ANN ARBOR, Mich. - Cher Zhao recently had the rare opportunity to practice skills belonging to the most advanced surgeons: reconstructive cartilage grafting.

The setting, however, was fitting for the University of Michigan Medical School resident.

Scalpel in hand, Zhao sat at a table carving precise measurements out of realistic material designed to mimic the texture of human cartilage.
In the real world, these shapes would be cut from a patient's rib for grafts used for airway or ear reconstruction. In these procedures, then, it's vital that the pieces are carved exactly right.

The tool providing Zhao and her peers this immersive experience: Three-dimensional models based on real human cases.

Surgical training is one more way University of Michigan researchers are using 3-D printing to advance the quality of care. And the lifelike printed replicas are providing a cost-efficient tool to improve practical experience for more trainees such as Zhao, U-M researchers say in an article published in Otolaryngology- Head and Neck Surgery.

Historically, a surgeon's skills have been acquired in live patients, anaesthetized animals or human cadavers, but authors say surgical simulation is increasingly recognized as a vital educational tool.

"3-D printing is bringing a whole new meaning to hands-on experience for surgeons in training," says David Zopf, M.D., the article's senior author and a pediatric head and neck surgeon at C.S Mott Children's Hospital.

"Hands-on experience is critical for acquiring and improving surgical skills, especially of new and complex procedures," adds Zopf, who keeps a laser 3-D printer in his own office. "This is an exciting tool that not only offers trainees exposure to opportunities they otherwise wouldn't have but that also allows them to demonstrate proficiency of skills before being performed on children."

Mott teams have used 3-D printing for almost six years, with the ability to now produce models at a low cost and a much faster rate. The models are based on computer designs of CT scans.

The ways in which the technology can be applied are many.

Groundbreaking 3-D printed splints made at U-M have helped save the lives of babies with severe tracheobronchomalacia, which causes the windpipe to periodically collapse and prevents normal breathing. Mott has also used 3-D printing on fetuses to plan for potentially complicated births.

It also has been applied to complex cases involving surgically removing tumors -- including the full replica of a young patient's skull to plan a best course of action.

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