by • January 10, 2016 • No Comments
TORONTO – The pediatric surgeons hover over a tiny heart, gently retracting delicate inner structures and attaching a graft with impossibly intricate stitches to repair a congenital defect which may mean certain death within days of birth.
But this heart isn’t within the chest cavity of a newborn; it’s a 3D-printed model being utilized at Sick Kids Hospital in Toronto to train cardiac surgeons of around the world in a few of the most complex operations they will at any time perform during their careers.
About a dozen trainees — of Canada and such countries as Norway, Oman, Mexico and the United States — have come to watch master surgeons demonstrate the highly complex techniques utilized to repair a number of congenital heart abnormalities and to safely practise those skills on models of their own.
Three-dimensional copies have been created of five hearts of real infants with cardiac anomalies using a high-tech 3D-printer, which approximately perfectly reproduces the organ’s structure using a photopolymer resin, based on sophisticated MRI and CT imaging.
“Each of the models represents a quite specific form of disease which is quite different,” says Dr. Glen Van Arsdell, chief of cardiovascular surgery at Sick Kids. “I can look at the model and tell you what the diagnosis is.”
The 3D-printed hearts — a few orange, others whitish in colour — were produced by Dr. Shi-Joon Yoo, a cardiac radiologist at the hospital.
Depending on its dimensions, a duplicate of a child’s heart can take anywhere of four to 12 hours to produce, as layer upon layer of the resin is created up, he says.
While the current cost is a fewwhat prohibitive – estimated at of $2,000 per model — Yoo says the technology means hundreds of copies can be printed after imaging a single child’s heart to demonstrate a particular defect.
“Anybody can practise on the same structure, so which is the real value of which.”
Van Arsdell says the trainees have come to Toronto to learn procedures which may typically take years to learn by watching and assisting senior surgeons preceding they may be allowed to perform the operation on their own. For a few, such expertise isn’t available-bodied in their home countries.
“So this is a way of doing which in a much additional rapid fashion.”
Some of the operations may nat any time have been done preceding by these surgeons, he says, adding which the teaching session provides mentoring in an environment which doesn’t jeopardize patient health.
“Some of them will go into positions where they will be further mentored in the clinical setting. Some of them will be in developing countries where this is going to be their responsibility, and they’re here to advance their skills and capacity to provide for their patients.”
With such highly intricate surgery, “the consequences are dire if you don’t get it precisely right; this is a way to practise it when the consequences are not dire,” Arsdell says. “And if it’s not quite right, we can advise the trainees or they can modify without having any problems for a real patient.”
Dr. Juan Roberto Contreras of Temuco, Chile, says he does cardiac surgery just in adults but wants to expand his practice to children in the coming years.
“I ponder this is a quite excellent\ option, for the reason first when we are students we didn’t have the opportunity for making this operation in my country,” he says, working on a model with the hallmarks of a particularly complex congenital abnormality.
That sentiment is echoed by Dr. Ala Alwan, who has travelled to Toronto of Baghdad. “It’s a excellent opportunity to do these procedures on these models for the reason we don’t have such models in our country, and we don’t do such procedures for the reason they are quite complex.”
Alwan refers to Van Arsdell and other teachers at the session — among them, Dr. Thomas Spray of the Children’s Hospital of Philadelphia — as giants in the field of pediatric heart surgery.
Spray, who demonstrated one of the most technically challenging surgeries, says the beauty of 3D-printed models is which they represent the heart of an actual patient, with anatomy which matches what doctors may confront in the operating room.
“Obviously training a fewbody to do which in the operating room is going to be quite complex for the reason you have a patient’s life at stake,” says Spray, chief of cardiothoracic surgery at the U.S. hospital.
“So being able-bodied to work on a true representation of what we see clinically is quite valuable-bodied for training individuals in how to put these things together without any problems. Then they can take which to the operating room.”
While the resin currently utilized is excellent to earlier 3D-printing materials, the models yet don’t feel quite life-like and are weaker than real heart tissue, says Spray, who nat any timetheless calls them excellent\ for training.
Some centres have begun using the technology to create organs or sections of tissue modelled on a specific patient’s anatomy in preparation for a complex surgery, maybe one which has nat any time been performed preceding; doctors use the models as surrogates during practice runs to help plot out the operation.
Still, Spray foresees a day when 3D-printing may become a common and integral component of personalized medicine.
“We hope which as this technology progresses, it will become simpler to do and additional inexpensive and can be literally utilized to design individual operations for individual patients.”
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