A surgeon operating on the sinus knows the tiniest error could have devastating consequences. An incision just a few millimetres off-target could mean serious injury or death. Thorough training is crucial. But current practice models of the sinus may lack accurate detail or be too expensive. The use of material from cadavers involves many difficulties, not least of which is a lack of disease indicators necessary for training. And there is concern that the working time directive for junior doctors means less time for training. But now a breakthrough with extraordinary potential has come from the work of Dr Russell Harris and his colleagues.
Using data from CT or MRI scans, they employ an additive manufacturing (3-D printing) technique to create accurate ceramic models of the sinus. These are modified using polymers to simulate the area’s complex combination of soft and hard tissue. The models, which are relatively cheap, are so lifelike that training is hugely enhanced. Even rare disorders can be replicated.
The work has already meant a Best Young Scientist award for team member and PhD student Matteo Gatto. Another recent development from the project is software that clinicians can use to simulate specific disorders. They can “swell” selected areas, or reproduce tumours or inflammation. Another exciting possibility is the creation of models based on specific patients, allowing “dummy runs” before actual operations.
“There’s also great potential to move this into other clinical areas, such as orthopaedics, neurosurgery or cardiac surgery,” said Dr Harris.
“The ultimate raison d’être of our work is patient safety. We’re looking at savings in theatre time, reductions in litigation and greater surgical capability. But ultimately it’s about better results for patients – making sure that when surgery is conducted, it’s as good as possible first time round.”
The huge potential of the project has been recognised by the Engineering and Physical Sciences Research Council, which has awarded funding in the form of a Knowledge Transfer Account, to help exploit it further.
“This kind of project would not have been feasible with out the collaboration with Loughborough University. To have a well-trained individual before getting into the theatre environment and operating on patients will undoubtedly add to patient safety”, said Mr Anshul Sama, Consultant Otorhinolaryngologist, Head and Neck Surgery, Nottingham University Hospitals NHS Trust.
This project has had direct funding from Nottingham University Hospitals R&D, with active involvement from R&D Director Dr Brian Thomson.