The application of 3D printing in the medical field is becoming more widespread, with numerous applications helping surgeons with accurate and detailed plastic surgery planning.
Now, the potential of 3D printing is to help hospitals treat patients fighting for their lives.
ETZ (Elisabeth-TweeSteden Ziekenhuis) is one of 11 trauma centers in the Netherlands.
As the only center in the country with trauma surgeons available 24/7, it is also the primary facility for emergency patients in North Brabant province. 3D printing is used
for visualizing fractures, but pioneering researchers believe it can also be used to help treat trauma patients.
Dr. Mike Bemelman, a trauma surgeon at ETZ, recognized the potential of 3D printing as early as 2016. Together with Dr. Lars Brouwers and trauma surgeon
Dr. Koen Lansink, they began researching the advantages and effectiveness of 3D printing compared to traditional and other new technologies.
Their idea was to 3D print scanned fractures to give surgeons and patients a clear understanding of each case before surgery.
Before 3D Printing
To prepare for surgery, surgeons analyze the patient's CT scan results. Even for experienced surgeons, getting an exact idea of each situation
is challenging. CT scans are converted into 3D reconstructions, allowing surgeons to physically examine them on a computer screen. While this improves the understanding of various situations,
it has limitations: surgeons sometimes find it difficult to orient the model, and viewing 3D reconstructions on a 2D screen also lacks a true sense of depth.
Creating a patient's CT scan
3D Printing Fractured Bones
Lars started using Ultimaker to print fractured bone structures, allowing surgeons not only to analyze fractures by observation but also to touch and rotate them,
which brings significant added value to the surgical planning process. Using water-soluble PVA support material allows complex organic geometries to accurately reproduce small cavities
and include important details.
The Process of Adopting 3D Printing
One challenge in adopting 3D printing was finding a simple and effective method to convert DICOM files (the specialized file format for CT scans) into 3D printable STL
files. Using Philips IntelliSpace Portal, Lars was able to directly export the scanned 3D models, which could then be prepared in Ultimaker Cura and sent to
Ultimaker 3.
3D printing a fractured bone model from CT scan data.
Benefits for Patients
Once the patient is in a stable condition, a CT scan is performed for the doctor to make a diagnosis. The CT scan information is immediately available to Lars in the 3D printing studio,
where he can begin printing the patient's fractured bone structure. The 3D print will be ready within a day, and the surgeon will use it to plan the surgery and
explain the procedure to the patient.
"Our goal was to investigate whether 3D printing could have added value in classifying acetabular fractures. The most important conclusion of our study is that 3D printing has added value."
Lars' Research Results
When a patient has a fracture, doctors will analyze X-rays or 2D CT scans and determine the appropriate treatment plan. The better the understanding of the situation, the more accurately the correct
procedure can be confirmed. Surgeons will use an agreed-upon scoring system (commonly known as the kappa score) to reach a solution. On average, surgeons with little experience using traditional 2D CT images
score around 0.2 on the Kappa scale. Surgeons with many years of experience score around 0.4 on the Kappa scale. Lars studied the agreement scores when surgeons used other technologies such as 3D CT, 3D printing, and VR visualization.
When using 3D printed models, both novice and experienced surgeons scored between 0.6 and 0.7, which was the highest score among all methods.
Kappa scores are used to measure agreement between surgeons.
The increased kappa score indicates the added value of 3D printing to the decision-making process.
By conducting this research, Lars hopes to demonstrate that 3D printing can provide high added value for patient satisfaction, surgical satisfaction, operating time, and health-related quality of life.
Disclaimer: Ultimaker 3D printers are designed and manufactured for fused deposition modeling with Ultimaker engineering thermoplastics in a commercial environment.
The combination of precision and speed makes Ultimaker 3D printers the perfect machine for concept models, functional prototypes, and small-batch production. While we achieve very high levels of 3D model reproduction using
Ultimaker Cura, it remains the user's responsibility to evaluate the application of printed objects and validate their use, especially for medical devices and aerospace applications.
Original link: https://ultimaker.com/en/stories/52516-research-on-the-benefits-of-3d-printing-in-a-trauma-hospital