Blog - Page 2 of 3 - 3D-Lab+ 3DLab-LUMC

Design & Prototyping

The 3D-Lab+ works closely together with Design & Prototyping. Design & Prototyping is the innovation hub of the LUMC for the development of new medical devices. Translation of bench-to-bedside plays a central role, in which groundbreaking research and innovative ideas get the chance to have a lasting impact on healthcare within and outside the LUMC. Using a multidisciplinary approach, in-depth knowledge of healthcare challenges, legislation, materials and design are combined in innovation that meet the needs of healthcare.

In addition, Design & Prototyping can also help out in regular healthcare, where specific products or modifications are needed for the care of atypical patients that are encountered in academic hospitals like the LUMC.

Website: https://prototyping-lumc.nl/

Allograft Reconstruction

Biological reconstruction is still the preferred method to reconstruct bone defects caused by bone tumor resection in young patients. The removal of the tumor including a required margin is 3D virtually planned in which the information of different imaging modalities, such as CT, MRI and PET, is combined. The surgical resection plan is translated to the operation room by designing patient specific surgical guides that uniquely fit the patient anatomy and indicate the virtually planned resection. To validate the use of these guides surgical navigation is used during surgery. Data from a digital bonebank, that contains 3D models of all available allograft bones, is used to select the best matching allograft bone and to design resection guides for accurate allograft preparation during surgery.

Proximal Femur Osteotomy

Complex proximal femur deformities can result after (pathological) fracture mal-union. Deformities in this location can be very invalidating due to the relation to the hip joint and negative effect on leg-length, rotations and limb biomechanics. Proximal femoral deformities can be treated by corrective osteotomies and are preferably secured with a compressive blade plate. In complex cases, careful surgery planning in 3D is necessary to achieve the desired correction in multiple planes. A key part of this procedure is to position the blade of the plate in the femoral head and neck correctly. First, the desired post-operative correction and blade position is virtually planned using 3D models generated from 3D CT scans. Second, to translate the virtual planning to the patient in the operating room, patient specific guides are designed, 3D printed and sterilized for intra-operative use. These custom surgical guides, that precisely fit the unique bony shape of the patient, indicate the desired osteotomy location, osteotomy planes and blade direction and facilitate the execution surgical procedure with high accuracy.

Anatomical Models

For surgical preparation and shared decision making between multidisciplinary surgical teams, patient specific, multi colored 3D printed anatomical models can be very useful. 3D models of (bony) pathology also have a high educational value for surgeons in training. Also paramount is the use of 3D printed anatomical models for patient insight into their disease and shared decision making between surgeon and patient.

Surgical Instrument Tracking

Decision-making and dexterity, features that become increasingly relevant in (robot-assisted) minimally invasive surgery, are considered key components in improving the surgical accuracy. In this project, motion tracking is used to study the added benefit of a novel tethered gamma detector.

https://doi.org/10.1007/s00259-021-05387-z

Optical navigation of DROP-IN probes

With translation of the DROP-IN gamma probe, radioguidance has advanced into laparoscopic robot-assisted surgery. Since it is not always trivial to locate preoperatively marked lesions during surgery, especially when using tumor-targeted tracers such as 99mTc-PSMA I&S, surgical navigation can further enhance the translation between planning at the dept. of nuclear medicine and the actual treatment in the operating room. In this project, a method is generated to navigate a DROP-IN probe during surgery using optical (fluorescence) techniques.

https://doi.org/10.2967/jnumed.120.259796

Freehand Fluorescence tomography for image-guided surgery

Within image-guided surgery, ‘hybrid’ guidance technologies have been used to integrate the complementary features of radioactive guidance and fluorescence guidance. In this project, a novel freehand fluorescence imaging and navigation approach was generated to complement existing freehand SPECT modalities in a hybrid setup. Combined the freehand technologies render a unique hybrid imaging and navigation modality that exploits the strengths of the individual technologies.

https://doi.org/10.1109/TMI.2019.2924254

DROP-IN gamma probe

In oncology, radical surgical resection of cancerous tissue is one of the most efficient forms of treatment. For accurate lesion localization during surgery, image-guided surgery methods play an ever-increasing role. Such methods predominantly rely on radio- and/or fluorescent-tracers to ‘illuminate’ targeted tissues, e.g., sentinel lymph nodes (ICG-99mTc-nanocolloid) and PSMA-positive tumor (99mTc-PSMA I&S). To optimally integrate radioguidance during robot-assisted surgery, a tethered and miniaturized gamma detector for wristed robotic instruments, the so-called DROP-IN gamma-ray-detection probe was engineered. This has resulted in two commercial products that are now CE-marked for routine clinical use (Crystal Photonics GmbH and LightPoint Medical). In one of our most recent clinical studies on this topic, the DROP-IN proved to be superior to the use of fluorescence guidance and rigid laparoscopic gamma probes.

https://doi.org/10.1016/j.eururo.2020.10.031.

Trauma

After trauma a part of the skull might be damaged or lost. A reconstruction of the skull can be performed using patient specific implants. The implants are designed to exactly fit the defect and restore the patient anatomy. Reconstruction includes the skull bone, but can also incorporate surrounding structures such as the orbital roof, orbital wall, orbital rim or zygoma. The patient specific 3D virtually designed implants enables us to perform reconstructions that may have not been possible using conventional reconstruction methods.

Skull reconstruction with patient specific implant

Oncology

When a tumor invades the skull bone and surgical removal is indicated, the procedure is 3D virtually planned. The removal of the tumor including a required margin is 3D virtually planned combining information from different imaging modalities, such as CT and MRI. The surgical resection planning is translated to the operation room by designing patient specific surgical guides that uniquely fit the patient anatomy and indicate the virtually planned resection during surgery. Because the use of a surgical cutting guide creates a predictable bone defect, a patient specific skull implant can be designed to accurately reconstruct the bone defect.