3D printing makes difficult procedure easier to carry out in children

An exact replica model of a trachea, created using a 3D printer, has been used to trial a complex procedure with incredible accuracy prior to a child going under anaesthetic at GOSH.The model allows for equipment that is best matched to individual patients in both size and shape to be selected prior to surgery, reducing the time spent on the operating table.

3D printing has already shown potential in creating models that can help doctors to explain to patients in a visual way what is happening inside them and how surgical procedures can treat medical problems. A team of clinicians and researchers at GOSH now show that it could also make complex surgical procedures even safer for children.

Following successful use in a number of cardiac conditions, the team demonstrated that a simple CT scan of a patient’s chest can be used to create anatomically accurate 3D tracheal models that allow procedures to be trialled by surgeons and anaesthetists before operating on the patient. The models are completely personalised to patients and can be created in a matter of just hours.

The technique was trialled in a 6-year-old patient with a lung condition that requires repeat ‘lung-washing’ treatments in order to clear dangerous build-ups of material in these organs. During the procedure one lung is ventilated while the other lung is washed out and although this process is relatively straightforward to perform in adults, the tubes used to ventilate and wash out the lungs are large and sometimes difficult to use in children. Multiple tubes therefore have to be positioned with great precision as quickly as possible in order for it to be safe in children who have little normal lung capacity with which to breathe.

After CT scanning the patient, the team 3D printed a ‘made-to-measure’ tube that was an exact replica of the patient’s trachea in terms of shape and size. This allowed the anaesthetic team to match up the most appropriately sized tubes and practice their insertion in to the airways prior to surgery. This made the actual surgical procedure quicker and more efficient.

Colin Wallis, respiratory consultant physician at GOSH and co-author, says “Each time a child comes in to have their procedure they will have grown and so require different equipment to be used for their treatment. A model that is tailor-made to the child each time they have treatment means that the right sized tubes can be identified prior to surgery and a child can potentially be under anaesthetic for a shorter period of time.”

Mike Sury, GOSH consultant anaesthetist who collaborated on the project, says, “When I heard about Dr Wallis’ patient I realised that a 3D model could be really helpful to plan the anaesthetic safely”.

Owen Arthurs, GOSH consultant radiologist and study organiser, who scans patients to gain exact sizes for the model, explains: “This work demonstrates that it is possible to create precise anatomical models of complex organs cheaply and in a very short space of time from standard CT scans and a 3D printer. In the future, 3D printing could feasibly be adapted to scan and create many more organs in the body making a larger number of surgical procedures safer, quickly and easier.

The team are now looking to create a bank of different sized tracheal models and other organs so that we can allow doctors at GOSH to practice these tricky procedures with different size equipment early on in their training.