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 3D Systems
Helps Walter Reed
Army Medical Center Rebuild Lives
Although Walter Reed Army Medical Center isn’t on the front
lines, the hospital is not far removed from the action. The mission of
Walter Reed is to provide advanced and sub-specialty health care and
services to soldiers, their families, and a large community of military
retirees.
Through its 60 clinics, Walter Reed provides patient care, medical education
and training, medical research, and combat medical readiness. An important
function of the Medical Center is to treat Army and other military personnel
following surgical, accidental, or combat trauma.
To support effective treatment interventions, the Walter Reed 3D Medical
Applications Center plays a vital role. The Center provides 3-D models
for pre-surgical and post-surgical planning, as well as for patient and
provider education. For that work, the Center
uses the SLA® 7000 (stereolithography) system from 3D Systems (Valencia,
California, USA). The SLA 7000 system is constantly in use, helping surgeons
rebuild shattered bodies and lives.
This support provided by the Center
extends throughout the United States military. Because it is the only facility
with a reasonable turnaround time today in building 3-D anatomical models,
the Center supports all service branches.
Track Record, Speed, and Consistency
Some years ago, surgeons at Walter Reed began to look into rapid prototyping
for pre-surgical planning. Thanks to computed tomography (CT) and magnetic
resonance imaging (MRI), the Army surgeons had very accurate two-dimensional
images of their patients. These imaging technologies revealed the location
of bones and tissues through a series of single, isolated snapshots, instead
of using an actual three-dimensional volume reconstruction. Whereas the
CT and MRI images had to be examined one cross-section at a time for accurate
patient diagnosis, the 3-D stereolithography technology allows these images
to be converted to a 3-D model so that physicians can actually hold the information
and examine all of the data at one time.
To create these prototypes, Walter Reed surgeons needed a rapid prototyping
tool. In 2001, the Medical Center chose a 3D Systems SLA 7000 system. This
device has a low-vibration optical system, dual-spot laser technology,
and high throughput. The build material used is translucent or transparent,
making it possible for surgeons to see through a model. Also, 3D Systems
is a company
with a long track record in the stereolithography arena.
Today the 3D Medical Applications Center produces many models that are
used by both healthcare providers and patients. The models allow for more
rapid and accurate diagnoses, more effective treatment planning, better
informed patients, reduced time and costs related to the operating room
and anesthesia, reduced need for follow-up surgeries, and better education
and training of healthcare providers.
The 3-D models are used for pre-operative planning and reconstruction,
such as mock-ups of shoulders, pelvises, femurs, and facial bones. While
originally intended primarily for other uses, the system has been pressed
into service to help with the cranial and facial reconstruction that
military personnel may require after combat. The machine runs between
six and nine full models at a time.
Shorter
Surgeries to Reduce Risk and Cost
In the Center’s rapid prototyping operations, data is transmitted
in raw CT form, and then third-party software combines the 2-D images
into an accurate 3-D rendering. Working with that image, Center personnel
apply a filter to highlight desired features, such as bone.
With the items of interest selected, the staff then submits the information
to the SLA 7000 system. The machine creates a model, which can be multicolored
to further highlight different regions. This patient-specific model is
then used by the surgeon to plan an operation and for other activities,
such as patient education. Prior to making an incision, the 3-D models
provide the opportunity for the physician to see and feel the anatomy
as it will be seen in the operating room, which facilitates more effective
pre-operative planning.
The system has only been in use at Walter Reed for a few months, and
models have been employed in nearly 90 major cases. Although a complete
study comparing the use and non-use of models has not been done, preliminary
results are available. Surgeries done with a 3-D model have taken four-and-a-half
hours less operating room time and cost $15,000 less than comparable
surgeries done without a 3-D medical model.
Shorter surgeries enable greater utilization of operating rooms and
resources. Cutting time in surgery and the length of time a patient
is under anesthesia should lead to better patient outcomes, faster healing
times, and a lower morbidity rate.
More Effective Patient Education
Rapid prototyping with the SLA 7000 system enables patients to make
decisions based on better information. In one case, a patient with
cancer was considering surgery. A two-color model, however, clearly revealed
that the surgery would require removing so much bone that the patient
would find it difficult to walk.
Using the model, the surgeon sat down with the patient and discussed
the available options. Because of the 3-D model, the patient had a better
understanding of the consequences of the surgery. That degree of truly
informed consent means fewer surprises for the surgeon or the patient.
The added information from the 3-D model is useful for more than just
planning for surgery or deciding on surgery. In many combat trauma
cases, surgeons are confronted with patients who are missing large pieces
of
their skulls. For patients and their families, dealing with the injury
and surgery is highly stressful. Part of the problem is facing the unknown,
and detailed 3-D models help with this aspect. Center staff, for example,
will build a model of a cranial plate and take this to a patient education session.
With model in hand, staff can put a replica of the proposed cranial
plate against the damaged area of the patient’s skull and show
the patient and family exactly how the implant will restore the original
contours of the skull. That visual aide helps the situation greatly.
Safer Vehicles
While most of the work of the 3D Center has understandably been helping
surgeons do their jobs, the Center and its 3D Systems-driven modeling
have also contributed in other ways. For instance, work at the Center
has saved soldiers on the battlefield. In one case, a soldier arrived
at Walter Reed with blast damage to his face, which should have been
protected by the shielding of the vehicle in which he was riding. Using
a model of the injury, Army investigators were able to reconstruct the
explosion and pinpoint why the shielding failed to protect the soldier.
With that information, Army personnel went back to the manufacturer of
the vehicle and showed how it needed to modify it to prevent injury to other
soldiers.
With help, the Walter Reed 3D Medical Applications Center will continue
to combine the latest computer technology and 3-D modeling fabrication
with traditional CT and MRI scans to greatly enhance medical efficiency
and patient outcomes.
 Company Overview
The Walter Reed Health Care System provides comprehensive health care
for more than 150,000 soldiers and other military members, both active
duty and retired. The System consists of 10 major treatment centers in
three U.S. states, with a staff of more than 6,000. That total includes
more than 600 Army physicians, many in training in graduate medical specialty
programs. The Walter Reed Health Care System is the Army’s leading
center of clinical research and innovation.
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