SSM Health Cardinal Glennon Children’s Hospital, a non-profit 195-bed inpatient and outpatient pediatric medical center in St. Louis, Missouri, is partnering with Stratasys to create a new Center of Excellence (COE) with the goal of helping physicians and researchers advance the use of 3D printing for a wide range of medical applications.
Cardinal Glennon also serves as a teaching hospital affiliated with the neighboring Saint Louis University Schools of Medicine and Nursing, and nine other education institutes. On site is a Stratasys J750 used to both prototype new kinds of medical devices and make patient-specific models, as well as enriching clinical education and training. The COE will also serve as a resource for hospitals, clinics, labs and research facilities that are considering adding or accelerating the use of 3D printing technology.
As the COE opens it doors, we were able to sit down with Brian Albers, Dr. Alexander Lin and Dr. Wilson King from SMM Cardinal Glennon for a two-part blog series to discuss their experience with 3D printing and the impacts it has had on patients they serve.
How has pre-surgical planning with 3D models influenced or changed your original planned procedure?
3D printed models have been extremely helpful in congenital heart disease. Being able to hold a physical model provides a tremendous amount of information beyond standard imaging. It has given us the confidence to take cases previously thought to be inoperable, and has helped us achieve better results in complex patients through improved presurgical planning.
For cardiac catheterization, it has shortened procedures significantly by helping the interventional cardiologists understand complex intracardiac and extracardiac anatomy. It has decreased the number of catheters used in electrophysiology cases.
For neurosurgical cases, it has been extremely valuable approaching complex spinal surgery and tumor resection.
For Plastic Surgery reconstruction, babies and children have limited amounts of bone graft available (compared to adults who have thick skulls). We are currently working on a way to “heat map” the skull and face, to show different thicknesses visually, to preoperatively plan which regions have bone graft to spare, and may even be able to guide intraoperative quick decision-making if we can convert these colors into sterilizable intraoperative guides. In addition, other virtual surgical planning we have done have changed whether certain areas have acceptable risk or not for reconstruction, which also greatly affects the surgical plan and benefits patient safety.
Tell us about how it has effected your experience in the operating room?
It provides increased confidence in the operating room, and results in a faster operation in congenital heart surgery, neurosurgery, and plastic surgery. For example, a recent Plastic Surgery reconstruction of a skull defect had a 3D-printed intraoperative guide that matched the skull defect precisely, and without hesitation we could use this on another part of the skull to cut a partial thickness piece confidently knowing that it would fit the skull defect precisely! Otherwise in the past we may have gotten a full-thickness skull graft (which is higher risk to brain and blood loss) and make it too large to accommodate the estimation. For catheterization laboratory it has significantly decreased the amount of fluoroscopy time for interventional procedures.
What effect has it had on patient outcomes ?
3D printing has helped achieve better operative results in patients recovering from pediatric cardiac surgery resulting in decreased length of ICU stay and decreased time on the ventilator. In Plastic Surgery, children with skull defects are our most common application of 3D-printed sterilized intraoperative guides. This results in faster surgery, which means less blood loss, which means a shorter ICU stay.
How has pre-surgical planning with 3D models affected your practice?
Congenital heart disease can be very scary for patients and families. 3D printed models has helped families understand their child’s heart disease, and how their child’s condition will be treated which improves communication, informed consent, and patient satisfaction. Families are excited that Cardinal Glennon Hospital and Saint Louis University is using the best technology available to deliver exceptional care to our patients.
In Plastic Surgery, we have combined 3D-printing with 3D-camera for preoperative planning, and in some cases virtually doing the surgery into final splint positions that are then taken into the operating room to guide the reconstruction into the final predicted positions. Virtual surgical planning allows us to “try” different surgeries to see which ones work best with the patient’s anatomy. Families are also very pleased to know we are using the most advanced technology available, to allow us unprecedented precision in surgical reconstruction.
To learn more about how SMM Cardinal Glennon has engaged the community with 3D printing, check out these suggested articles.