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.
SSM Health Cardinal Glennon Children’s Hospital 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 Health Cardinal Glennon Children’s Hospital for a two-part blog series to discuss their experience with 3D printing and the impacts it has had on patients they serve.
3D printing has been used at SSM Health Cardinal Glennon Children’s Hospital and Saint Louis University to make patient care more effective, safer, and faster. It has been a successful collaboration between pediatrics, surgery, radiology, and engineering. The SSM Health Cardinal Glennon Children’s Hospital Plastic Surgery department has been using 3D printed sterilized intraoperative surgical models and guides since the year 2000 for the most complex craniofacial cases, but through an external commercial 3D printing company. Pediatric Cardiology and Radiology in conjunction with the department of mechanical and aerospace engineering at Saint Louis University Parks College of Engineering produced the first 3D printed medical model on campus in 2013 using a Stratasys Eden 260 Polyjet printer. This life-sized heart model was critical in helping pediatric cardiologists and cardiothoracic surgeons determine the operability of the patient, who ultimately did extremely well. This experience generated a great amount of enthusiasm, and was followed by cases in orthopedic surgery, neurosurgery and vascular surgery.
3D printing opened a new frontier where we could improve diagnostic precision, procedural outcomes, and surgical outcomes on site. With many departments benefitting their pediatric patients with clinical applications of 3D printing, we were moved to ask our hospitals and university
to create a medical 3D-printing center. Multiple sources attempted to raise funds, but we were finally fortunate when one of our team members spoke to and inspired William and Connie Kallaos who made an extremely generous gift through our pediatric hospital’s SMM Health Cardinal Glennon Children’s Foundation, which allowed us to purchase our first Stratasys printer at Cardinal Glennon Children’s Hospital. This donation also allowed us to hire our first technician, and thus our 3D printing center was born.
Describe the types of surgical cases in which you find pre-surgical planning with 3D models critical to the success of the procedure. How have 3D models help you overcome the challenges faced in these cases?
In pediatric cardiovascular surgery, 3D printing has been extremely helpful in planning surgical repairs for patients with complex heart defects, particularly those with heterotaxy, unbalanced atrioventricular canals, and double outlet right ventricle. Being able to physically hold the model can help physicians and surgeons understand how a complex heart can be repaired. The use of multiple colors and compliant materials with the J750 adds information and even allows for repairs to be simulated.
In interventional cardiology, 3D printing has been used in the cardiac catheterization laboratory, particularly for simulating interventional procedures. We have simulated deployment of transcatheter pulmonary valves using a compliant patient-specific 3D model, and successfully performed the procedure using the same equipment the following day. We have used 3D printing to assist with complex electrophysiology ablations.
In neurosurgery, 3D printing has been extremely helpful in planning complex neurosurgical and spine cases. The J750’s multimaterial capability allows tumor, blood vessels, parenchyma, tractography, and bones to delineated in one model. This has been used for tumor resection, complex vertebral fixation, and neurovascular cases.
In plastic surgery, 3D printing is taking care of the human qualities, including the body, extremities, and especially the head and face for cleft lip-nose-palate and craniomaxillofacial reconstruction, as well as for congenital anomalies and acquired tumors or trauma. Many congenital anomalies have unique anatomic configurations, and it is very difficult to conceptualize the 3-dimensional anatomy of the packed face and skull. Cutting the bones of the orbits and jaws and skull to move and create a more normal face has high-risks of injury that can cause blindness or brain injury. The most common areas we have utilized it are for cranial reconstruction, jaw orthognathic surgery to restore a normal occlusion, and trauma fractures of the orbits, cheeks and jaw. In fact, we published in May 2017 in Plastic and Reconstructive Surgery, the #1 Plastic Surgery journal, an academic paper explaining the four ways 3D printing can be used intraoperatively.
To read more about how SMM Health Cardinal Glennon has engaged the community with 3D printing, check out these suggested articles.