3D Printing for Surgical Planning

•Dedicated technologist creating and printing 3-D surgical models on site
•Some of the most technologically advanced equipment available
•Rapid imaging interpretations by experts in the radiology field

3D Printing for Surgical Planning

Overview

Three-dimensional (3-D) printing is now being used to help doctors plan patients' surgeries. Individually created 3-D models help surgeons better understand the unique anatomy of a patient before heading into the operating room.

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“Not all anatomy can be easily or even fully understood from a book,” says James Brown, MD, a radiologist who is the co-founder and director of 3-D printing, and an assistant professor of radiology and biomedical imaging at Yale School of Medicine. “When a surgeon is able to have a patient-specific 3-D model to study prior to surgery, it can enhance the understanding of a patient’s anatomy that may change the approach to the surgical procedure.”

At Yale Medicine, we have some of the most technologically advanced equipment available, including 3-D printing technology. Dedicated technologists create these surgical models on site for our surgeons when needed.

How does 3-D printing for surgical planning work?

A virtual surgery model is created on a computer from MRIs or CT scans using 3-D modeling software.

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“The computer doesn’t understand anatomy, so we manually circle and color in anatomy to show, for instance, a pelvic bone with a tumor," says Dr. Brown.

Then, in consultation with the surgeon, the radiologist corrects errors and identifies what the surgeon wants to see. “The final version is agreed on, and we send it for printing,” Dr. Brown advises, “usually at life-size or a bit smaller.” Sending the image to a 3-D printer is just like sending a digital photo or drawing to a standard office printer.

What are some common applications for 3-D printing?

“The uncommon is most common,” Dr. Brown says, explaining that 3-D printing is not often used for routine surgeries. “The printing is especially valuable for understanding anatomical anomalies such as rare congenital abnormalities or other diseases that a surgeon may see once in their lifetime and which may be hard to understand from imaging alone.

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When surgeons can hold something in their hands—in three dimensions—it provides a sense of relative size and depth. Another use for 3-D printing is to provide surgeons a field of view that may not otherwise be available to them.

“A surgeon may be repairing a 12-inch pelvis,” Dr. Brown says. "But by creating a 3-D model and bringing it into the operating room for reference and guidance, it's now possible to get the job done with a single, 3-inch incision.”

Who is a candidate for 3-D printing?

“Anyone requiring complex surgery may be a candidate,” Dr. Brown says. The technique can be especially valuable in reconstructive surgery. “You can use a 3-D model as a surgical cutting guide in reconstructing a jaw in a person who may have had a tumor removed."

Dr. Brown says a CT scan of the jaw gives the surgeon an edge because the model not only helps locate the tumor but also helps the surgeon to find the best angles to cut so that after surgery, the person's facial structure is maintained.

What should a person expect if a 3-D model is suggested?

Yale Medicine believes most people benefit from seeing the anatomy in a 3-D model because it provides a better understanding of the condition. The 3-D model can generally be created from the initial CT scan without the patient needing to go through additional procedures. “It helps patients make more informed decisions about their health care,” says Dr. Brown.

What makes Yale Medicine’s 3-D printing program unique?

In 2013, Yale Medicine’s Department of Radiology & Biomedical Imaging partnered with Yale New Haven Hospital to purchase and house three 3-D printers. “We have a dedicated technologist trained to create quality surgical-planning 3-D printings,” Dr. Brown says. “Most other places have the software, but not the printer itself, so they have to send jobs off-site for printing.”

By printing our own models, Yale Medicine keeps the cost lower, which can make a difference to patients when 3-D printing is not covered by insurance. Most of all, “The insight a 3-D model can give to our surgeons is invaluable.”