 3D printing can have on team-based precision medicine.
Building Confidence, Decreasing Complications in the OR
Surgeons use physical guides or templates in the operating room to serve as a landmark for maneuvers such as cutting and drilling to increase their accuracy and confidence, as well as improve the outcome of the procedure. Generic surgical guides come in nonpatient specific standard sizes and shapes that must be formed and placed once the surgery has begun, which can add a significant amount of precious time in the operating room, even without complications.
A recent literature review, however, found that using patient-specific 3D-printed anatomical models (digital representations of the patients’ anatomy) saved 62 minutes of OR time. The use of patient-specific 3D-printed surgical guides (single-use appliances shaped to fit the patient’s anatomy that position a surgical drill at the right location, angle and even depth) saved 23 minutes. Those time savings do require extra prep time prior to surgery to create the 3D printed materials from radiological imaging — but most surgical facilities would agree that saving time in the OR and decreasing patient complications is well worth the extra prep.
How does this process work? First, the patient’s unique diagnostic radiology images are digitally segmented for 3D printing. The segmentation process is intuitive enough for a clinician to customize the 3D structure to produce a cross-sectional model that will guide the results, and a variety of resins and materials can be used depending on the purpose of the 3D model or guide. Furthermore, the 3D printing system is compact enough to sit on a desktop workspace in a plug-and-play fashion akin to a paper printer, which makes it feasible to perform the process in-house versus sending off images and waiting for a 3D model to be shipped back to the facility.
Once the 3D model is printed, clinicians now have tangible pre-operative planning tools at their disposal to aid in identifying pitfalls and building confidence for complex cases. That confidence can be extended to the OR with a sterile surgical guide or template that works as a mental and physical cue to carry out the plan as expected.
Enhanced planning, efficiency in the OR and anatomical confidence can reduce surgical complications and using 3D printed models in pre-operative planning also can have financial benefits. For example, a 2019 study showed savings of approximately $3,720 per case by using 3D models and surgical guides to reduce time in the OR. For a facility that performs multiple complex surgical cases per week, onsite 3D printed models and guides can provide tangible clinical, operational and financial benefits.
Less Space, Greater Innovation
3D printing also can be used to develop and prototype personalized or specific medical devices that can solve clinical challenges or improve patient outcomes. The notion of prototyping widgets is nothing new for global manufacturers of medical devices, but some medical teams have taken the opportunity to develop devices to serve the purposes of their practice. It’s no surprise that clinicians who perform certain procedures often, or specialize in treating a specific patient condition profile, sometimes innovate a makeshift gadget that enhances their process or outcomes.
An in-house 3D printer can provide the ability to develop and prototype innovative solutions that meet clinicians’ needs or that provide a patient-centric enhancement. In-house printed solutions like custom fitted masks for non-invasive ventilators, ultrasound training devices, personalized nasal stents for post-surgical cleft lip patients and even photo acoustic drill bits to avoid blood vessels are some examples of creative solutions using 3D printing. These innovations can be created with the same desktop systems that are used for anatomic models — a clear value-add proposition to having a 3D printer onsite at a healthcare organization.
Bringing Patients and Providers Together
3D-printed surgical models are powerful educational tools for patients, trainees and providers. Physicians often refer to their occupation as “practicing” medicine, which is an accurate description of their time spent in residency training. Repetition and exposure are key elements to clinical training, and 3D printing can offer a valuable supplement to this process.
A recent study showed that physician trainees who simulated endovascular aneurism repair (EVAR) procedures using a 3D-printed model performed better in surgery than the control group for several metrics and reported higher confidence levels during the procedure. This is a remarkable effect that medical teaching facilities should take note of, and when you consider that the 3D model can also be used for patient education and consent, the benefits multiply. For example, using a 3D model for consent can be particularly helpful for parents of pediatric patients who require a complex or invasive procedure such as spine surgery.
When you consider the surgical, educational and value-add applications of a 3D-printing system from a medical perspective, a common element to these benefits is team-based precision medicine. Healthcare providers understand that when clinical care teams and patients can all work together to create and execute personalized care plans, the results are superior clinical outcomes and increased patient satisfaction. 3D-printed medical models and devices can offer the tangible connection point that is needed for clinicians, patients and family members to huddle as a team. Modern technology should be used to promote and enhance team-based precision medicine, and 3D printing provides a valuable example of how to do so.
About the author
Adam Fairbourn is a senior portfolio executive on the diagnostic imaging team at Vizient. Leveraging his technical and clinical background, Adam manages a portfolio of sourcing agreements in the diagnostic imaging product and services category. He works closely with industry partners and Vizient members to strategically align sourcing contracts that create value in the diagnostic imaging space.