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Pediatric Surgeons Use 3D Printing To Help With Complex Operations

March 13, 2019 1:40 p.m.

GUEST: Susan Murphy health reporter, KPBS news

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Surgeons at Rady Children's Hospital in San Diego are turning to 3-D printing to help with complicated operations. KAYE PBS health reporter Susan Murphy tells us the procedure can be a lifesaver for young patients.

It basically helps my body and keep my body alive. Little Lincoln Matthews knows a lot about his heart. It's basically normal. It pumps normally.

But sometimes when I'm leaning my heart it stops that keeps going.

At 7 years old he's had three open heart surgeries.

I won't be living here today without you guys.

He was born with a rare and life threatening heart defect. His most recent surgery was the most complex. So his surgeon had a replica model made of Matthew's most precious organ to help prepare for the risky procedure hotline of. Three heart models he proudly holds up his heart model encased in glass.

This is what it. It's the size of it and I let the color of it.

And it looks like the three dimensional life size model detailing every valve vein and artery was created by Justin Ryan director of the hospital's new 3D innovations lab which opened in October.

Inside here we can see all these muscle fibers and this patient. This area is way more narrow than where it should be.

The 3-D models help doctors plan for complicated surgeries and improve outcomes of the region's youngest patients. It's one of the first 3-D hospital labs in Southern California.

So on this patient there's a whole just kind of deep inside the model exactly how big that hole is can change the course of surgical correction. You don't know how big the patch needs to be where that patch might need to be in order to fix that hole.

Ryan AP HD and biomedical engineering churns out about a dozen 3-D models every week from hearts to spines to skulls to create the models he uploads a patient's medical images into a special computer program. And they need to be a three dimensional nature so that's going to be a C.T. scan or an MRI or through the ultrasound.

Not allow us to create a 3-D computer model which then gets sent to a 3-D printer.

The models are printed one thin layer at a time using resin or nylon powder or a liquid plastic he says creating a spine with airways takes nearly 20 hours.

At the heart the size of my hand might be finished in about four hours.

Some models are printed in color to make it easy for patients and their families to better understand the diagnosis and surgery plan.

Were you able to see that purple Chambers connected to the red and blue vessel. It shouldn't be that way. You create a new way to communicate with families.

The colors also helped surgeons differentiate who is going to work on which parts. Dr. John Nigro is chief of Rady Children's cardiac surgery and director of the Heart Institute.

So we actually sit and analyze the models and that helps us understand what is the optimal approach to kind of repairing the defect.

Dr. Nigro encouraged the opening of the lab and recruited Justin Ryan after working with him in Arizona. He says the 3D models are crucial so they really do help our children who have the most complex disease and are the sickest he says holding a replica a life size anatomy in his hands to study difficult anomalies is empowering. He compares working without a model to driving without G.P.S. before.

I think we kind of had an idea in our mind but you know sometimes we would be fooled. We would get in and it was a little different than we had anticipated.

He says most of all the models help reduce the risk of surgery to the child.

We decrease the amount of time that the child is actually on the bypass machine and in the operating room and that definitely translates to less complications and better long term outcome sat and play with my cars.

Upgrades like the little Lincoln Matthews says he's feeling much stronger these days.

Like I can't run that fast but since like a month ago I can run like a pro..

But he faces another surgery down the road when I'm 21.

They say. My mom says I have to have a heart transplant. And so my mom hopes that they are something to like put in my body.

He hopes by sharing his experience he'll help other children facing difficult surgeries.

He has this advice be brave and know that you're very special.

K PBS health reporter Susan Murphy joins me now and welcome Susan. Thanks Maureen. I want to talk a little bit more about Lincoln Matthews can you tell us more about his procedure.

Sure he was born with just one working ventricle and a hole in the place of the other. His heart was also tilted to the opposite side of his chest. So you know most people have two working ventricles that pump blood one pumps blood to the lungs the others to the body. Lincoln's heart was having to work extra hard with one ventricle so doctors basically rerouted his venous blood to the lungs so that his working ventricle could focus on pumping oxygenated blood to his body. So it's very complicated surgery but it was successful and as a result of the surgeries he has much much more oxygen in his body is one that's great to know.

Now the 3D modelling they're doing at Rady is I would imagine only on child size organs. Can this 3D technique be used for adult surgeries.

Well absolutely so right now the program focuses on all sorts of anatomy. It started with hearts solely cardio but now they're printing a lot of different anatomy. When we were visiting the lab it was really fascinating. Justin Ryan who's the director of the new 3D innovations lab he was printing a spine with airways so they print joints brain skulls and everything you can imagine.

Ryan says anything they can image they can print and it's basically opening this whole new frontier of opportunity and the process of making them I'll have to explain is very fascinating as well.

It starts in a powder for most of the models do it. It's a resin or a nylon powder it's bound together with a glue substance. The machine basically deposits a thin layer of powder and in between each layer a laser prints the outline of the object and it's just builds once slowly or at a time. It's really amazing how detailed these models come out. They also print using this liquid plastic so they can make these models in color like I explained in the piece and they are also printing with a soft polymer it's like a translucent material so surgeons can actually cut into the soft pieces and practice these surgical operations.

I think they have about five different printers in the lab currently and they're hoping to continue to expand has Rady actually recorded better surgical outcomes because of the 3D technology they're currently studying. So the main goal is to reduce the time a child is in the operating room and on a ventilator. And as you know the longer a child is under sedation the riskier a surgery can be. So the cardio surgeon who I talked to Dr. John Nigro so they're currently measuring the amount of time saved in the operating room because of the 3D models.

He says he has seen a huge benefit firsthand. His team performs as many as 400 open heart surgeries per year on children at Rady Children's. And they also conduct about a dozen heart transplants. So you can see the potential here of keeping children safe.

Now is it only for surgeries. Are there other medical uses for this.

These 3-D models the lab is the innovation lab and so it's being offered to everyone in the hospital every division every specialty. And Ryan says that more and more doctors are taking advantage of this technology when they see the benefit. He says that they come back over and over again for every complex operation that they they have they can create forceps surgical tools clamps.

They can create stents and other body repair parts. So he is kind of a one man band in this print lab. He has a couple of helpers but he is really hoping to bring on some student interns to help him out. He's hoping to expand the lab because he's you know in high demand where do experts see this medical 3-D technology expanding in the future will they believe this is just the tip of the iceberg as far as the potential for this technology. Ryan sees it greatly expanding across all hospitals and medical centers and he says the technology goes beyond printing because he says virtual reality and augmented realities are another big emerging technology.

And finally back to Lincoln Matthews you said he'll probably need a heart transplant when he's older. But until then is he expected to be like he told us running fast and enjoying being kid.

Absolutely. He seems to be doing great. He's in the first grade. He loves sports especially soccer. He is loving to run. He is a super talented Lego builder. He has a collection of hot wheel cars. He is such a precious child and he's wise beyond his years. So yes his mom says he will need a heart transplants. You know by the time he's 21. But right now he is active. He is healthy and I know he's going to continue to inspire others along his journey.

I've been speaking with K PBS health reporter Susan Murphy Susan thank you. Thank you.