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vlad

Wash U. Medical Center invests in print lab for surgical planning

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In house print lab has multiple different machines, including professional tier polyjet printer for medical grade resin to make craniofacial models as "surgical molds" (aka surgical templates) for sterilized use in the O.R.:

 

http://video.stltoday.com/Video-3D-Printer-helps-Washington-University-surgeons-30210082?vcid=30210082&freewheel=91130&sitesection=stltoday

 

http://www.stltoday.com/lifestyles/health-med-fit/health/d-printing-comes-to-the-hospital/article_bd0ac87b-2f02-5d37-ae75-c761e10f7e45.html

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This is actually very amazing, and it is really doable with some practice and mastery of the softwares.

We have printed numerous models, from crania-maxillofacials to vascular malformations, and also some interesting craniosynostosis cases. It is getting pretty common in the hospital. 

IMG 6606

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This is actually very amazing, and it is really doable with some practice and mastery of the softwares.

We have printed numerous models, from crania-maxillofacials to vascular malformations, and also some interesting craniosynostosis cases. It is getting pretty common in the hospital. 

What software do you use for 3D printing? Is the skull image you posted something you printed? Can you share some details about the print?

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What software do you use for 3D printing? Is the skull image you posted something you printed? Can you share some details about the print?

 

Hey!

 

I have used many, like Materialise, 3D Slicer and so on. You have to use an array of softwares.

And yes! this is one of the many models I have printed. I use a RepRap printer with PLA (1.75 mm), with 0.2 mm layers. This kind of models like the above picture takes about one whole day to print and sometimes you have to start over due to technical errors.

 

Have you printed any models? And what kind of use do you expect from it?

 

Cheers

Amir

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Hi Amir,

 

Yes we print many different medical 3D models including vascular models, bone models and organ models. For the most part we use the open source software 3D Slicer, Blender, and Meshmixer when on a PC computer. If we are using a Mac we use the same basic workflow but use Osirix instead of 3D Slicer. We have found Formlabs printers to be a good fit for our needs.

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Hi Amir,

 

Yes we print many different medical 3D models including vascular models, bone models and organ models. For the most part we use the open source software 3D Slicer, Blender, and Meshmixer when on a PC computer. If we are using a Mac we use the same basic workflow but use Osirix instead of 3D Slicer. We have found Formlabs printers to be a fit for our needs.

 

 

I hear Formlabs offers great printers. The printer I use is a RepRap (prusa) and it works great, although I had to calibrate it and try a lot of different configurations first. But I owe a lot to this machine because I learned everything from this process.

Please share some images of the models you make with us, if you like.

I have worked with 3D Slicer on PC and Mac, but I have a Mac myself so, most of the time I do the segmentation with 3D slicer on my Mac, which is great, and I go straight to Meshmixer for further editing and things like separating the mandible from the cranium.

I recently worked with OsiriX which is a cool software, but somehow I like the mesh 3D Slicer produces more. Do not under estimate the power of this wonderful free app. It does the job pretty good with reasonable results.

 

 

Amir, that skull is amazing! Fine work!

 

 

Hi Dr. Mike!

 

Thank you very much  :D

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These models are pretty nice! What material do you use? Are they flexible or rigid? We have some experience in vascular models also. Among them are some rigid study models like stenosis cases, and also Aorta models used for angiography training.

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Here is another good case worth sharing:

 

The patient is suffering from a mass in mandible, which is extended into the ramus and mandibular condyle. The mass has perforated the bone and in CT data, air is seen in the ramus. The left mandible is the pathologic and study model. The right one, is made with a technique called "Mirroring".

 

IMG 7086

 

This is a pretty useful technique to produce a rather normal anatomy, so the surgeon will pre-bend the surgical plate on the mirrored model, so after they have resected half of the mandible, they don't have to do the time-consuming plate bending while on the operating table. Our colleagues have reported that this method reduces the time of the surgery up to 2 hours!

 

Please let me know what you think.

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Time savings in the OR is one of the most tangible benefits of 3D printing. Even though in the US it currently isn't reimbursed, OR costs can be very high and saving time can be a reason in itself to implement 3D printing in a hospital. The Mayo Clinic folks have told me that they charge $220 PER MINUTE of OR time. By that calculation, your 3D print saved $26,400 in OR costs.

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Hi Amir,

 

Would you please mind posting your pediatric craniosynostosis case to the marketplace as a downloadable file (or for sale)? My company is collecting some pedi craniofacial cases for an anatomy project at a medical school in our area. Thank you for considering it, and please let me know if it's not possible.

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Amir,

Thanks for sharing. This is a really interesting case and others will find the technique useful.

 

 

No problem at all!

 

 

Time savings in the OR is one of the most tangible benefits of 3D printing. Even though in the US it currently isn't reimbursed, OR costs can be very high and saving time can be a reason in itself to implement 3D printing in a hospital. The Mayo Clinic folks have told me that they charge $220 PER MINUTE of OR time. By that calculation, your 3D print saved $26,400 in OR costs.

 

 

A very great point. And wow, I didn't know Mayo Clinic is that expensive!

In addition to cost, the outcome of the surgery is improved very much. In the OR, there is always other tissues and edema, and when a surgeon is bending the plate in the OR, the result is often not very predictable because of that. This way they can shape a more symmetrical plate, which leads to a more symmetrical appearance. Also, patient is under less anesthesia time.

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Hi Amir,

 

Would you please mind posting your pediatric craniosynostosis case to the marketplace as a downloadable file (or for sale)? My company is collecting some pedi craniofacial cases for an anatomy project at a medical school in our area. Thank you for considering it, and please let me know if it's not possible.

 

Hi Vlad,

 

I would love to, but as this patient is not mine, I'm afraid I don't have the permission to share any files but images right now. Do you want me to inform you if I could get my hands on any other craniosynostosis patient's files? 

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Hi Vlad,

 

I would love to, but as this patient is not mine, I'm afraid I don't have the permission to share any files but images right now. Do you want me to inform you if I could get my hands on any other craniosynostosis patient's files? 

Yes, please. The rendered 3D model (.stl file) should be anonymous, meaning free of any personal identifying information or any headers or metatags from the DICOM data and therefore HIPAA exempt. I agree it is still a good idea and professional courtesy to request permission from the clinician who obtained and supplied the DICOM data to you.

 

If you can upload these anonymous craniofacial .stl files to the marketplace then other members of the community (like myself) can use them for educational projects. Also supplying clinical diagnosis would be very helpful. Thanks!

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I guess you're right. 

I have found another case of craniosynostosis, but I can't upload the files in the marketplace. When I hit the ATTACH button, nothing happens. Do you know what could be done?

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Dear Amir,

 

Thank you for letting me know about your problem with uploading. To encourage sharing among members of the community, we want uploading to be as easy as possible. I have written a blog article explaining the process to help you out. There are probably many others with the same questions, so hopefully they will find this helpful as well. Please let me know if you have any other questions, and thanks for sharing! 

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Hello everyone

 

We have been working on another interesting case recently, and I thought I would share it with you.

The patient had been diagnosed with odontogenic myxoma, and had undergone hemimaxillectomy. Due to loss of literally half the face, the patient is seeking a solution to help bring back his facial profile. We designed a prosthesis, using mirroring techniques, and the result turned out to be like this. The next step is to determine how to make the actual prosthesis. 

hemimaxillectomy

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Great work Amir!!! This looks fantastic!!!

 

I have been working on similar project with mandibula, more like demonstration model for custom 3d printed grafts in reconstructive maxillofacial surgery.

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