Three‐dimensional printing in medicine

Coles‐Black, Jasamine; Chao, Ian; Chuen, Jason

doi:10.5694/mja16.01073

Cited by 20 publications

(19 citation statements)

References 14 publications

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“…Three-dimensional (3D) printing has emerged as an invaluable tool to produce anatomic models with high delity. The special and anatomic complexity that can be replicated with this technology has enabled the reproduction of patient-speci c replicas with high delity and has been widely used in medical education and training [4][5][6][7][8]. Studies [9][10][11] have shown the value of this technique in training and practices of healthcare providers of congenital heart disease, but its role in physician-patient communication remains to be de ned.…”

Section: Introductionmentioning

confidence: 99%

A three-dimensional printed model in preoperative consent for ventricular septal defect repair

Deng

Huang

et al. 2020

Preprint

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Background: The 3D printing technology in congenital cardiac surgery has been widely utilized to improve patients’ understanding of their disease. However, there has been no randomized controlled study on its usefulness in surgical consent for congenital heart disease repair.Methods: A randomized controlled study was performed during consent process in which guardians of candidates for ventricular septal defect repair were given detailed explanation of the anatomy, indication for surgery and potential complication and risks using 3D print ventricular septal defect model (n = 20) versus a conventional 2D diagram (n = 20). A questionnaire was finished by each guardian of the patients. Data collected from questionnaires as well as medical records were statistically analyzed.Results: Statistically significant improvements in ratings of understanding of ventricular septal defect anatomy (p = 0.02), and of the course of procedure and potential complications (p = 0.02) were noted in the group that used the 3D model, though there was no difference in overall ratings of the consent process (p = 0.09). There was no difference in questionnaire score between subjects with different education level. The clinical outcomes, as represented by the duration of intensive care unit stay, intubation duration was comparable between the two groups.Conclusions: The results indicated that it was an effective tool which may be used to consent for congenital heart surgery. Different education levels do not affect guardians’ understanding in consent. The impact of 3D printing used in this scenario on long term outcomes remains to be defined.

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Section: Introductionmentioning

confidence: 99%

A three-dimensional printed model in preoperative consent for ventricular septal defect repair

Deng

Huang

et al. 2020

Preprint

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“…Fused deposition modelling (FDM) printing is the most commonly used and lowest cost approach since the expiry of patents. In describing the low cost of 3D printing, many medical research papers quote a price of USD 300 for a 3D printer (2)(3)(4). However, many clinicians may be unaware of the quality of print that can be achieved with such a low cost 3D printing method when compared to conventional manufacturing.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional printing versus conventional machining in the creation of a meatal urethral dilator: a cost and mechanical strength analysis

Chen

Skewes

Daley

et al. 2020

Preprint

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Background Three-dimensional (3D) printing is a promising technology in medicine. Low-cost 3D printing options are accessible but the limitations are often poorly understood. We aim to compare fused deposition modelling (FDM), the most common and low cost 3D printing technique, with selective laser sintering (SLS) and conventional machining techniques in manufacturing meatal urethral dilators which were recently removed from the Australian market.Methods A meatal urethral dilator was designed using computer-aided design (CAD). The dilator was 3D printed vertically orientated on a low cost FDM 3D printer in polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS). It was also 3D printed horizontally orientated in ABS on a high-end FDM 3D printer with soluble support material, as well as on a SLS 3D printer in medical nylon. The dilator was also machined in medical stainless steel using a lathe. All dilators were tested mechanically in a custom rig by hanging calibrated weights from the handle until the dilator snapped.Results The horizontally printed ABS dilator experienced failure at a greater load than the vertically printed PLA and ABS dilators respectively (503g vs 283g vs 163g, p < 0.001). The SLS nylon dilator did not fail but began to bend and deformed at around 5,000g of pressure. The steel dilator did not bend even at 10,000g of pressure. The cost per dilator is highest for the steel dilator if assuming a low quantity of five at 98 USD, but this decreases to 30 USD for a quantity of 1000. In contrast, the cost for the SLS dilator is 33 USD for a quantity of five but relatively unchanged at 27 for a quantity of 1000.Conclusions SLS and conventional machining created clinically functional meatal dilators but low-cost FDM printing could not. We suggest that at the current time 3D printing is not a replacement for conventional manufacturing techniques which are still the most reliable way to produce large quantities of parts with a simple geometry such as the meatal dilator. 3D printing is best used for patient-specific parts, prototyping or manufacturing complex parts that have additional functionality that cannot be achieved with conventional machining methods.

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“…Various modes of 3D printing technology have seen use in the surgical field. Printing technologies such as fused deposition modelling, stereolithography and selective laser sintering are well described 3 with the chosen technology based on considerations such as: cost of the printer, cost of printing material, printing time, print resolution and the option of sterilization for inclusion into the surgical field. 2 Current preoperative planning in orthopaedic surgery relies on the use of plain radiographs or computed tomography (CT) images to convey topographic information of the pathology to the surgeon.…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional printing in orthopaedic preoperative planning improves intraoperative metrics: a systematic review

Jiang

Chen

Coles‐Black

et al. 2019

ANZ Journal of Surgery

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Background Three‐dimensional (3D) printing has seen increasing interest in surgery, where it improves the visualization of difficult anatomy in complex cases. This literature review investigates the benefits and limitations of 3D printed models in preoperative planning in the field of orthopaedic surgery. Methods A literature search was performed using the Ovid platform on the Embase and MEDLINE databases using the terms ‘3D printing’, ‘Orthopaedics’ and ‘Surgical Planning’. Studies using 3D printed models as a part of preoperative planning were included. All others were excluded. Data regarding the metrics used to assess the benefit of the use of 3D models, surgical outcome, and surgeon or patient opinion on the technology were extracted. Results A total of 41 studies resulted. Eight (19.5%) were case–control studies, the remainder were case reports or case series. Assessment of benefit was mostly subjective, although the case–control studies included objective metrics such as operation time, intraoperative blood loss and intraoperative fluoroscopy time. The use of 3D printing technology showed subjective benefit for both patient and surgeon as well as indicating clinically significant improvements in intraoperative metrics. Conclusion Despite the current absence of large scale trials, 3D printing has clear benefits in preoperative planning, particularly when utilized in complex cases. A streamlined workflow for case selection, in‐house model creation and preoperative rehearsals is still required to be developed before the process is ready for routine use. Evidence supports an improvement in intraoperative metrics and patient engagement but data to support improved clinical outcome is lacking.

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Three‐dimensional printing in medicine

Cited by 20 publications

References 14 publications

A three-dimensional printed model in preoperative consent for ventricular septal defect repair

A three-dimensional printed model in preoperative consent for ventricular septal defect repair

Three-dimensional printing versus conventional machining in the creation of a meatal urethral dilator: a cost and mechanical strength analysis

Three‐dimensional printing in orthopaedic preoperative planning improves intraoperative metrics: a systematic review

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