Hanoi, September 11, 2024 – Doctors at Vinmec Times City International General Hospital, with support from engineers at the 3D Lab of VinUni University, successfully performed a radical surgery to remove a mediastinal tumor and reconstruct the defect using 3D printing technology.
Initial Symptoms
A 55-year-old female patient from Ha Nam experienced severe left chest pain for several weeks, with continuous pain that intensified during breathing, making daily activities difficult. She was diagnosed with a mediastinal tumor at a provincial hospital and was referred to Vinmec for multidisciplinary consultation and treatment planning.
The results showed a large mediastinal tumor, measuring up to 11.5 cm, which had complexly 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 on the heart, lungs, and surrounding organs. The case was diagnosed at a late stage, with chemotherapy and radiation therapy no longer effective, leaving wide excision surgery as the only solution, including the removal of the sternum and adjacent ribs.
Challenges in Chest Wall Reconstruction
In addition to the radical tumor removal, the case also posed a significant challenge in reconstructing the chest wall to protect heart and lung function post-surgery. Improper reconstruction could lead to a high risk of respiratory failure and injury to internal organs.
Previously in Vietnam and Southeast Asia, large chest wall defects after cancer surgery were often covered using muscle flaps from other locations, resulting in large scars and psychological trauma for patients. Artificial materials used previously only provided morphological coverage, failing to protect the heart and lungs inside the chest in their correct position and normal function, and against external impacts. Therefore, traditional surgical methods could not be considered optimal solutions.
The chest is not a static structure; it continuously expands and contracts with the breathing and the activity of the heart and lungs. Therefore, a large defect in the anterior chest wall poses a significant challenge in restoring the anatomical structure of this area. According to previous medical literature, several studies worldwide have proposed various 3D-printed graft designs. However, each design still has certain drawbacks, such as complexity and difficulty in handling, leading to prolonged surgery times. This has been a challenge for experts to create a maximally compatible graft for patients while minimizing the disadvantages of previous graft designs.
2 Months of Research for a Superior Product
To solve this problem, a design team consisting of thoracic and cardiovascular experts, orthopedic trauma specialists, and engineers from the 3D Lab spent nearly two months researching and improving to overcome the limitations of previous designs. They tested dozens of simulated scenarios to achieve a meticulous, sophisticated design, ensuring thinness and precision to the highest standards.
The product not only breaks through in design but also integrates a hernia mesh to prevent lung herniation, surpassing global surgeries that require multiple separate grafts to protect the lungs and heart. This innovation minimizes the risk of graft displacement within the body post-surgery.
The entire process, from design to production, was approved by the Vinmec Medical System's Professional Council and Ethics Council, in close coordination with the VinUni Health Sciences Institute, 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 engineering training, contributing to successful surgery with optimal quality.
Left Chest Reconstruction Surgery
On September 11, 2024, under the direction of Dr. Đặng Quang Huy and Professor Dr. Trần Trung Dũng, the nearly complete left chest reconstruction surgery for the patient was successfully performed after nearly 3 hours in two stages. The first stage involved removing the invasive mediastinal tumor, and the second stage restored the anatomical structure of the chest area.
During the surgery, the graft was tested for functionality and fit, achieving 99% accuracy and ensuring normal respiratory function for the patient. Just one day after the surgery, the patient was able to sit up and converse normally, recovering well and being discharged after only five days. The precision of the surgery, thanks to 3D technology and advanced ESP pain relief techniques, shortened the surgery time and helped the patient recover quickly, with the hospital stay reduced to half the usual time.
According to published scientific articles, in the past 10 years, there have been about 50 cases of 3D chest wall reconstruction using titanium alloy materials in the USA, Europe, South Korea, and China. Notably, if focusing on patients who used entirely artificial bones and hernia mesh for the heart and lungs, designed and 3D printed with titanium material without integrating or mixing other materials, the patient at Vinmec is considered the first case in Southeast Asia and the fourth in Asia.
Additional Information on 3D Technology Application in Treatment at Vinmec. Since 2021, surgeons at Vinmec have successfully performed over 300 limb reconstruction and large joint replacement cases with anatomical accuracy up to 99%, exceeding expectations and delivering impressive results. Reconstructing external rigid structures such as the chest wall and sternum to repair defects for cancer patients who have had large portions of bone removed has been a significant challenge studied in the USA, Europe, and several Asian countries over the past 10 years. However, this technology is still relatively new in Southeast Asia.
With a world-leading advanced 3D lab system, Vinmec is at the forefront in Vietnam in addressing this issue. The success of the surgery not only marks a milestone in the field of large chest defect reconstruction in Vietnam but also opens up significant opportunities in other areas such as maxillofacial defect reconstruction, soft tissue reconstruction, and precise stent interventions, contributing to improved treatment effectiveness and shortened recovery times for patients.
Vinmec continues to affirm its pioneering position in the medical field by combining advanced technology with top-notch expertise to deliver optimal treatment outcomes for patients. The recent success of the chest wall reconstruction surgery not only strengthens Vinmec's reputation in modern medicine but also underscores the hospital's commitment to enhancing healthcare quality not only in Vietnam but also across the region.
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