Advancing surgical excellence through Mediclinic Winelands 3D lab

The new Winelands 3D lab is a partnership between the Institute of Orthopaedics and Rheumatology at Mediclinic Winelands Orthopaedic Hospital and the Radboud 3D lab in the Netherlands.

It helps surgeons improve patient care using advanced 3D technology as well as artificial intelligence, and augmented reality.

Creating collaborations

Dr Franz Birkholtz, an orthopaedic surgeon at Mediclinic Winelands Orthopaedic Hospital and CEO of the Institute of Orthopaedics and Rheumatology (IOR), often hosts local and international surgeons to teach advanced limb reconstruction techniques. Through these interactions, he became acquainted with a group from the Netherlands. While on a roadshow in the Netherlands to share his expertise, he first encountered the 3D lab at Radboud University Medical Center.

“I had long been interested in the 3D lab concept,” he says. “My interest grew organically into a collaboration. It was born of exposure to the people involved and a natural affinity for the type of work they do and their global philanthropic projects.”

Dr Birkholtz, who has a background in complex trauma management, knew he and his team could help Radboud too. “They are one of the NATO hospitals that receive patients from military environments in Ukraine, and we can assist them in dealing with these patients,” he explains.

In addition, the collaboration will yield valuable skills transfers. “An exchange student programme between our facilities will provide research and development opportunities for both units, and grow our local capabilities.”

Locally, the 3D lab will also collaborate with Tygerberg Hospital. “We’re excited to team up and see what sort of 3D capabilities we can work on together,” Dr Birkholtz says. “I'm interested in how we can use these technologies not only for first-world environments, but also to help South Africans who don’t have access to advanced technology.”

Three-dimensional surgical planning

Ultimately, the Winelands 3D lab’s role is to ensure the best patient outcomes, attract more complex cases and grow the IOR’s position as a leader in orthopaedics and rheumatology. “We’re empowering our surgeons to go from analogue to digital, improving their accuracy with digital and 3D technologies and enabling them to better help patients,” says Dr Birkholtz. The lab is still in its growth phase but already houses a 3D printer and 3D software.

Dr Birkholtz explains that 3D technology can help surgeons to properly visualise pathology in three dimensions. “This enables us to plan and execute surgeries more accurately. We can actually ‘step into’ the patient's three-dimensional anatomy using these technologies and visualise what the bone or limb looks like, pick up potential pitfalls and see how to correct the issue.”

This is done through advanced software that allows doctors to create virtual models of a patient's anatomy on a computer and simulate strategies to correct abnormalities. “We can plan surgery in three dimensions before we actually touch a patient,” Dr Birkholtz says.

Through 3D printing, doctors could also take a virtual model of a patient’s anatomy and turn it into a physical, plastic model. “We can use this to orientate ourselves intraoperatively and to better visualise the pathology. We could also simulate surgery, for example, cutting and straightening bones on the plastic model without going into the operating theatre. So, once we get into the operating room, we’re well-rehearsed and prepared for the patient’s specific case.”

A new surgical reality

The 3D lab also allows surgeons to use technologies like virtual (VR) or augmented reality (AR). “We’re already doing virtual training using specialised headsets to transmit what we do in the operating room to a group of students and other orthopaedic surgeons,” Dr Birkholtz explains.

That way they get a first-person view of the surgery. “The sky's the limit with this sort of technology as it expands – there are also applications for artificial intelligence (AI). All these things can tie into a 3D lab, improving our capability to work with greater accuracy.”

AR could also be applied to create a projected virtual pre-operative plan that doctors could look up to as they operate. “You can have a patient’s pre-operative planning in three dimensions superimposed on the patient's real anatomy,” Dr Birkholz explains.

A 3D lab also potentially offers crossover into the area of patient-specific implants. “This would allow for the generation of dedicated implants for patients where we can work very closely with engineers to develop specific implants and devices for patients. The lab would also be a place where colleagues who have a prototype or a new device or concept in mind, could design that prototype and start working on dedicated device manufacturing or development.”

Dr Birkholtz feels AI should be seen as complementary to the work doctors do. “Modern medicine is missing the point to a certain extent because we’ve become much less patient-centred as we’re placed under demands from a medico-legal perspective,” he says. AI can play an important role in executing complex administrative tasks so doctors can spend more time interacting with patients.

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