Virtual reality and 3D printing prepares anesthesiologists for pediatric lung surgery

A surgical team in Israel has benefitted from the use of 3D printing and virtual reality to model the exact airway dimensions and shape of 7-year-old girl, prior to live-saving surgery on her lungs.

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A team of anesthesiologists in Israel has reported that they are the first to employ 3D printing coupled with virtual reality (VR) to model an airway of a 7-year-old patient to the exact shape and dimensions, in preparation for a surgical procedure removing part of her lung.

Detailed in the European Journal of Anaesthesiology, the report describes how the young girl needed to have part of her right lung removed due to a case of Ewing’s Sarcoma, whereby the bone and soft tissue cancer had spread to her lung.

Because of her small size, the doctors and surgical team had concerns about the use of conventional tubing and equipment. The team decided to use data from CT scans to develop a VR-based model of her windpipe and lungs, 3D printing a replica to use to rehearse the procedure.

Despite extensive adult experience, our familiarity with one lung ventilation in the very young pediatric population is limited. We used a combination of 3D printing and VR bronchoscopy to develop a personalized airway plan reducing the potential for trial and error in airway manipulation during the operation." explained lead author, Ruth Shaylor from the Division of Anesthesia, Pain and Intensive Care at Tel Aviv Sourasky Medical Center (Tel Aviv, Israel).

Figure 1: The treating anesthesiologist spent time the day before the procedure familiarizing himself with the airway anatomy via virtual reality. Credit: Ruth Shaylor, Tel Aviv Sourasky Medical Center.

The treating anesthesiologist spent time the day before the surgery was due to take place, familiarizing himself with the airway anatomy with the VR simulator. The team reports that the 3D-printed model was then used to design a personalized plan.

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Following the planning and rehearsal processes, the team was able to substitute some of the equipment originally planned for the procedure for equipment of a more appropriate and safe size, facilitating a successful isolation and ventilation of the patient’s left lung.

Figure 2: The 3D-printed model of the patient's airway used to develop a personalized surgical plan. Credit: Ruth Shaylor, Tel Aviv Sourasky Medical Center.

During the procedure, the treating anaesthesiologist reported a good correlation between the patient's anatomy and the VR model, allowing the operation to proceed as planned. At the end of the procedure, the tubing and equipment was removed easily and the patient made an uneventful recovery," added Shaylor.

To date, the use of 3D printing in anesthesia has been mainly for educational purposes. 3D printing in anesthesia is underutilized for patient-specific pre-operative planning. The same applies to the use of VR in anesthesia. We successfully combined both technologies to produce a personalized airway plan for a child patient. The final airway plan was substantially different to the plan developed using standard imaging techniques. This reduced the number of attempts at lung isolation that would have otherwise been performed on the patient," Shaylor concluded.

Sources: Shaylor R, Verenkin V, Golden E, Matot I. The use of three-dimensional printing and virtual reality to develop a personalized airway plan in a 7.5-year-old child. Eur. J. Anaesthesiol. 37: 308—515 (2020);

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