Roy’s Story:

Nicklaus Children’s Hospitalutilizes 3D printing and othertechnologies to save a young
patient’s life
Case Study

Planning tumour surgery with 3D printing

23D printing the skull using the Stratasys J5 MediJet

At Nicklaus Children’s Hospital in Miami, theCardiovascular Surgery Advanced Projects
Laboratory (APL) uses a range of digital 3D
technologies, including Stratasys 3D printers, tovisualize anatomy and plan surgical proceduresfor pediatric patients. A previous case study
featured Nicklaus Children’s application of 3D
printing to help repair a child’s heart, showing
the great potential using of anatomical models
in clinical settings. The latest Nicklaus Children’s
success story involves planning a life-saving
operation for Roy, an 8-year-old boy with adifficult-to-treat tumour.
In Roy’s case, Nicklaus Children’s surgeons, aspart of a multidisciplinary team, had to plan fora very complicated and difficult case in which apotentially lethal cancer, an osteogenic sarcoma,
was situated in a region where surgeons typically
don’t operate. However, Roy’s case was anexcellent opportunity for Robert Hannan, MD, theDirector of APL, to realize the Laboratory’s goal
to “bring hope and the future to patients andfamilies over the course of a lifetime.”
Document
Case StudyTitle Here

2Jordan P. Steinberg, MD, Surgical Director of
the Craniofacial program, described how “a lotof the motivation behind the way in which weapproach this, is to figure out a way that wecould get to this (the sarcoma), but yet put thingsback together to allow for minimal disturbancein his appearance.” Help was obtained fromJohn Ragheb, MD, Director of the Department ofSurgery at the hospital, to help surgeons locate
the tumour, which sat underneath the brain andunder the eye in a difficult, but not impossible,
location to reach.
The team at APL assisted in preparing for thesurgery by using Synopsys Simpleware software
to import and segment imaging data of Roy’sskull, relevant anatomical features, and thetumour. The resulting segmented data was thenmanufactured using a Stratasys J5 MediJet™
printer into a diagnostic medical model*. For
Dr. Ragheb, “this model was really very helpful
for us to envision how to reach the tumour,”which was highlighted in pink. The tumour waseventually and successfully removed, mostly
through the child’s mouth, which enabled theteam to avoid a disfiguring scar. The techniqueinvolved making a skin incision behind the hairline
and opening a portion of the skull, then removing
a small section of cheek so the surgeons could
see the tumour directly from above.

3In addition to the 3D printed model, the data
was also imported to the Augmented Reality (AR)tool DICOM Director Intravision XR for viewing
through a Microsoft HoloLens 2, allowing Roy
and his family to virtually interact with the skull
and better understand the surgery. Accordingto Dr. Steinberg, “with these technologies
now, we’re able to really show them and topinpoint exactly what we’re doing, what are
the nearby structures that we are dealing with,
communicating the level of risk and benefit in away that we really simply could not do before.”

Case Study

For these breakthroughs in surgical planning, Dr.
Hannan has highlighted the importance of “ourcollaborators in industry – Stratasys, who’s been
supportive for almost 10 years, Simpleware,
SphereGen DICOM Director and Microsoft,” andthe continued ambition at Nicklaus to use thesetechnologies to help find solutions for cases likeRoy’s and other children.

This model was really very
helpful for us to envision
how to reach the tumour.”Dr. Ragheb, MD
Director of the Department of Surgery,
Nicklaus Children’s Hospital*Synopsys Simpleware software has FDA 510(k) clearance to go fromDICOM data to image processing and export of files for 3D printing
using Stratasys printers such as the J5 MediJet. Simpleware software
has been validated with Stratasys printers and materials for selectanatomies, and makes it straightforward for Stratasys users wanting touse diagnostic medical models from patient-specific images”

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