First 3D-printed titanium thoracic reconstruction surgery in Southeast Asia.

First 3D-printed titanium thoracic reconstruction surgery in Southeast Asia.

Doctors at Vinmec Times City International General Hospital have just performed the first 3D-printed titanium chest reconstruction surgery in Southeast Asia.

On September 18, 2024, doctors at Vinmec Times City International General Hospital and engineers from the 3D Technology Center in Medicine, VinUni University, announced the successful radical surgery to remove an 11.5 cm mediastinal tumor and reconstruct the chest cavity using titanium.

Doctors at Vinmec Times City International General Hospital have just performed the first 3D-printed titanium chest reconstruction surgery in Southeast Asia.

A 55-year-old female patient from Ha Nam province experienced severe left chest pain for several weeks, with the pain being constant and particularly worsening with breathing, causing difficulty in daily activities.

The patient visited the provincial hospital and was found to have a chest tumor (anterior mediastinal tumor). The patient was then transferred to Vinmec for a multidisciplinary consultation and treatment plan.

The results showed that the large mediastinal tumor, measuring up to 11.5 cm, had extensively invaded the left chest wall, ribs 2, 3, and 4, the upper lobe of the left lung, and part of the sternum, causing severe compression of the heart, lungs, and surrounding organs.

The case was diagnosed at a late stage, and chemotherapy and radiation therapy were no longer effective; the only solution was wide surgical resection of the tumor, along with the sternum and adjacent ribs.

In addition to eradicating the tumor, the case also presented a major challenge in reconstructing the chest wall to protect heart and lung function after surgery. Without proper reconstruction, the risk of respiratory failure and injury to internal organs would increase significantly.

Previously in Vietnam, and Southeast Asia in general, large chest defects after cancer surgery were often covered using skin and muscle flaps from other locations, resulting in a large scar and causing psychological trauma to patients.

The artificial materials used previously only served to cover the physical form; they did not protect the heart and lungs inside the chest cavity, ensuring they remained in the correct position and functioned normally, or withstand external impacts. Therefore, traditional surgical methods cannot yet be considered the optimal solution.

The rib cage is not a static structure but is constantly moving and expanding with breathing and the activity of the heart and lungs. Therefore, a large defect in the anterior chest wall presents a significant challenge in restoring the anatomical structure of this area.

According to previous medical literature, several studies worldwide have presented some graft designs using 3D technology. However, each design still has certain drawbacks such as complexity and difficulty in manipulation, leading to prolonged surgical time.

To solve this problem, the design team, comprising cardiovascular and thoracic specialists, orthopedic trauma specialists from Vinmec, and engineers from the 3D Technology Center in Medicine at VinUni University, spent nearly three weeks diligently researching and improving to overcome the limitations of previous designs. They tested dozens of simulated scenarios to achieve a design that was meticulous, sophisticated, thin, and precise to the highest standards.

The product is not only groundbreaking in design but also incorporates a mesh to prevent lung herniation, surpassing surgical procedures worldwide that require the use of multiple separate grafts to protect the lungs and heart. This innovation minimizes the risk of separate grafts shifting within the body after surgery.

The entire process, from design to production, is reviewed by the Vinmec Healthcare System's Professional and Ethics Councils, in close collaboration with the VinUni Institute of Health Sciences, ensuring compliance with the highest international standards.

This process also received support from experts at SLM - a leading German company in 3D printing and medical engineer training - helping to ensure the surgery was successful and of optimal quality.

On September 11, 2024, under the direction of Dr. Dang Quang Huy (Deputy Director of the Cardiovascular Center, Vinmec Times City) and Prof. Dr. Tran Trung Dung (Director of Orthopedics & Musculoskeletal Surgery, Vinmec Healthcare System), a near-total left chest reconstruction surgery for the patient was successfully completed after nearly 3 hours. Prior to this, the patient had undergone a first surgery to completely remove a mediastinal tumor that had invaded the chest cavity.

In this second surgery, the doctors focused on restoring the anatomical structure of the chest area, ensuring respiratory function and providing necessary protection for vital internal organs.

During the surgery, the implant was functionally tested. Accordingly, the fit was 99%, ensuring normal breathing for the patient.

Just one day after surgery, the patient was able to sit up and converse normally, recovered well, and was discharged after only five days. The precision of the surgery, thanks to 3D technology, along with advanced ESP pain management techniques, shortened the surgical time and helped the patient recover quickly, with the hospital stay reduced by half compared to normal.

According to published scientific reports, over the past 10 years, there have been approximately 50 cases of 3D thoracic defect reconstruction using titanium alloy materials in the US, Europe, South Korea, and China.

Notably, the patient at Vinmec is the first in Southeast Asia and Vietnam is the fourth country in Asia to use a fully artificial skeleton and cardiopulmonary support mesh designed and 3D-printed from titanium, without integrating or mixing any other materials.

The success of the surgery not only marks a turning point in the field of major chest defect repair in Vietnam but also opens up great opportunities in other areas, such as maxillofacial defect reconstruction, soft tissue reconstruction, and precision stent placement, contributing to improved treatment effectiveness and shorter recovery times for patients.

Source: https://baodautu.vn/phau-thuat-tai-tao-long-nguc-bang-titan-cong-nghe-in-3d-dau-tien-o-dong-nam-a-d225246.html