Flatten theLearning Curve
3D printing changes the way medical
students learn.

Carefully cutting open the cadaver’s nose, theexperienced surgeon points to the major vesselsthat had been invaded and lectures on theoperation procedures while a group of medical
students watch intently. They all wish they could
get enough practice on the body before they enter
the real world and operate on living patients. But
cadavers are expensive, and pathologies cannot
be ordered.

Case Study

But things don’t get much better when they start topractice on their own. Every patient has a uniquepathology, and for surgical planning, surgeons
only have the MRI/CAT data on the screen. In thewords of Mark Roe, founder and CEO of Fusetec,“Football players train on weekdays and play on
the weekend. Surgeons play and play and play.”

3D printing has reallychanged the way in which
we train our surgeons.”
Prof. Peter John-Wormald

Chair of the Department of Otolaryngology
Head and Neck Surgery at Adelaide andFlinders Universities

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Reproduce theIrreproducible
Nestled in Adelaide, a coastal city in Southern
Australia, Fusetec is the first commercial
anatomical soft tissue reproduction company in thecountry. Years ago, Mark Roe became fascinatedby 3D printing technologies and wanted to find aproblem to the solution. Realizing that a numberof American hospitals and medical schools werealready making use of Stratasys® technology, heknocked on the door of Stratasys in Minnesota
and walked straight in.

Document
Case
StudyTitle Here“3D printed models completely change how
medical students learn,” said Roe, “and this is why
we have developed a variety of products to help
them flatten the learning curve.” Surgical trainingis all about apprenticeship, and medical students
have been traditionally trained on cadavers.
However, there are several important issues withthis method.

accuracy and its materials, including the newly
released TissueMatrix™, BoneMatrix™ andGelMatrix™, offer a gamut of Shore hardness, from0 to 100. Consequently, these models can replicate
the feel, responsiveness and biomechanics of actual
human anatomy — pixel by pixel.
“It’s not easy to print human anatomy, but if one man
can do it, so can another,” smiled Roe. First, the MRIor CT scans of the living patients are acquired. Then,they are segmented layer by layer with software.
The engineers transfer the data to a CAT program tofix potential issues and then use GrabCad Print™ toselect the appropriate texture, material and color.
“Hit the print button, and the magic happens!”

Cadavers are very expensive to acquire, transport,store, maintain and dispose later. They are alsorare and difficult to obtain in developing countries.
This means that students cannot get enoughhands-on training; most of the time, they are
passive observers. Practice makes perfect, butwhat if you don’t get to practice? Furthermore,
pathologies cannot be ordered — you get what
you get. As a result, students have towait a long time before they have a chance topractice on a specialized pathologies. From ateacher’s perspective, this is highly troublesome,because the learning curve depends too much on
the limited availability of cadavers, with pathologythat cannot be controlled. In general, this type ofunstructured, if not opportunistic, education cannot
provide the rigorous training that surgical students(and their future patients) deserve.
With the Stratasys J750™ Digital Anatomy™ 3Dprinter, Fusetec is manufacturing a wide varietyof medical models that solve all these problems.
The J750 Digital Anatomy printer has a 0.014 mm

Dr. Sammuel Sobey practicing on the 3D printed model.

3 3A Real GameChanger
Prof. Peter John-Wormald, Chair of theDepartment of Otolaryngology Head and Neck
Surgery at Adelaide and Flinders Universities,
is busy operating on a 3D printed sinus modelwith juvenile nasopharyngeal angiofibroma (JNA),
a rare benign tumor arising predominantly inthe nasopharynx of adolescent males. JNA isextremely difficult to remove, as it invades the vital
structures like nasal cavities in sinus. The multilayer material used to print this model faithfully
replicated the pathology in terms of color andtexture. This allowed Prof. PJ (the name he goes by)
to explain each step to the students and enabled
them to try the procedure themselves later on.

Document
Case
StudyTitle Here“3D printing has really changed the way in which
we train our surgeons,” commented Prof. PJ.
The pathology on cadavers could not be predicted,
hence the limited and uncontrolled experience.
Yet with 3D printing appearing on the scene,surgeons can now order pathologies in large
quantities. Not only can students get morepractice, they could also choose different levels ofcomplexity and difficulty — which means that they
can tackle challenging conditions step by step.
Furthermore, because all students get exactly thesame models, it is much easier for the teacher tomonitor their progress.
Dr. Sammuel Sobey, who is learning with Prof. PJ,
completely agrees. “With 3D printed models, I canoperate on the same conditions again and again,
until I perfect my skills and become confident in myability. I also get the chance to try rare cases thatmight otherwise only present at certain hospitals
once or twice per year; in this way, I won’t be
thrown a curve ball when I go from school to theoperation room.” In addition, Dr. Sobey stated thathe could operate on specific pathologies in thesemodels, while these pathologies may not bepresent in cadavers.
The 3D printed models are also very helpful for
surgical planning, according to Prof. PJ. Everyyear, 313 million surgical procedures are being
performed, and as many as 4.2 million patientsdie within 30 days after the surgeries. It has been
said that going through a surgery could be as
dangerous as bungee jumping.
While the surgeons used to rely on CT scans
for surgical planning, now these scans aretransformed into patient-specific models that they
can actually hold in their hands. The surgical plans,
which used to exist only in the surgeons’ heads,
can now be verified during the mock operation —and the risks are minimized. The detailed texture ofeach layer of the head — including the skin, bone,spinal fluid and brain tissue — has been developed
to a point where it will bleed once under the knife.

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What theFuture Holds
Prof. PJ has already run a course in Montreal andAdelaide, in which 40 surgeons participated. At
their respective stations, those surgeons operated
on exactly the same models based on real-life
conditions under supervision. After they completed
the course, they could watch the actual real-life
video and find out what they had done wrong andlearn how they could improve. This course hasreceived marvelous feedback.
“The future for 3D printing in surgical training
is infinite: where we can go, what we can do,”commented Prof. PJ, who hopes to run similarcourses in places where students and surgeonscannot practice on cadavers. More materials arestill needed though. For instance, he envisions
to have blood flowing in the vessels in future 3D
printed models.
At this moment, Fusetec is providing brain models
and frontal sinus models, but Roe is determined to
expand the tech’s capabilities into other anatomical
areas, including the ear, thorax, eye and heart.
Fusetec is also developing models for nurses who
rely on live patients to practice skills, such as wrist
cannula insertion. Each model costs only a fractionof the price of a cadaver. Roe concluded, “I am
impressed by Stratasys’ commitment to R&D. I
surely can’t do this without Stratasys technologies.”

Hyperrealistic models printed by Fusetec.

Recording the operation on 3D printed models for students and surgeons.

Fusetec, the first commercial anatomical soft tissue reproduction
company in Australia.

Stratasys Headquarters

Case Study

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