Surgeons at Guy’s and St Thomas’ NHS Foundation Trust, London used 3D printing technology to improve success rate of life-saving, complex kidney transplantation of a two-year-old child, Dexter Clark. In first-of-its-kind surgery, 3D printing played a vital role in the operation as surgeons used the technology to pre-plan the successful transplantation and overcome various challenges that they encountered in case of Dexter who received larger-than-average kidney from his father, Brendan Clark.
Dexter Clark, a two-year-old child required a kidney transplant due to complications of his illness. Unable to lead a normal life of small child, Dexter required a kidney transplant. However, considering the age of Dexter, the case presented surgeons with distinct challenges. Firstly, Dexter weighed less than 10 kg. This significantly increased the risk of transplantation. Secondly, since Dexter’s father’s kidney was larger than that of average adult male – this raised questions about the feasibility and safety of implanting the kidney into Dexter.
3D Printing: The Solution
Considering the distinct challenges, surgeons turned to 3D printing technology and using a multi-material 3D printer from Stratasys, produced patient-specific models for pre-surgical preparations. Traditionally, to conduct such complex transplants in children as young as Dexter, surgeons place such young children under anaesthesia, and in some cases, use invasive surgical exploration to determine the feasibility of the transplantation.
However, with the help of 3D printed models of the patient, the need for surgical exploration is largely reduced. This is mainly because the 3D printed models help surgeons to determine the optimal surgical approach in the pre-planning stages or before the patient is on the operating table.
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In case of Dexter, surgeons even took the 3D printed models in the operating theatre on the day of transplant and used the models during the operation to evaluate the best way in which the donor kidney could be ideally implanted into Dexter’s abdomen.
Providing details of how 3D printing technology helped in the complex transplantation, Mr. Pankaj Chandak, Transplant Registrar at Guy’s and St Thomas’ NHS Foundation Trust, said, “Using our 3D printer, we worked in collaboration with Nick Byrne and his team – clinical scientists from our medical physics department who specialize in medical imaging. They converted patient CT scans into anatomically accurate, multi-material 3D models. These helped us appreciate aspects such as depth perception and space within the baby’s abdomen, which can often be difficult to ascertain when looking at conventional imaging.”
“The ability to print a 3D model of the patient’s anatomy in varying textures, with the intricacies of the blood vessels clearly visible within it, enables us to differentiate critical anatomical relations between structures. The flexible materials also allowed us to better mimic the flexibility of organs within the abdomen for simulation of the surgical environment,” explained Mr. Chandak.
“This technology has the potential to really enhance and aid our decision-making process both during pre-surgical planning and in the operating room, and therefore can help in the safety of what is a very complex operation and improve our patient care,” added Mr. Chandak.
Offering details about Dexter’s speedy recovery after transplantation, a rejoiced Emily Clark, Dexter’s mother said, “Since the transplant, Dexter is a changed boy, eating solid food for the very first time. We always knew the operation would be complicated but knowing that the surgeons had planned the surgery with 3D models that matched the exact anatomy of my husband’s kidney and son’s abdomen, was extremely reassuring. We hope that Dexter’s case will offer other suffering families similar reassurance that cutting-edge technology, such as 3D printing, can help surgeons better treat their loved ones.”
Guy’s and St Thomas’ NHS Foundation Trust is one of the largest National Health Service (NHS) trusts in the U.K. Involved in treating more than 2.4 million patients in acute and specialist hospital services and community services every year, surgeons across the Trust are using Stratasys multi-material 3D printing for planning the most intricate of operations.
In fact, it is the first Trust in the world to use 3D printed models to pre-plan the successful transplantation of an adult kidney into a small child with anatomical complexities.
Michael Gaisford, Stratasys’ Director of Marketing for Stratasys Healthcare Solutions, concludes: “Guy’s and St Thomas’ NHS Foundation Trust is pushing the boundaries of what can be achieved with multi-material 3D printing within healthcare. It is a clear demonstration of the ability for 3D printing to enable physicians to better plan, practice and determine the optimal surgical approach. We are delighted to see Dexter has fully recovered and hope many other children can benefit from such forward-thinking applications of our technology.”
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