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3D Unit

The 3D Unit consolidates the planning and simulation of complex surgery and provides a service to all paediatric specialities

In 2013, the SJD Barcelona Children’s Hospital planned the first-ever complex oncological surgical procedure using three-dimensional printing for a paediatric patient. Since then, the number of surgical specialities that use this technology to plan or guide surgery has multiplied. Currently, more than 6 surgical specialities at the centre use these techniques to treat patients.

Mixed model and interdisciplinary study of cases

The staff members who specialise in 3D planning and printing work under a mixed work model, in a specific unit in the same Hospital where the virtual simulations and printing are performed. We also have an external team of professionals and providers that collaborate in the more complex cases. This model allows a more efficient and effective service to be given to the centre’s professionals.

The transversal and multidisciplinary team is coordinated by the Innovation Department, and is comprised of engineering experts, members of the Diagnostic Imaging Service, the Surgery Service, the Finance Department and the Darwin Advanced Simulation Programme team. The Unit members  study each case and assess the possibilities and clinical benefits of applying 3D techniques to the patient.

Clinical applications of 3D technology

Virtual surgical planning

The planning of surgeries allows us to simulate and test the surgical approach, which is personalised and adapts to each individual patient. It achieves better outcomes and reduces surgery time.

It is not covered by public health

Cutting and positioning guides

In Maxillofacial or Orthopaedic and Traumatology Surgery, custom-made parts can be designed to guide the cuts and movements planned for surgery. This facilitates surgical precision and improves outcomes and times.

It is not covered by public health

Anatomical models printing

Life-size 3D modelling of tumours, organs or bones for use in medical training and research. The parts can be used by the surgeons to prepare surgery and to explain the condition and the procedure to the patients and their relatives.

It is not covered by public health

Orthoses and prostheses prototyping

3D manufacturing enables us to create prostheses for children with mobility issues and amputations. The orthoses are normally used for rehabilitation and musculoskeletal correction.

It is not covered by public health

Teaching and simulation

3D models are already being applied in the Teaching Department of the SJD Barcelona Children’s Hospital to simulate cases of tracheal malformation or maxillofacial surgery.

It is not covered by public health

Advantages of 3D planning and printing

Safety

Reduction in anaesthesia and ischaemia time and fewer complications with the help of simulations and surgical rehearsals. Surgical rehearsals allow for a very high degree of precision and can pre-empt possible difficulties in the operating theatre. The Maxillofacial Surgery team has performed 25 mandibular distractions; the Oncological Surgery team has worked on 6 cases of neuroblastoma and the Traumatology and Orthopaedics team reconstructed the pelvis of a patient with Ewing’s sarcoma.

Efficiency and efficacy

Planning reduces surgery time, thus enabling faster patient recovery and reducing resource use and costs. In cases such as hip surgery with autologous fibular grafting, surgery time is reduced by up to 40%. This reduction in the required surgical time has also been demonstrated in maxillofacial and oncological surgery.

Outcomes and quality

Improved precision and outcomes

The high-precision approach makes it possible to achieve the planned outcome in practically all cases, while also reducing reintervention rates.

Improving experience

This technology helps patients and families to have a better understanding of the surgical procedure for treating the disease.

It facilitates clinical learning

Application in medical resident training. Practice in mandibular distraction techniques in which 3D helps to protocolise the surgery.

3D unit figures

Surgeries planned using 3D
46
during 2017
Orthognathic surgery
30
of the total
Reduction of up to
40%
of surgical time in certain cases

Expert 3D. Transversal Programme in Medical Image Postprocess, Training Professionals: 3D Printing to Research.

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