I’m a surgical resident in training and PhD-candidate in the Elisabeth-Tweesteden hospital, Tilburg, the Netherlands. The Elisabeth-Tweesteden Hospital, a level 1 trauma center with a large neurosurgical department aims to care for 75% of all major trauma patients from North Brabant, the second largest province in the Netherlands (2014 population of 2,482,000). Currently, 2,300 trauma patients are admitted to the Elisabeth-Tweesteden hospital annually. One-fifth of this population is severely injured.
I investigate the health-related quality of life after a pelvic or acetabular fracture in 10 hospitals in the North Brabant province. However, more important for the readers of PW, I also investigate the added value of 3D printing in acetabular fractures, which I discussed in my PW feature article “Implementing In-Hospital 3D Printing.” Traumasurgeon Mike Bemelman and I set up our own low-budget 3D lab to provide all students, residents, and surgeons with anatomical models for better understanding complex fractures and surgical preparations.
In my opinion, 3D printing can be divided into 3 parts: anatomical models, surgical guides, and patient-specific surgery. Building anatomical models can be done easily by medical doctors. However, preparing patient-specific surgical guides is much more difficult. Some surgeons and hospitals choose to outsource this to commercial companies; however, this costs several hundred dollars and is definitely not cost efficient. Therefore, we cooperate with the medical 3D lab of the Radboud University Medical Center (Radboudumc). Thomas Maal, PhD, is coordinator of this lab. The Radboudumc 3D Lab originated from the department of Oral and Maxillofacial Surgery in 2006. It has developed and has since grown into a key element for patient care in the Radboudumc. The main question in the Radboudumc 3D lab is how we can improve individual patient care with use of 3D-technology. With solutions like patient-specific virtual surgery planning and 3D-printed anatomical models, an optimal personalized treatment plan can be created.
A few weeks ago, malunion of a distal radius was seen in our trauma department. Frank van der Heijden, PhD, consultant for trauma surgery, decided a correction osteotomy was needed. We prepared this operation using 3D printing technology. Both wrists were scanned, 3D reconstructions were made, and the healthy side was mirrored. We then anonymously sent the files to the Radboud 3D lab and–during a videoconference with medical technician Arico Verhulst–decided where the osteotomy had to be performed, and finally created surgical guides. We printed the wrist and surgical guides with our Ultimaker 3 (production costs 5 euro) to practice the operation. The surgical guides were also sent to a commercial company using SLS technique (classified for medical use). This material can be sterilized and therefore used during surgery. This cost 30 euro. The operation went well, and the patient can now use her wrist pain-free.
This is just an example of our cooperation. In fact, Thomas and I are convinced that non-academic hospitals should cooperate more often with academic hospitals to create a low-budget workflow and to create a learning momentum in both hospitals.
Look for my next medical 3D printing-focused blog in the coming weeks!