Novel Application of Rapid Prototyping for Simulation of Bronchoscopic Anatomy

doi:10.1053/j.jvca.2013.08.015

Journal of Cardiothoracic and Vascular Anesthesia

Volume 28, Issue 4, August 2014, Pages 1122-1125

https://doi.org/10.1053/j.jvca.2013.08.015 Get rights and content

Objective

The authors used rapid prototyping (RP) technology to create anatomically congruent models of tracheo-bronchial tree for teaching relevant bronchoscopic anatomy.

Design

Pilot study.

Setting

A single level tertiary academic medical center.

Interventions

Two 3 dimensional (3D) models of tracheo-bronchial tree (one showing normal anatomy and another with an early take off of right apical bronchus) were recreated from Computed Tomographic images using RP technology. These images were then attached to mannequins and examined with a flexible fiberoptic bronchoscope (FFB). These images were then compared with the actual FFB images obtained during lung isolation.

Measurements and Main Results

The images obtained through the 3D models were found to be congruent to actual patient anatomy.

Conclusions

RP can be successfully used to create anatomically accurate models from imaging studies. There is potential for RP to become a valuable educational tool in the future.

Section snippets

Background

It has been recognized that anesthesiologists with limited thoracic experience face difficulties in obtaining lung isolation. This is attributed to insufficient knowledge of bronchial anatomy and lack of proficiency with flexible bronchoscopy (FB).⁷ Current educational tools used to teach bronchial anatomy and FB include online simulation, instructional DVDs, mannequin simulators, and virtual reality simulators.⁸ The use of RP is a novel concept in anesthesia simulation. The authors used this

Methods

The authors used computed tomographic images of the thorax that were in the DICOM (Digital Imaging and Communication in Medicine) format to create the models; however, magnetic resonance images also could be used. The lung window series was 3D-reconstructed using Tera-Recon Aquarius Intuition (TeraRecon, Foster City, CA) software. A semiautomated process then selectively identified the area of interest—in this case, the tracheobronchial tree. These images then were converted into a Standard

Discussion

The use of RP is a relatively new concept in medical education. As is evident from this pilot study, this technology can be used in simulation in anesthesia education. RP takes advantage of air and soft tissue contrast on a CT scan or by magnetic resonance imaging, which clearly show the bronchial anatomy. After adequate post-processing, the obtained information then can be exported to a 3D printer that allows for high-fidelity reconstruction. Because unfamiliarity with endoscopic bronchial

Conclusion

Because this technology is relatively nascent, the biggest limiting factor is the cost involved in the construction; another limiting factor is the availability of the technology. The estimated cost of materials is approximately $250 per model. This cost is comparable, if not less than, many mannequin simulators and much less expensive than virtual reality simulators. The reproduction of the structures is dependent on the resolution of the images available—the higher the resolution, the better

References (8)

A factory on your desk. Manufacturing: Producing solid objects, even quite complex ones, with 3D printers is gradually...
N. Jones
Science in three dimensions: The print revolution
Nature
(2012)
V. Waran et al.
The creation and verification of cranial models using three-dimensional rapid prototyping technology in field of transnasal sphenoid endoscopy
Am J Rhinol Allergy
(2012)
C. Wilasrusmee et al.
Three-dimensional aortic aneurysm model and endovascular repair: An educational tool for surgical trainees
Int J Angiol
(2008)

There are more references available in the full text version of this article.

Cited by (58)

