The Use of 3D Printing Technology in Advanced Pediatric Urologic Care

Figure 1A: Picture of 3D printed model showing a large left renal mass (black) and its relation to normal kidney, vasculature, and collecting system. Figure 1B: Interactive document that allows full rotation as well as addition/removal of all pertinent clinical structures in relation to the tumor. Figure 1C: Using both modalities, precise measurements can be made intraoperatively to ensure complete tumor resection while minimizing damage to adjacent normal kidney.

Reference: Long CJ, Mittal S, Kolon TF. Expanding the use of nephron-sparing surgery for Wilms tumor. J Natl Compr Canc Netw. 20;(5):540–546. 3D printing technology is revolutionizing the field of surgery by providing new possibilities for patient-specific treatment planning and surgical simulation. The Division of Urology at Children’s Hospital of Philadelphia, in conjunction with the Children’s Hospital Additive Manufacturing for Pediatrics (CHAMP) 3D lab, has been at the forefront of this innovation leading toward improving care for countless children.

In terms of treatment planning, 3D printing allows for the creation of detailed, anatomically accurate models of a patient’s specific condition, which can be used to plan and practice complex surgeries. Thomas F. Kolon, MD, a urologic oncology surgeon at CHOP, uses this technology to help patients with Wilms tumor and rhabdomyosarcoma. Wilms tumor affects 500 to 600 children a year and manifests with large, multi-focal, complex renal tumors. Using 3D printing technology (see Figure 1), Dr. Kolon was able to spearhead efforts to remove these tumors with precise margins while preserving normal kidney function.

In the previous era, primary treatment was radical kidney removal. But now, a nephron-sparing approach provides equivalent oncologic success while avoiding the need for renal replacement and/or dialysis. This can also help reduce the need for multiple surgeries and decrease the risk of complications.

3D models used to practice surgeries

Figure 2: 3D model of a female patient with complex anatomy including duplicated bladder, vagina, cervix, and uterus with cloacal anomaly fusing urologic, gynecologic, and colorectal structures Surgical simulation using this 3D printing technology is proving to be valuable. By printing realistic models of patient anatomy, our team can practice procedures in a safe and controlled environment, which can help to improve clinical skills, confidence, and patient outcomes. This is especially important for rare or complex conditions that may not be encountered frequently.

In addition to oncology, 3D printing technology can be used to treat patients with congenital malformations of pelvic anatomy. Treatment for patients born with rare disorders such as cloaca malformations, congenital adrenal hyperplasia, and many others, can have detailed 3D models created of their pelvic anatomy (see Figure 2). Our team uses these models during pre-surgical multidisciplinary conferences. This allows all surgical subspecialties to understand the spatial relationship between all anatomical structures and create a coordinated surgical plan.

Continuous improvement in imaging, materials

Despite our use of 3D printing technology for advanced pediatric urologic care, it’s worth noting that this is not yet widely available at many institutions. Our team of collaborators is constantly working toward improving our image acquisition, model creation, and materials utilized. We are motivated to continually improve when we see how this cutting- edge care leads to extraordinary outcomes for our patients.