Monday, 14 June 2021

Aortic surgery: 3D printing allows for greater precision

UniTrento and the Vascular Surgery Division of Santa Chiara Hospital join forces for safer, faster and more accurate surgeries

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An aortic aneurysm is a swelling that occurs in a portion of the aorta, the major blood vessel in the human body. It is a very serious condition and can lead to death. Aortic aneurysms need to be repaired quickly, and are often treated with the insertion of a stent or a custom-made prosthesis. Every patient, however, is unique and has a unique anatomy, but now new technologies are helping surgeons train for medical procedures. At the request of the Ultrasound Lab Trento (ULTRa) of UniTrento at the Department of Information Engineering and Computer Science (Disi), the ProM Facility laboratory of Trentino Sviluppo at Polo Meccatronica has created an aorta model using an advanced 3D printer. The model is a reproduction of the aorta of a patient who is waiting for surgery. It was commissioned on the basis of information and data obtained from the CT scan provided by the Vascular Surgery Division of Santa Chiara Hospital in Trento.

Thanks to this model, the surgeons of the Division led by Dr. Stefano Bonvini were able to examine the aorta before operating on the patient and in complete safety, and to choose the most effective procedure among the various possible solutions, planning the procedure in great detail. 

Although this is not the first ever 3D print of an aorta, the model created by the University of Trento has some characteristics that make it very interesting for surgical teams: it can be manufactured quickly, and the material used is radiopaque and transparent. The time saved benefits the patient's health.

The engineers of the ProM Facility made a model of the thoracic cavity, and used it to focus on the portion of the aorta that needed treatment to obtain a printable 3D file. They processed the file using the most advanced software tools to have total control over the model, and this allowed them to build an exact reproduction of the internal and external anatomy of the aorta.

"Almost all vascular surgery procedures today follow a minimally invasive approach through two small incisions in the groin, which are used to insert prostheses in the patient which are then opened under radioscopic guide", says Stefano Bonvini, director of the Vascular Surgery Division of Santa Chiara hospital. "These are very complex procedures that must be performed with great precision. We must be sure that the stent graft opens in the precise point because a few millimeters can change the outcome of the procedure. In some cases, the anatomy of a patient does not allow us to predict the outcome of the procedure. In these cases, the opportunity to train for the surgery is of great help and increases the chances of success of the surgery, because we can evaluate the feasibility of the procedure, consider different variables and reduce the necessary steps and therefore the time and costs of the procedure".

"This 1 to 1 model will also be useful to train new doctors, because it will allow them to learn surgical techniques on a complex network of vessels", explains Libertario Demi, professor of Electronic and Computer Bioengineering and head of the Ultrasound Lab Trento (ULTRa) at UniTrento. "We are now working to integrate the data obtained by CT scan with ultrasound data in order to provide a live guide to help surgeons during the procedure. The idea to use new technologies to solve these complex problems comes from the intense collaboration between Department of Information Engineering and Computer Science and the Provincial Health Care Service. An important part of this success is the result of the opening of new laboratories at Disi, which provide state-of-the-art equipment in the field of augmented reality, ultrasound technology, robotics and 3D printers". 

On the collaboration with the University, Bonvini adds: "Vascular surgery, which focuses on simple structures, provides the ideal provides testing ground for collaborations with various areas of engineering. In recent years there has been a strong push to improve and innovate medical technologies, and we can do that in Trento too. There is a desire to apply different skills to new areas of research". 
This one is in fact the latest in a series of recent collaborations between the Provincial Health Care Service and the University of Trento involving researchers from the Department of Information Engineering and Computer Science. One in particular focused on lung ultrasound to diagnose Covid-19.