It’s amazing to think that in many child transplant operations, surgeons don’t know whether an operation can go ahead until their young patient is on the operating table.
That means the donor – usually a parent – will be in the next operating theatre with surgical staff on stand-by to remove the donor organ if they get the go-ahead.
For Pankaj Chandak, transplant registrar at London’s Guy’s and St Thomas’s Hospital, the uncertainty for families and the surgical time wasted were issues that needed to be solved, and he did that using technology.
Chandak became the first in the world to use 3D printing to plan for a paediatric kidney transplant in November 2015.
He pioneered the method after winning a hospital charity-organised competition to come up with an innovative use for its 3D printer just three months earlier.
Using the printer, Chandak and physics colleague Nick Byrne produced models of two-year-old Lucy Boucher’s abdomen and the kidney she would receive from her father, Chris.
It allowed them to assess whether the organ would physically fit and plan the logistics of the complex procedure, which would normally be done using scans.
Pankaj Chandak, who helped initiate our use of #3Dprinting to support complex surgery. #RoboticSurgery #WRSE24 pic.twitter.com/mQH1hSOuBr
— Guy’s and St Thomas’ (@GSTTnhs) May 23, 2016
Since then four other operations have been carried out using 3D printing in the planning stage, with the method focused on those patients weighing less than 20kg and with significant vascular abnormalities or previous surgery that may complicate the transplant.
“One of the problems we have with child transplant patients is fitting an adult sized kidney into a small child,” Chandak says.
“Previous operations and the resulting scar tissue left behind can distort the anatomy, which can lead to a difficult transplant.
“Using 3D printing gives us that additional layer of planning that reduces any anxiety or challenge in the operative process.
“We’re taking increasingly complex cases now for children who would have perhaps been deemed untransplantable before.”
Chandak and Byrne are developing the technology all the time to improve the technique, which costs £1,000 for two models.
While the method is still fairly new, that hasn’t stopped it gaining recognition and it has already won the prestigious Cutlers’ Surgical Prize and an award from the Royal Society of Medicine.
It has also been used by the hospital in a first for the NHS when a surgeon 3D-printed a cancerous prostate to plan robotic surgery in May.
Next Chandak says the method could extend to all abdominal surgery and be used to treat complex cancers.
“The technology is transferable and that’s the greatest value,” he says.
“My vision is to set up some sort of abdominal 3D printing referral centre nationally in a few years’ time, where other hospitals can use our expertise and our technology.
“As well as the potential for surgery we can build up a teaching archive using the models, which will be a really valuable resource.”
BusinessCloud has reported how wearable devices could save the NHS billions every year and Dr Jack Kriendler is fighting cancer with technology.