The advent of 3D printing technology, or additive manufacturing (AM) has had a profound impact on many fields across the medical landscape, with the creation of customised and precise surgical models and instruments revolutionising both presurgical planning and actual procedures alike.
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Within the delicate and complex landscape of brain surgery, however, it offers even greater advantages, enhancing surgical accuracy and often reducing risk in the most challenging, invasive and high-stake operations.
Navigating complexity: The challenges of cavernoma surgery
Cavernomas (also called cavernous haemangiomas) are abnormal clusters of small blood vessels embedded in the brain, affecting around 1 in 200 people. Treatment often involves surgical removal to reduce the risk of rupture and haemorrhage. With this kind of surgery, however, also comes an inevitably high risk of damaging healthy tissue, which can cause catastrophic neurological deficits and impairments, such as loss of vision. This makes advances in surgical processes paramount and means that innovations in instrumentation can have huge implications for surgical success.
From CAD to OR: The micro-opportunity
AM has long since earned its stripes and cemented its value within the surgical world as a means of developing surgical aids, including those specifically designed to assist in positioning when operating on cavernomas. However, it is micro-additive manufacturing (micro-AM) that offers new hope in refining these surgical processes and improving patient outcomes. Traditional positioning tools, such as tubular retractors, for cavernoma surgeries are already 3D printed in certain scenarios. The provision of 3D printed solutions at the point of care offers the ability to produce highly customised parts to the unique size, location and shape of the cavernoma and wider medical requirements of each patient. Now, micro-AM is taking these tools to even higher heights, unlocking the possibility to create more intricate parts with micron-scale features – ultimately meaning added functionalities and superior efficacy and precision.
Committed to driving the advancement of personalised healthcare and improved outcomes through 3D technology, Synergy 3DMed has leveraged Nano Dimension’s Fabrica micro-AM system to reimagine the specific neurosurgical tubular retractor, pivotal to enabling surgeons to access and excise cavernomas.
Previously, the surgical aid would have been a fairly simple monofunctional tool. Through the shift to micro 3D printing, Synergy 3DMed was able to recreate the tubular retractor, redesigning it to thread fibre optics into its very thin structure – resulting in advanced functionality, that enhances the ease and precision of surgery and ultimately, improves patient outcomes.
For hospitals, the use of micro-3D printing for such patient-specific instruments will be crucial to their point-of-care capabilities. Indeed, the ability to adjust the shape of the retractor according to specific medical scans of the patient's diagnostics and the physician's requirements, are the game changers in this new approach to how tubular retractors are used. Adding the ability to bring lights & camera right at the bottom of the retractor (by creating tiny channels along the retractor through which fibre optics are threaded) are the ultimate improvement only enabled thanks to micro-AM’s ability to construct these channels inside the retractor’s thin walls.
“Leveraging micro-AM, we are able to add minute, integrated channels within the device, measuring just 300 microns in diameter, for fibre-optics to be threaded inside,” explains Synergy 3DMed CEO, Mickey Librus.
“Facilitating the addition of both lights and a surgical camera, this game-changing boost in usability takes the micro-3D printed instrument far beyond being a positioning tool and into a pivotal addition to surgery – and a critical piece of the puzzle that offers us huge potential in shaping patient outcomes in the future,” he adds.
Scaling down to elevate outcomes
As Librus explains, while fibre-optics may seem like a simple addition, the integration of lights and cameras within the retraction tool, rather than through external supplementary equipment, is transformative for the neurosurgical team.
“These additional capabilities increase visibility by better illuminating the surgical field; by bringing the light close-in to the cavernoma, surgeons are able to eliminate any shadows that might be present with traditional top-down lighting, providing an improved view of the cavernoma,” he says.
“Combining this with cameras enables the entire surgical team to visualise the process up-close, in real time, further equipping them to operate with enhanced clarity and precision. By providing a magnified view of the area with built-in cameras, the surgeons can achieve more accurate navigation and minimize trauma to surrounding tissues,” continues Librus.
Critically, the benefits of this advanced tooling also extend beyond the operating room. Arming the surgical team with tools that facilitate close-up video recording of the procedure opens up additional possibilities for post-operative surgical analysis and documentation. The added functionalities thereby not only improve outcomes for the individual cavernoma patient, but also support education and therefore boost patient outcomes more widely over the longer term.
Micro-3D printing a new future for cavernoma care
Although the development of this advanced, micro-3D printed retraction tool is still a relatively novel development for cavernoma treatment, its potential impact for future care is clear. Excitingly, however, the significance of this development also extends far beyond cavernomas, paving the way for a new era of more accurate and specific surgical tooling. The possibility of taking 3D printing to a micron level opens up an almost unimaginable field of new opportunities that improve hospitals’ point-of care facilities and elevate surgical devices with built-in supplementary functions. These will not only undoubtedly enhance surgical capabilities but transform patient outcomes across an array of medical fields, offering new hope for some of the most complex and traditionally hard-to-navigate operations. For now, however, it seems the future of cavernoma care is here – mightier and more promising than ever, thanks to micro-sized tools.