3D printed models help doctors prepare for fetal surgeries
3D printing technology helps doctors identify potential barriers and reduce the risk of surgery in babies with spina bifida.
How can a 3D printer help surgeons perform delicate surgery on a patient they’ve never met before, a patient who hasn’t even been born yet?
At Orlando Health Winnie Palmer Hospital for Women & Babies in Florida, a team uses a combination of MRI and ultrasound imaging as well as 3D printing technology that allows doctors to identify potential obstacles and reduce the risk of surgery on babies with spina bifida, said in a statement.
Spina bifida is a birth defect that occurs when the spinal cord does not close normally during development. The disease can lead to lifelong neurological damage, including the inability to walk.
“I am used to operating on patients that I know, or patients that I have met before, if you think about it, I am about to operate on a fetus in the womb. And I’ve never met this patient before, ”said neurosurgeon Samer K. Elbabaa. He is the director of the Orlando Health Arnold Palmer Hospital for Children Neurosurgery.
Fetal surgery typically looked at an ultrasound or MRI, and “imagine what this defect is going to be like once the uterus is opened and the baby’s back or the back of the fetus is exposed through the defect in the uterus.” , Elbabaa mentioned. Then the surgeons begin to perform surgery on a defect that they have never seen before until today.
Having the model printed in 3D helps to understand the anatomical aspects of the defect and to plan the surgical technique. Plus, it helps doctors talk to parents about the potential challenges of surgery.
“They can hold the model in their hands and understand exactly what the surgeon is about to do, what potential challenges the surgeon may face during the operation,” Elbabaa said.
Since the hospital began offering the program, doctors have performed some 25 surgeries.
Fetal surgery, which has been around for many years, may improve long-term outcomes for children with specific birth defects, such as spina bifida.
A study funded by the National Institutes of Health and published in 2011, Elbabaa said, showed that the benefits of fetal surgery on babies with spina bifida include improved leg function, giving them a better chance to walk independently; improve their cognitive function; and help reverse some of the anatomical changes in their brains by reducing the degree of fluid buildup in the brain – “or what we call hydrocephalus and the need for further surgery after birth.”
What does surgery look like? It is done before 26 weeks gestation.
“The baby is connected to the mother by the umbilical cord and the surgeon performs the repair on the back of the fetus while the baby is connected to the mother by the umbilical cord,” Elbabaa said.
Surgery should be done quickly and efficiently, as any potential problems can affect the health of both mother and baby.
Using the 3D models, the surgeon knows what the defect and the baby’s lower back will look like, what technology and techniques are needed for the operation, and it also helps parents understand the potential challenges, Elbabaa said.
“These mothers are so brave. They undergo two surgeries. A Caesarean section or a temporary Caesarean section for fetal surgery to do labor and the baby, then put the baby back in the womb, then continue the pregnancy and then deliver again, by caesarean section around 37 weeks, ”Elbabaa said.
Kristi King of OMPP contributed to this report.