Saving lives with 3D printing: Seattle Children's Hospital is using printed airways to transform surgery

These 3D printed components could also revolutionize medical school training, enabling students to work with realistic printed models rather than cadavers.

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Image: Seattle Children's Hospital

In recent years, 3D printing has transformed into an innovative one-stop-shop of sorts for innumerable applications. This includes printing tools on the International Space Station and bolstering the production of critical medical components during the coronavirus pandemic.

These printing capabilities are also revolutionizing the medical industry offering unique presurgical planning and new training capabilities for medical students.

The 3D printing company Stratasys is working with academic medical centers to train medical students with 3D printed cardiac models rather than using traditional cadaver hearts, said Jessica Coughlin, healthcare marketing and market development leader at the company.

This helps cut costs when it comes to storing cadavers at appropriate temperatures, Coughlin explained, but also allows students to train for specific defects by printing these defects and training on these components.

In essence, 3D printing enables programs to print tissues related to medical conditions in-situ. With cadavers, on the other hand, "you only get what you get," Coughlin said.

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Image: Seattle Children's Hospital

At the point of care, Coughlin said physicians can order 3D printed models from a radiologist as they would a CT scan. Coughlin discussed use cases at Seattle Children's Hospital involving 3D-printed components used to help with babies born with pulmonary defects.

"These are tiny, tiny airways," Coughlin said.

"If you think of the branches that go into your lungs and having a clogged airway and having it be smaller than a shoelace, it's really hard to operate on something that small," Coughlin said.

These 3D models give medical teams physical items to assist with surgical preparation, Coughlin explained, specifically noting the softness of these components and the significance of these printed textures.

"You're able to print that tiny little airway and mimic the squishiness and have a team of physicians sitting around a board table talking about the patient model, [and] each of them having it in their hands, talking about the best approach for treating that child," Coughlin said.

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Image: Seattle Children's Hospital

Dr. Kaalan Johnson, the surgical director of the aerodigestive program at Seattle Children's Hospital discussed a scenario involving a young girl named Nia who was born with bronchial stenosis which caused narrowing in her right lung making it difficult for her to breathe.

The situation became "very dangerous" as she grew because air was able to enter the lung but could not easily escape it. This caused the right side to become so large that it shifted the girl's heart to the left side of her chest, he explained.

In the days leading up to a slide tracheoplasty, teams use virtual surgical planning sessions to talk through the approach and practice the operation together on the 3D models, Johnson said. Although it's important to note that these printed models also provide utility on the day of the surgery.

"When we get to the day of the procedure, we have the surgical planning models with us in the operating room. This allows us to compare, and we have the way the anatomy was to start with, and then we have the surgical model that we rehearsed the procedure on," Johnson said.

These models also at times serve as anatomical references during operations.

"We've also referred back to them during some of the surgeries to compare the actual anatomy we're seeing in real life to what we had seen in the virtual surgical planning. Continually refining our understanding is critical because sometimes the tissues characteristics we encounter are incredibly abnormal and making sense of it can be a bit of an exercise at times," Johnson said.

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Image: Seattle Children's Hospital

Interestingly, these 3D printed models also play an important role for patients and their families as the medical teams explain these complex medical procedures. During medical evaluations and conversations surrounding the risk and benefits of these procedures, it can be difficult for patients and their families to "wrap their heads around" the risk and benefits of these procedures, Johnson explained.

"When you can walk in with a model that shows a life-sized representation of what their child's anatomy looks and feels like, and then show them what you're actually planning to perform surgically with that airway, it really drives the story home," he said.

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Image: Seattle Children's Hospital

Johnson said conversations with 3D printed components allow families to feel "more confident that their surgical team is not just prepared but is prepared specifically for their child's unique anatomy when they go into the procedure."

Even months after Nia's successful operation, Johnson said that Nia's mother, Reem, continued to carry the 3D printed model of her daughter's airway in her purse.

"She's found it valuable anytime someone asks her a question about Nia and what she's been through, to not only explain her surgery to other people, but also to have a clear understanding and reminder herself of what Nia was dealing with and what she went through for the surgery," he said.

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