VAMC 3D Fellowship

What is Three-Dimensional Printing?

Three-dimensional printing (3DP) is a manufacturing process initially undertaken in the aeronautic and automotive engineering industries. [1],[2] 3DP refers to an “additive manufacturing process” in which new material is added to the surface of existing material to build up a physical three-dimensional model.

[1] Sachs E, Cima M, Cornie J, et al. Three-dimensional printing: the physics and implications of additive manufacturing. CIRP Ann – Manuf Technol 1993;42:257.

[2] Kroll E, Artzi D. Enhancing aerospace engineering students’ learning with 3D printing wind-tunnel models. Rapid Prototyping J 2011;17:393.

3DP and Surgery?

3DP has been applied broadly in the field of surgery in the following categories: 1) anatomic models, 2) surgical instruments and 3) implants and prostheses.[1] Broadly, 3DP has been applied successfully in surgery due to its ability to allow for rapid transformation or conversion of anatomical images into physical objects.3 Surgical applications with 3DP fall into three broad time points: p    re-operatively, intra-operatively and post-operatively. Usually pre-operative applications of 3DP center on planning an operative approach that a model could potentially help define for a surgeon before an operation. Intra-operatively, 3DP is commonly used for incisional cut aids used during an operation. Finally, post-operatively the surgeon can use 3D models for education of trainees and/or patients on a particular procedure. Surgeons have traditionally reconstructed what they see on flat two dimensional representations of anatomy as captured by imaging into how they work with the world into three dimensional details as seen intraoperatively.[2] A common goal in surgery is to have a clear understanding of patient anatomy preoperatively for the successful planning of surgery.[3]This process can be difficult for junior surgeons especially when anatomy is complex and/or is varied from studied standard arrangements. 3D virtual reconstructions have been developed to assist in understanding surgical anatomy.[3] 4The limitations of this approach have been dedicated personnel, software and 2D constraints for presenting these renderings.4 5

[1] Malik HH, Darwood AR, Shaunak S, Kulatilake P, El-Hilly AA, Mulki O, Baskaradas A. Three-dimensional printing in surgery: a review of current surgical applications. J Surg Res. 2015 Dec;199(2):512-22.

[2] Pietrabissa A, Marconi S, Peri A, Pugliese L, Auricchio F (2015) From CT scanning to 3-D printing technology for the pre-operative planning in laparoscopic splenectomy. Surg Endosc 30(1):366–371.

[3] Pugliese, L., Marconi, S., Negrello, E. et al. (2018) The clinical use of 3D printing in surgery. Updates Surg 70, 381–388.

4 Pietrabissa A, Marconi S, Peri A, Pugliese L, Auricchio F (2015) From CT scanning to 3-D printing technology for the pre-operative planning in laparoscopic splenectomy. Surg Endosc 30(1):366–371.

5 Pugliese, L., Marconi, S., Negrello, E. et al. (2018) The clinical use of 3D printing in surgery. Updates Surg 70, 381–388.