3D Printing of Surgical Instruments for Children: Testing the Novel Concept

Abstract

BACKGROUNDThree-dimensional (3D) printing is currently being explored in various medical fields with promising results, and customized surgical instrument prototyping and production seems to be one of the promising approaches, particularly in pediatric surgery. This study aimed to test the possibility of desktop 3D printing of surgical instruments for use in pediatric surgery. MATERIAL and METHODSRoux retractor and infant laparoscopic trocar were designed using Solidworks 3D CAD software (Dassault Systemes, FR). Mechanical durability simulation tests were performed using Solidworks Simulation software. The instruments were printed in Ultimaker 2+ Extended 3D printer (Ultimaker, NL) using 2.85-mm polylactic acid filaments. RESULTSRoux retractor was designed in 15 min and printed in 90 min. Laparoscopic trocar was designed in 2 h and printed in 2 h. Application of 5-kilogram force (kgf) resulted only in 0.84-mm displacement in infant laparoscopic trocar. The 5 kgf applied to the Roux retractor's curved face caused 9.22-mm displacement. The laparoscopic trocars weighed 7.40±0.07 g, and Roux retractors weighed 12.50±0.04 g. The interior chamber of the 3D-printed laparoscopic trocars withstood a mean of 10±1.5 mmHg pressure without any obvious air leakage. Poststerilization culture results of all prototypes were proven to be sterile. CONCLUSION3D printing of surgical instruments is a promising field in pediatric surgery as it offers a great versatility regarding both design and production.

3D printed cannulas for use in laparoscopic surgery in feline patients: A cadaveric study and case series

“…This one time cost is less expensive than many laparoscopic instruments and this machine can be used for other purposes as previously described. Our data confirmed the results from previous report that sterilization with hydrogen peroxide sterilizer was effective before use of the cannulas, but studies have determined plasma and steam sterilization to also be effective 27,43 …”

“…While there have been many improvements to laparoscopic instrumentation to allow for better approaches to smaller patients including 3 mm telescopes and instrumentation, needle‐scopes, and varying needle‐related grasping devices, continued expansion into new possibilities for devices should be encouraged. Mammadov et al investigated the creation of 3D printed cannulas and a retractor for use in laparoscopic pediatric surgery and found the implants durable and sterilizable 27 . The authors in the two studies assessing 3D printed cannulas also used the original silicon leaflet valves from the inspiration trocar as we did in this study 27,34 .…”

“…Mammadov et al investigated the creation of 3D printed cannulas and a retractor for use in laparoscopic pediatric surgery and found the implants durable and sterilizable. 27 The authors in the two studies assessing 3D printed cannulas also used the original silicon leaflet valves from the inspiration trocar as we did in this study. 27,34 Both studies demonstrated adequate seal with this configuration which we confirmed.…”

“…In human dentistry, 3D printing has been employed for over three decades and uses include manufacture of patient specific surgical drill guides, temporary and permanent crowns and bridges, orthodontic appliances, implants, and mouthguards for drug delivery 25,26 . Recently a group of pediatric surgeons created a Roux retractor and infant laparoscopic trocar using 3D printing technology and found the instruments to be sterilizable and able to withstand the force of use and pressure when tested 27 . The authors concluded that this technique was promising and could allow for increased versatility for smaller patients.…”

“…25,26 Recently a group of pediatric surgeons created a Roux retractor and infant laparoscopic trocar using 3D printing technology and found the instruments to be sterilizable and able to withstand the force of use and pressure when tested. 27 The authors concluded that this technique was promising and could allow for increased versatility for smaller patients. 3D printing has been used in veterinary surgery as well, most commonly to create anatomic models of angular limb deformities, specific cutting guides, and implants for bony defects.…”