3D printed organ for healthcare applications
2022, Biomedical Product and Materials Evaluation: Standards and Ethics
The rapid emergence of three-dimensional (3D) printing for commercial healthcare applications is not only revolutionizing traditional medical science, but also paving the way for a healthy and sustainable living system. This cutting-edge technology has shown promise in applications for drug discovery, disease modeling, and creating personalized prosthetics, implants, patient-specific organ replicas, anatomical models, and surgical equipment. In our constant quest for developing greener and more ecofriendly techniques, 3D printing technology has shown robust potential, owing to its time and cost-effectiveness, the democratization of design and manufacturing, enhanced productivity, excellent reproducibility, and, last but not the least, minimization of hazardous wastes. Additionally, steady but significant advancements in 3D bioprinting are unfolding, providing unprecedented possibilities, and it could become the next big thing in healthcare and customized medicine. However, there are serious social and bioethical complexities that need to be addressed to ensure its safe medical use. Therefore this chapter aims to summarize the historical background, various approaches, techniques, and materials employed in the fabrication of 3D-printed organ models. This chapter addresses the fundamental challenges associated with 3D printing and provides insights into ongoing developments and potential applications of 3D-printed organs. It also underlines the urgent need for updated legislation and presents the authors’ views on possible solutions and future prospects.
An overview of mechanical properties and form error for rapid prototyping
2020, CIRP Journal of Manufacturing Science and Technology
Citation Excerpt :
Results depicted that RP models were more accurate in comparison to the conventional process. Bustamante et al. [96] have fabricated tracheo-bronchial tree by using RP technology to teach bronchoscopic anatomy. For this purpose, computed tomographic (CT) data were used for the generation of physical model.
Rapid prototyping (RP) is one of the most imperative advanced manufacturing techniques. RP has attracted attention in the prototyping community due to its capability of reducing the lead time of the product development. It has emerged as an alternative method to fabricate component. RP has recently shown a wide range of engineering as well as medical applications. However, dimensional accuracy, surface roughness and part strength of the component fabricated by RP technology are poorer compared to that of traditional manufacturing process. The main emphasis of authors in this research work is to describe the methodology adopted by researchers. The novelty of this work lies in the fact that it provides a systematic approach to enable potential for persons from industry as well academic users to select suitable process parameters for fabricating the component.
The role of 3D printing in ENT surgery
2019, 3D Printing: Applications in Medicine and Surgery
Three-dimensional (3D) printing is a rapidly growing technology, with numerous applications in Otolaryngology and Head & Neck Surgery. Several articles can be found in the literature on the applications of 3D printing in Otolaryngology and can be categorised according to the relevant subspecialty (Otology, Rhinology, Paediatric Otolaryngology, Head & Neck Surgery/ Laryngology) but also according to the proposed application. Thus, the 3D printed models can be used in perioperative planning, patient education, surgical training, grafting, prosthetics and reconstruction. At present, the progress in technological aspects and materials has lowered the cost of 3D printing significantly. Based on the literature review, there is still room for improvement when it comes to model accuracy and material tactile feedback. 3D printing applications can provide realistic training simulation, bio-printed functional grafts and accurate models for patient education and pre-op planning.
Clinical Applications of 3D Printing: Primer for Radiologists
2018, Academic Radiology
Citation Excerpt :
The anatomic model allowed detection of areas of low wall shear stress with different stent placements to prevent early stent restenosis. Other reports have used 3D models for operative rehearsal of cerebrovascular aneurysm repairs (92), transapical aortic valve repairs (93), nephrolithotomy (13), and fiberoptic bronchoscopy (94). Because medical 3D printing is fundamentally image-centered—creating patient-specific anatomic models, implants, and constructs typically requires CT and MR imaging—the radiologist should play a central role in 3D printing.
Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care.
Advanced Pediatric Airway Simulation
2017, Otolaryngologic Clinics of North America
Citation Excerpt :
Although common in craniofacial and oncologic reconstruction, it is not a commonly used technique for preoperative surgical planning in pediatric airway reconstruction to date.27,28 Case reports have described the use of three-dimensional (3D) printing as an aid for anatomic evaluation of the airway and to assist in endoscopic stent placement and endotracheal intubation.29–32 Pediatric airway endoscopy simulation has changed significantly from the days of Chevalier Jackson’s “Michelle the Choking Doll.”
Development and Validation of a Hybrid Bronchoscopy Trainer Using Three-Dimensional Printing
2024, Simulation in Healthcare

View all citing articles on Scopus

: Gerard R. Menecke, Jr, MD

: Marco Ranucci, MD

: Section Editors

: Presented in part at the 2013 Annual Meeting of the International Anesthesia Research Society, San Francisco, May 4 to May 7, 2013.

View full text

Emerging Technology ReviewNovel Application of Rapid Prototyping for Simulation of Bronchoscopic Anatomy

Objective

Design

Setting

Interventions

Measurements and Main Results

Conclusions

Section snippets

Background

Methods

Discussion

Conclusion

Science in three dimensions: The print revolution

Nature

The creation and verification of cranial models using three-dimensional rapid prototyping technology in field of transnasal sphenoid endoscopy

Am J Rhinol Allergy

Three-dimensional aortic aneurysm model and endovascular repair: An educational tool for surgical trainees

Int J Angiol

Emerging Technology Review
Novel Application of Rapid Prototyping for Simulation of Bronchoscopic Anatomy