Advanced medical training requires particular tools for specialized procedures. Sometimes this training carries risks to the patients and doctors alike. At the University of Minnesota Medical School, the urology department is taking advantage of 3D printing to create models of both the surgical field and the specialized tools required to learn advanced techniques.
Urologists perform a number of procedures on kidneys that require access through the skin (percutaneously). Most often, the physician finds the correct spot using a “C-Arm,” a real-time fluoroscopic guidance machine that involves placing a long needle through the abdominal wall into the kidney. The traditional training model exposes patients to prolonged X-rays and potential injuries, as well as exposing the trainee to X-rays. Mastering this procedure takes many trials, as the surgeon has to safely direct the needle to its target based on a two-dimensional, gray-scale image.
Researchers at CREST, the Center for Research in Simulations and Education Technologies at University of Minnesota Medical School, are using Stratasys 3D Printers to design an alternative solution. CREST is producing realistic, anatomic models from PolyJet and FDM 3D printing materials based on actual patient imaging studies. Additionally, modelers are using the Fortus 3D Production System and the Objet Connex multi-material 3D Printer to 3D print fixtures and molds, so the center is now building devices that mimic fixed X-ray image intensifiers.
Fixed X-ray image intensifiers turn X-rays into visible light images, allowing doctors to perform “keyhole” surgeries, during which they view their movements on a TV monitor. However, these machines are very expensive for practicing purposes and often students are sent to practice the procedure on an actual patient.
By designing a table and C-Arm in Solidworks and 3D printing them on a Fortus 3D Production System, CREST is able to mimic the effects of the fixed X-ray image intensifier at a fraction of the cost. An HD camera is used to capture an image through a clear kidney model and display it on a computer monitor, just as a surgeon would project an X-ray image of an actual kidney. The real-time view of the simulated X-ray image is shown.
The clear mold was made using PolyJet 3D printing technology and a technique called RTV silicone molding. This allows the team to produce inexpensive practice models and gives trainees the opportunity for repeated, deliberate practice until they reach proficiency.
With a customized table and anatomic models, physicians in training have opportunities that were not available only a few years ago. Having the freedom to design custom parts, CREST can quickly meet the changing demands of the medical industry. Thanks to FDM and PolyJet 3D printing technologies, CREST is solving a long-standing problem in advanced medical education while improving the lives of patients and their health care providers.