(1093) The Utility of 3D-Printed Videolaryngoscopes at Tertiary-Care Hospital in Eastern India

Introduction: Fused deposition modeling is one of the most cost-effective methods of 3D printing. 3D printing of medical devices using polylactic acid, is a viable option. We aimed to assess the utility of two types of 3D-printed Video Laryngoscopes, standard (VL) and hyperangulated (ang VL). The study was conducted across multiple teaching hospitals, including doctors from different specialities and varying levels of expertise in airway management.

Methods: 98 doctors, majority from EM team (73.5%) and ICU team (23.4%). Teams consist of specialists, residents, medical doctors of the concerned departments. A manikin-based experiment, Mac blade size 4 for Direct laryngoscope (DL), 3D-printed VL Mac 4, and a 3D-printed ang VL were used. The production of the 3D-printed laryngoscopes was by MELT3d (Kolkata, India). t tests and a p-value of < 0.05 were employed.

Results: 49% of medical professionals had fewer than 25 intubations. Successful first attempt intubation in those with < 1 year of experience with intubation (n=33) was highest for VL (97%) compared to DL (82%) and ang VL (67%). Participants who learned intubation through self-directed learning (64%) exhibited a higher acceptance of VL and achieved a 100% success on their first attempt. Among those who followed modules/ workshops (71%), 97% had successful first attempt intubation with VL. The average time taken to visualize the vocal cords was lower in VL compared to DL (5.63±2.73 vs 7.47±3.29 seconds, p< 0.001). The ang VL also had lower average time compared to the DL (7.09±3.92 vs 7.47±3.29 seconds, p< 0.001). Average time taken to perform intubation using DL (24.18±8.72 seconds, p< 0.001) was similar to intubation using VL (28.13±13 seconds, p< 0.001). Lastly, the average time taken to perform intubation using ang VL was the highest among the three techniques (49.58±35.45 seconds, p< 0.001). The time taken to intubate with DL and VL had Spearman's rho of 0.64 (p < 0.001), and DL and ang VL had 0.59 (p < 0.001). Results showed 100% satisfaction rate and 78.6% preference for future use of 3D printed VL.

Conclusions: VL showed potential in novice operators with less years of expertise. The ease of use of VL, its cost-effective nature, and its portability make 3D-printed VL beneficial in situations where traditional VLs may not be available.