At one point in time, 3D printing in healthcare was a dream, a wave of the future that seemed very far off. However, times have quickly changed, and 3D printing and scanning is now having a big impact on the way we approach and deliver surgeries.
Some of the biggest impacts that the use of 3D techniques is having in healthcare is on proficiency, efficiency, and cost. Which is why our centre for 3D Surgical Planning and Innovation (3dSPIN) is playing a big role in the way we approach complex surgery at the Northern Care Alliance.
The fallout from the pandemic and the current pressures we are experiencing in the NHS are still having a significant impact on surgical wait times. Currently it isn’t realistic to rapidly increase the number of theatres we have or hire and train lots of new surgeons, so this is where the 3dSPIN Centre can help. 3D technology can help us to develop new devices and techniques that allow us to use theatre time more efficiently, saving time and producing better outcomes.
The team in charge of the 3dSPIN Centre is the Clinical Engineering and Physics Unit, based at our Salford Royal site, within the NCA Medical Devices Service.
The team play a big role in research and development (R&D) including the development of medical devices for clinical service - where there are clinical needs not met by commercially available devices, in designing clinical research devices – instruments to enable research projects, and supporting clinicians interested in developing or adapting instruments.
While the team itself is made up of clinical scientists who carry on their own research and publish their work, their main aim is to enable research and service development within NCA through the design, development, and use of medical devices to meet the needs of patients and surgical teams.
Since 2019 the 3dSPIN centre has carried out more than 80 surgical projects using 3D models and tools in the fields of ear, nose and throat (ENT), anaesthetics and orthopaedics. Examples of tools and models created include custom supports for patients undergoing complex spinal surgery, anatomical planning models for challenging procedures, 3D airway workups and virtual endoscopies, and patient specific surgical instruments and guides for orthopaedic surgery.
One key piece of work for the 3dSPIN centre in Salford has been the collaboration between the Ear, Nose and Throat (ENT), Anaesthesia and Medical Physics departments called the Airway Innovation Group. The group was created to research and develop innovative solutions to treating patients who are diagnosed with having complex airways - airways that are difficult to get oxygen through using tracheal intubation and face mask ventilation required during surgery.
The group was set up by ENT surgeons and anaesthetists, specifically Mr Chai Gadepalli and doctors Glyn Smurthwaite, John Large and Govind Tol. Their aim is to utilise medical imaging techniques and 3D printing methods to make procedures on patients with complex airways safer.
One very innovative tool that has been created by the group is virtual endoscopies. For patients with complex airways, it is difficult to receive traditional endoscopies - an investigative procedure where a small camera inside a thin tube, called an endoscope is inserted into a patient’s airway. The team therefore developed virtual endoscopies, video flythroughs of the patient’s airway produced directly from CT images which provide the ENT team with a simulated endoscopy, avoiding the need for trial procedures.
Chaitanya Gadepalli has found this work to be very beneficial to his ENT patients,
“We have a sector of patients whose airways are so complex we are unable to assess them under anaesthetic.
Over the last five years we have been working closely with the Medical Physics team to come up with a method of assessing complex airways by building models of the airways that we can use in surgical planning, anaesthetics, and prognosis. This work has improved patient safety and outcomes, and we hope to share these techniques not only across the NCA but also across the UK.”
These methods are now well established in Salford and are moving into routine use, with a pilot service called the Difficult Airway Passport. Clinicians can use an on-line form to order the components of the passport they need: virtual models, prints, virtual endoscopies, and the newest addition - simulation models, more complex 3D printed models designed to allow clinicians to simulate and practice procedures.
The team has also been assisting in complex airway assessments, airway simulation and airway planning for a group of people diagnosed with a rare disease called Mucopolysaccharidosis who need cardiac surgery at the Liverpool Heart and Chest Hospital. Without this technology, the surgery would otherwise be impossible.
Dr Stuart Watson, Head of Clinical Engineering in the Medical Devices Service said,
“We believe we are the only centre in the UK, and one of a very few internationally, to offer this range of modern 3D planning techniques for airway management and the work we have done has produced a workflow which is practical, efficient, and cost-effective.
Our clinical scientists and engineers have a range of skills in software, data science, electronics, physical modelling, and design, and we’re happy to support clinicians working across all fields in the NCA.
We’re looking to roll out and make these methods available across the NCA to also support other specialties such as neuro and neurospinal surgery.”