Three-dimensional (3D) printers have the medical application of making exact replicas of human anatomy. A printer can utilize images from a patient’s MRI or CT scan as a template and lay down layers of rubber or plastic to build a replica. Will 3D printing become part of your anesthesia practice in the future? Perhaps. Three-dimensional models can be useful in anesthesia to plan difficult airway management, in the approach to challenging neuraxial blocks of the lumbar spine, or to plan single lung isolation anesthesia. The American Society of Anesthesiologists recently reviewed this topic here.
3D PRINTING AND AIRWAY MANAGEMENT
Three-dimensional printing of an expected difficult airway makes it possible to create an anatomically precise, patient-specific model for simulation-based learning. These models can accurately depict variations in airway diameter, curvature, and pathological obstruction. In the past, cadaver models or high-fidelity mannequins have been used to enable physicians to have repeated practice in a risk-free setting, to improve their technical proficiency and decision-making in a simulated setting, but 3D-printed models of a difficult airway enable physicians to practice on the unique rare airway abnormalities of a specific patient. These models can be created in less than 24 hours, allowing for preoperative practice and planning on an abnormal airway for a future patient.
In 2019, the anesthesia department at Tel Aviv Medical Center began to use 3D modeling to assist in preoperative anesthesia planning.
Twenty patients were referred for 3D modelling, and of these, 15 models were printed, including 12 children who required one lung ventilation. The use of these models for patients with challenging airway anatomy correlated well with the final clinical outcome in most of the cases. High-quality imaging was required to construct the models.
Benefits of utilizing 3D models of an abnormal airway include:
- A 3D model can better demonstrate anatomical structures and their relations with surrounding tissues.
- A 3D model can enhance the anesthesiologist’s understanding of the abnormal anatomy.
- Direct visualization of a 3D model with can enable an anesthesiologist to assess risks, adjust the plan, and provide technique, which can help shorten intubation time and reduce injuries to patients.
- Improving medical education for physicians in training.
- Giving patients a better understanding of their own airway and the potential risks.
SPINAL 3D MODELS
Three-dimensional spinal models also have the potential to assist in preoperative assessment. A patient’s spinal column can be 3D-printed in cases where neuraxial anesthesia is anticipated to be difficult. Patients with advanced arthritis, previous spinal surgery, or hardware such as Harrington rods, or anatomical abnormalities such as kyphoscoliosis or ankylosing spondylitis are examples that pose difficult spinal or epidural anesthesia. With a 3D-printed model of a patient’s lumbar spine, the anesthesiologist can predetermine and plan the most likely successful insertion site and angle of approach in which to perform a neuraxial procedure. In contrast, clinicians may decide there is no successful route for access to the subarachnoid or epidural space, and decide not to attempt neuraxial blockade.
BROCHOSCOPY AND LUNG ISOLATION TRAINING
Three-dimensional models of the tracheobronchial tree can be useful to teach bronchoscopy and lung isolation techniques for thoracic anesthesia cases. Anesthesiologists can practice using standard lung isolation devices such as double lumen tubes and bronchial blockers on these models. Pathologies such as tracheal stenosis or tumors can be reproduced from CT images of actual patients, allowing the anesthesiologist to obtain a realistic 3D reconstruction of the patient’s tracheobronchial pathology. This provides realistic conditions for teaching and training on multiple pathologies.
COMMENTARY
Will 3D printing find its way into routine community anesthesia practice? As of 2026, 3D models are not commonly used. Widespread adoption will depend on the costs of the technology, which requires both high resolution imaging and a 3D printer. The construction of 3D models is still a high-end option, requiring high-definition imaging and the use of Stereolithography (SLA) 3D printers, which are useful in healthcare for producing high-resolution, biocompatible, sterilizable models. At the present time, 3D printer applications are not in the budgets of most community healthcare systems, but may be found at some research universities.
Issues that need to be resolved in the future include:
- Can a healthcare system be reimbursed for 3D printing services and products?
- Do the benefits of establishing in-house 3D manufacturing outweigh the costs?
- What products fall outside of Food and Drug Administration (FDA) oversight and what potential risks might they present for patient safety?
CONCLUSION
I’m a fan of the KISS principle (Keep It Simple Stupid) in anesthesiology, and printing a 3D model of an airway, a spine, or the bronchial tree prior to anesthesia induction isn’t simple. At best, it may be applicable to less than 0.1% of anesthetics. But in the future, as prices come down and reimbursement is validated, we’ll likely see more widespread use of 3D modeling for cases involving difficult airways, difficult spinal cord anatomy, and difficult tracheobronchial anatomy.