The Straits Times ( 13 September 2021)
Doctors at Tan Tock Seng Hospital (TTSH) have used 3D printing technology to create tools for surgery and mock-ups of a patient’s body parts to use in consultations. They said the innovation can help make consultations clearer for patients and complicated procedures faster, more accurate and less risky.
In surgery, doctors often use surgical templates – called jigs – to guide tools like saws and screws when they operate on a patient.
But it can be difficult to source these jigs for more complex operations and custom orders can take weeks to arrive and cost thousands of dollars to produce.
With 3D printing done in-house, jigs that are built exactly to the patient’s specifications can be created in resin in a matter of hours.
It dramatically shortens the waiting time for some operations, said orthopaedic surgeon Michael Yam and radiologist Candice Leong. They head the hospital’s research on 3D printing technology.
The use of 3D printing has been gaining ground in hospitals worldwide. Local hospitals have used 3D-printed models for patient consultations and even in surgery.
But the doctors at TTSH believe that this is the first time 3D printing services are being provided inhouse locally.
Medical professionals at TTSH can request 3D-printed models based on a patient’s computerised tomography (CT) scans to prepare tools and plan ahead before an operation, reducing guess work and the risk of damaging vital parts.
Dr Yam conducted his first operation with the help of 3D printing last November. A model of the patient’s pelvis allowed surgical tools to be fitted precisely, reducing the need to make adjustments by trial and error during the operation.
Realising that operations could be done with more accuracy, he embarked on research into the technology.
By having these models ahead of time, surgeons can rely less on CT scans – imaging of the patient’s body created from multiple X-ray images taken from different angles – to monitor the progress of an operation. In turn, patients can be exposed to less radiation.
It reduces operating time, and improves accuracy and precision. It also improves the surgeon’s confidence in the operation.
ORTHOPAEDIC SURGEON MICHAEL YAM, on 3D printing being done in-house at Tan Tock Seng Hospital.
Dr Yam said: “It reduces operating time, and improves accuracy and precision. It also improves the surgeon’s confidence in the operation.”
TTSH also uses 3D printing to better explain to patients their conditions and surgical procedures.
Dr Yong Enming, a surgeon at TTSH, said the life-size models made it easier for patients to understand complex conditions compared with images taken from a CT scan.
Dr Yong added: “Most of us are visual in nature. It is easier for me to be able to point (at the model) and explain what we are doing.”
One of his patients, Mr Gan Khuat Hin, 78, was shown a 3D model of his inflated artery, which had to be operated on for swelling to be reduced.
Mr Gan said in Mandarin: “I realised how severe the condition was and the 3D model made it easy to understand. I was less worried after understanding the problem.”
Doctors can request 3D printing at their discretion, usually for more complex cases, said Dr Yam.
His research, which was published in the peer-reviewed Journal of Clinical Orthopaedics and Trauma, found that these jigs cost roughly $50 – at least 10 times cheaper than commercially available ones.
His team hopes to see 3D printing used widely in the months to come, with a long-term goal of creating a 3D-printing centre to work with other specialities in TTSH and other hospitals.
Dr Yam said it was challenging for 3D printing companies to understand the needs of healthcare providers, which often entails collaboration between multiple teams in a hospital, such as surgeons, radiologists and patients.
An in-house printing service operated by those familiar with the needs of healthcare makes coordination between these groups more efficient, he added.
What the technology is used for
Patient education
Doctors can print 3D models of body parts that are speci c to patients, to provide a clearer explanation of their issues and the procedures needed.
Pre-operation planning
Doctors can use the models to plan for an upcoming operation, which can help to better prepare them for complex operations.
Creating surgical jigs and tools
Custom surgical jigs that are used as a guide for operating tools can be sized and printed quickly, resulting in less waiting time in cases where the hospital does not have the templates needed for an operation.