3-D printing helped separate conjoined twins
For the first time, CT imaging and 3-D printing were used to plan the separation of conjoined twins, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
Specialists at Texas Children’s Hospital in Houston used CT imaging and 3-D printing for twins Knatalye Hope and Adeline Faith Mata, conjoined twins from Lubbock, Texas. Knatalye and Adeline were born on April 11, 2014, connected from the chest all the way down to the pelvis.
“This case was unique in the extent of fusion,” said the study’s lead author, Rajesh Krishnamurthy, M.D., chief of radiology research and cardiac imaging at Texas Children’s Hospital. “It was one of the most complex separations ever for conjoined twins.”
Dr. Krishnamurthy’s CT scans show that the twins’ hearts were in the same cavity but not fused. His team then translated the CT imaging results into a color-coded physical 3-D model with skeletal structures and supports made in hard plastic resin, and organs built from a rubber-like material.
The livers were printed as separate pieces of the transparent resin, with major blood vessels depicted in white for better visibility. The models were designed so that they could be assembled together or separated during the surgical planning process. The surgical team used the models during the exhaustive preparation process leading up to the surgery.
On February 17, a little more than 10 months after they were born, the Mata twins underwent surgical separation by a team of more than 26 clinicians, including 12 surgeons, six anesthesiologists and eight surgical nurses. The official separation took place approximately 18 hours into the 26-hour surgery.
The 3-D models proved to be an excellent source of information, as there were no major discrepancies between the models and the twins’ actual anatomy.
“The surgeons found the landmarks for the liver, hearts and pelvic organs just as we had described,” Dr. Krishnamurthy said. “The concordance was almost perfect.”
Dr. Krishnamurthy expects the combination of volumetric CT, 3-D modeling, and 3-D printing to become a standard part of preparation for surgical separation of conjoined twins, although barriers remain to its adoption.
“The 3-D printing technology has advanced quite a bit, and the costs are declining. What’s limiting it is a lack of reimbursement for these services,” he said. “The procedure is not currently recognized by insurance companies, so right now hospitals are supporting the costs.”
Besides assisting clinicians prepare for surgery, the 3-D model also served another important function: helping the twins’ parents, Elysse and John Eric Mata, understand the process.
“When I showed the mother the model and explained the procedure, she held my hand and thanked me,” Dr. Krishnamurthy recalled. “They said, ‘For the first time, we understand what is going to happen with our babies.'”
Knatalye Hope returned home in May 2015 and her sister Adeline Faith came home a month later. They are both doing well and have a Facebook page, “Helping Faith & Hope Mata,” with updates on their progress.
Category: Features, Technology & Devices
