The Future of Surgical 3D webinar shone a spotlight on the transformative potential of digital 3D technology this week, highlighting its potential for personalised surgery.
A panel of experts delved into the latest cutting-edge developments accessible to surgeons worldwide.
Delegates from across the globe joined the free-to-attend event to explore how advancements in 3D technology are revolutionising surgical procedures and enhancing patient outcomes.
Hosted by Surgery International in collaboration with The Confederation of British Surgery, AV Medical Events and Insight Surgery, this was the latest in the website’s Talk Surgery educational series. It covered many vital points that highlighted 3D’s revolutionary advantages.
Hosted by Shafi Ahmed, consultant colorectal surgeon and medical director of Surgery International, the panel included:
- Jonathan Perera, consultant orthopaedic oncology and joint reconstruction surgeon at the Royal National Orthopaedic Hospital, whose involvement in multidisciplinary cancer care teams underscores his comprehensive expertise.
- Professor Puneet Monga, a consultant orthopaedic shoulder surgeon at Wrightington Hospital, a specialist referral centre for orthopaedic problems. He works with specialist musculoskeletal radiologists and has access to the most up-to-date scanning facilities, such as 3T MRI scanners, upright open MR scans for claustrophobic patients, CT scans and nuclear scanning.
- Henry Pinchbeck, CEO of Insight Surgery, has extensive experience in the personalised surgery market, focusing on developments in the UK and US. His background as a scientist, businessman and UK-qualified lawyer positions him as a critical figure in the industry.
- Firoza Kothari, co-founder and CTO of Anatomiz3D Medtech and a pioneer in clinical personalisation and education since 2015, whose expertise in converting 2D DICOM images into 3D-printed anatomical replicas and medical devices has been instrumental in advancing this field in India.
Shafi Ahmed welcomed the panel, asking them: ‘If you go back a decade ago, 3D printing offered so much hope in terms of planning surgery for training purposes, also to be used in prosthetics, et cetera, to democratise healthcare across the world. We watched the whole platform and the technology over the last 10 years, but has it fulfilled its promise?’
Jonathan Perera started by explaining the significant advantages of 3D printing, particularly for the complex and demanding surgeries he performs.
‘We considered using guides to alleviate some of the cognitive load involved in these intricate procedures. These guides can significantly aid in preoperative planning, especially for the bony segments of the resection and the vascular components. By incorporating the vascular and bony elements into a single model, we can better visualise our usual access points.’
What 3D printing offers over traditional 3D reconstructions is a tangible model to hold and reference, he maintained.
‘We typically use a pelvis model that can be either smaller or the exact size of the area we’re operating on. This allows us to see the precise angles needed for surgery in regions where anatomical landmarks are absent or disrupted due to previous surgeries or tumours.’
Additionally, the fast turnaround time is crucial – from a referral on a Friday to seeing the patient on the following Monday, he had the 3D model printed that week, allowing him and his team to plan and perform the surgery by the following Monday. This, he suggested, demonstrates the efficiency and practicality of 3D printing in surgical planning.
Professor Puneet Monga also acknowledged that reconstructed segments enhance reliability but emphasised that Insight Surgery has advanced this concept significantly.
‘We can now send or import scans from other institutions, allowing us to produce these prints. This capability enabled us to quickly progress to developing 3D-printed guides for deformities. Insight Surgery’s engineers then created a negative print of the deformity, forming a channel to guide the wire, which elevated the precision of our joint reconstruction procedures. This was just the beginning.’
He also shared his experience with 3D-printed implants, which, he said, has taken the technology to a new and exciting level.
Shafi noted that if 3D printing is more accurate than a CTMR reconstruction, this clearly offers an advantage.
Henry Pinchbeck, CEO of Insight Surgery, is well-placed to offer a business perspective on the challenges of transitioning technologies from the research stage into clinical practice.
He explained that one of the significant overarching problems that every company in this market faces is the lack of a clear and comprehensive term for this entire set of technologies, with ‘3D’ terminology diminishing their significance.
‘We’re currently focused on the 3D printer, which only produces the final product. The real work, the technological “grunt work”, happens much earlier in the process – during the segmentation, design and scan merging stages. These are the crucial components. Therefore, calling it something related to 3D slightly undervalues it.
I believe we should call this “personalised surgery” because that’s what we’re offering surgeons: a tailored surgical approach.’
He hopes that a shift in terminology might lead to greater appreciation for the entire process.
‘While the 3D printer is essential, it comes at the end of the process. By reframing our focus from the machine to the process and technology, I believe we can advance much further, much faster,’ he said.
Firoza Kothari also shared her journey, which began nine years ago when the 3D printing industry in India was in its infancy, and there was little awareness about the technology.
She explained that the focus initially was on creating general awareness and addressing fundamental needs, such as soft tissue modelling. The first significant project was a complex paediatric heart model, which helped build confidence and credibility among doctors through word-of-mouth.
Over time, it became clear that 3D printing’s value lay in its application in solving specific surgical problems. The focus shifted to designing customised guides and implants, collaborating closely with surgeons. This collaboration led to the development of over 100 specialised protocols.
Significant growth occurred two to three years ago when hospitals began recognising the benefits and collaborating directly. This led to establishing micro labs within hospitals, offering quick turnaround times for surgical needs. She believes the industry has matured, and its applications are now well-understood.
The panel agreed that persuading hospitals to invest and finance is a common challenge worldwide, and surgeons are expected to work hard to address it.
Jonathan shared that his hospital has a research committee to approve and oversee new initiatives. These initiatives often start with small pilot trials to gather data and demonstrate benefits, such as reducing stress on surgeons during complex procedures like hip replacements.
Puneet emphasised the importance of clinical precision and started with research projects to gain hospital support. By presenting 3D-printed models to non-clinical managers, they effectively demonstrate the technology’s value. This approach, coupled with tackling highly challenging cases, has facilitated the adoption of personalised surgical solutions.
The panel discussed the broader implications and future potential of 3D printing in surgery, such as its capacity to provide precise, patient-specific implants and surgical guides. As the technology becomes more affordable and widespread, these advancements are expected to become standard practice.
Challenges include achieving cost parity with traditional implants and navigating different healthcare systems, such as the US’s insurance-based model vs public healthcare in countries like Canada.
However, the panellists were optimistic about the future of 3D printing in surgery. They envision a time when personalised implants and guides are commonplace, significantly improving surgical outcomes and efficiency. They welcome ongoing innovation, automation and broader acceptance as key to this transformation.
To watch Future of Surgical 3D in full and for free, click here.
