The team at CVS’ Highcroft Veterinary Referrals worked to develop and assess the design of a 3D printed guide to enable safer brain surgery for the challenging hypophysectomy procedure for patients suffering from Cushing’s disease.
Cushing’s disease is a common endocrine disease in ageing dogs that results in high levels of cortisol in the blood. This is frequently due to a mass within the pituitary gland secreting cortisol.
With transsphenoidal hypophysectomy surgery, the pituitary mass is removed, offerinh a cure. However, this advanced surgery is challenging due to the deep location of the pituitary gland underneath the brain.
The region is accessed through the mouth, but this is hard to locate and contains many important blood vessels to avoid. Precision is, therefore, at the essence of this surgery.
The study explored whether a 3D printed surgical guide, placed in the dog’s mouth, could aid specialist neurosurgeons in locating the correct site of the pituitary with good accuracy.
The team found that it was possible to create a 3D printed guide from CT images, and that it can be used by surgeons to accurately identify the exact location of the body cavity containing the pituitary gland.
The final design, developed with collaborator Dr Bill Oxley at Vet3D, is a guide that locks on the dog’s molar teeth and is bespoke to each patient, based on their CT images.
Recent data shows that long term survival is far greater for dogs receiving surgery compared to those treated with medication.
This new research offers a way to support surgeons undertaking this surgery more safely.
It could also help specialist veterinary neurosurgeons wishing to be trained to perform hypophysectomy, making this surgery more accessible to companion animals in the long run.
Nicolas Granger, European and RCVS specialist in veterinary neurology (small animals) at Highcroft Referrals and lead author, said: “The 3D printed surgical guide research lends itself well to being performed in clinical practice.
“Only a few specialist UK centres offer hypophysectomy which can be used for Cushing’s disease in dogs and acromegaly in cats.
“Testing the 3D printed guide was natural for us as it did not distract from performing the surgery, but allowed us to add another safety layer for our patients.
“We know that our 3D printed guide is useful to locate the exact entry point into the bony cavity containing the pituitary gland.
“Practically, we are now able to provide advice on the surgical indication from CT images of the patient.
“If a dog or cat is dimed a potential candidate, we will collaborate with Vet3D to design and print the guide from the CT images in a timely manner – usually within a few days. We can then assist with the surgery.
“We would now like to make this surgery more accessible to colleague neurosurgeons and to further assess whether this tool can help when teaching the procedure.”
The study, “A 3-Dimensional Printed Patient-Specific Surgical Guide to Facilitate Transsphenoidal Hypophysectomy in Dogs” study, published in Frontiers in Veterinary Science is one of 16 projects CVS has funded since its awards were launched.
Te study was funded by CVS Clinical Research Awards.
