Nova Scotia Surgeons Use 3D Printed Brain Model in Surgical Planning For the First Time

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Last spring, Nick Rahr of Canada began experiencing some puzzling dizziness. His doctor conducted a brain scan, and told him that everything was clear, but a few months later Rahr contracted both bacterial and viral infections, compounded with severe head pain, and decided enough was enough. His wife was away, so he took a taxi to the Halifax Infirmary emergency department of the Nova Scotia Health Authority…and that’s where things got really crazy.

The physician in the ER asked Rahr about the tumor that was definitely visible in the previous brain scan from his medical records.

Rahr explained, “They said it’s not clear and you’ve got a tumour there and we’re going to do an MRI tonight just to see if there’s any change.”

After getting a referral from the team in the ER (and breaking up with his original doctor!), Rahr met with Dr. Simon Walling, head of neurosurgery at the QEII Health Sciences Centre, and surgeon Dr. Adrienne Weeks.

Plans were laid for Rahr to have surgery to remove the benign meningioma tumor from the rear quarter of his brain, but rather than using 3D digital brain scans as diagnostic and surgical guide tools, for the first time in Nova Scotia, a 3D printed model of a patient’s brain was created for surgical pre-planning.

“Not everyone’s anatomy is the same. We know generally where everything is supposed to be . . . but every patient is slightly different. . . . Important structures vary from person to person,” explained Dr. Weeks. “You might have a vein that’s slightly higher or slightly lower, those things make a big difference in surgery when you’re operating through very small corridors.”

A 3D printed model of Nick Rahr’s brain. The cluster at the bottom right is the tumor. [Image: John McPhee]

We know that 3D printed models of organs, like the brain, can truly help save lives. No two surgeries are exactly alike, so surgeons and doctors can work to become as prepared as possible ahead of time, especially for if something unexpected happens in the OR, by embracing 3D printing.

Dr. Walling said, “Seeing something on a screen and actually being able to handle it in your hands are two different things.

“Yes, we work quite frequently with pictures on screens, but trying to position and figure out a clear corridor in a 3D model is very helpful.”

Nick Rahr hugs his wife Judy shortly before his surgery. [Contributed image]

Using 3D printed models, like this one of Rahr’s brain, can help surgeons map out the best route for tumor removal, which is one of the most important stages of surgery – and it happens before they even make any incisions. To determine the most efficient, and safest, way to the tumor, surgeons will typically spend close to an hour positioning the patient just so.

“You can turn them like this or like this, and that changes the access you’re going to get with the microscope. That’s the main reason for the 3D printout, to use in the operating room to get the best angle,” explained Dr. Weeks.

Dr. Walling and Dr. Weeks had been thinking about trying out 3D printed anatomical models for quite some time, as costs have dramatically decreased since the 1980s.

Dr. Weeks said, “I’ve used some of the traditional approaches to this type of lesion and I’ve seen some of the adverse consequences. That’s why when I had this case and came to Dr. Walling saying, how else can I get this out? He had just gotten the 3D printer so Dr. Walling suggested we should print it and use this approach and it worked very well.”

The two chose 3D printing for Rahr’s 16-hour surgery, as his tumor was deep in a part of the brain that was difficult to access. Before the surgery, which took place this winter, the surgeons warned Rahr that he could experience some post-op mobility and speech issues, but he only had some headaches and fatigue, which have since cleared up. The surgery, which took place back at the Halifax Infirmary, was successful, and the two surgeons definitely plan to use 3D printing in the future.

Dr. Simon Walling and Dr. Adrienne Weeks hold a 3D printout of patient Nick Rahr’s brain at the Halifax Infirmary. It was the first time the surgeons used 3D printing technology to help them prepare for a surgery. [Image: John McPhee]

“I can remember coming to Halifax when there was only one MRI scanner for the entire Atlantic region,” said Dr. Walling, who described the changes in technology over the 30 years he’s been a surgeon as “mindblowing.”

Dr. Weeks believes that operating rooms in the near future will move even farther past 3D renderings and 3D printed models, and start using virtual reality during surgeries instead.

“We’ll be able to project an image in front of us and manipulate it in 3D. And we may be able to hologram overlay your patient so you know exactly where it is on your patient,” Dr. Weeks said. “The technology is moving that quickly.”

As for Rahr, he’s just glad that the tumor was successfully removed – and that he has a memento from the surgery on a shelf in his living room to show off.

Rahr said, “Once they told me they were going to make this model, I said, could I have one? And they said sure.”

Discuss this and other 3D printing topics at 3DPrintBoard.com or share your thoughts in the Facebook comments below. 

[Source/Images: The Chronicle Herald]

 

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