Young boy receives Australia’s first custom 3D printed ear
Dr Joe Dusseldorp and patient Maxim Richter.
RAMSAY HEALTH CARE IS evolving Simplify
The Ramsay Way 2019 | 02 3
A four-year-old boy has become the first patient in Australia to receive a custom 3D printed ear implant.
Sydney plastic surgeons Dr Joe Dusseldorp and Dr Nicholas
Lotz performed the milestone procedure on Maxim Richter
at Castlecrag Private Hospital.
The surgery has only been completed 16 times across
Dr Dusseldorp said: “He is really quite advanced for his age
and he was asking his mum, ‘Do you think you could get me
a big ear’ and that is what inspired his mum to go looking for
Maxim was born with microtia, a condition which caused one
of his ears to be underdeveloped.
Microtia is known to affect one baby in every 6,000
births in Australia and can often cause hearing and
“It is not that uncommon, but it is still on the rare end of the
spectrum. A lot of kids have psychosocial concerns about it
and that is something we try to alleviate by reconstructing
them a new ear,” Dr Dusseldorp said.
An optical 3D scan of Maxim’s other ear was entered in to
the 3D printing software and flipped to create a model for
the ear implant.
It was then 3D printed using a biocompatible material known
as porous polyethylene, wrapped in a living tissue overlay
and covered with skin grafts.
“What is great about the computer design process, is that
families can be involved, they can see what we are planning
to do, and they can give their tick of approval. It makes
it a positive experience for everyone,” Dr Dusseldorp said.
Traditionally, ear reconstruction has been performed using
rib cartilage, which is harvested from the chest wall and then
sculpted in to the shape of the other ear.
This sometimes-painful method is performed after the age
of 10, requires at least two stages and can fail to resemble
the delicate features of an outer ear.
“I was quite amazed by the difference between this new
technique – where the patients have minimal pain when
they wake up and are home the next day – compared to
the rib technique which
requires several days in
hospital with drains and
pain killers and takes at
least two surgeries,”
Dr Dusseldorp said.
Both surgeons involved in the procedure have undergone
post-fellowship training in ear reconstruction overseas and
collaborated with leading surgeons in the USA – Dr John
Reinisch and Dr Sheryl Lewin – to learn the new technique.
The procedure is considered low risk with only a 1% major
complication rate. It also offers better outcomes for children,
including a more realistic looking ear, less pain, less time in
hospital and it can be completed at a younger age.
Maxim is recovering well at home in Brisbane, and doctors
are monitoring his progress.
Dr Dusseldorp said: “His mum told me the other day that
Maxim asked her to print out a photo of his new ear and put
it up on his bedroom wall because he’s so proud of it.”
“So that was really heart-warming when you realise how
much it means to him,” Dr Dusseldorp said.
Evolve is a program designed to simplify, standardise and
share best practice across Ramsay Health Care Australia’s
network of hospitals.
One of the first projects has been to adopt the improvement
principles of “Lean thinking” into the day to day workings of
Lean is focused on improving quality and safety, reducing
unnecessary work, and improving the customer experience
in our hospitals.
Lean is underpinned by the guiding tenets of continuous
improvement and respect for people. It has been used to
deliver improvements in many industries including health care.
Virginia Mason Health Systems in Seattle USA introduced Lean
principles to its hospitals a number of years ago and is now
a multi-award winning health care service that enjoys a net
promotor score of 82.
Ramsay Health Care Australia’s Chief Operating Officer, Kate
Munnings, was keen to apply Lean to Ramsay’s Australian
operations after having previously experienced its application
and associated benefits.
“I have seen Lean deliver significant performance
improvements when fully embraced; and importantly, Lean
aligns well with The Ramsay Way with its emphasis on respect
for people and continuous improvement,” Ms Munnings said.
The purpose of Lean is to rapidly identify and remove ‘waste’
from any system or process. This is achieved by measuring
lead performance indicators, increasing communication
between departments and empowering staff to enact
Obeya rooms (Japanese terminology for ‘great room’ or ‘big
room’) have been set up in all Ramsay’s Australian hospitals.
Department representatives, along with their respective CEOs,
meet once a day in the Obeya to monitor performance indicators
and work together to find solutions to any identified issues.
After Hours Theatre Coordinator at Wollongong Private
Hospital, Maddison Bahnert, said the introduction of Lean
was very beneficial.
“The establishment of leading performance indicators
has been invaluable to our department. The application of
Lean methods enables us to see what is really going on,
supported by data, and then make improvements quickly,”
Ms Bahnert said.
Employing new technologies is also an important part of the
Evolve program and works in step with the Lean principles.
Ramsay Health Care Australia has recently made – and will
continue to make – a significant investment in digital and
technology enabling tools to improve service, capability
and convenience for staff, patients and doctors.
The first of these tools is a new software system called
Workplan, which supports us to better plan and manage
rostering. It is a system, designed for Ramsay, in order to
meet the particular and often complex needs of a clinical
environment. It will improve the rostering capabilities,
transparency and communication of rosters for all Ramsay staff.
Implementation of the program is currently underway and will
be completed by the end of the year.
Project lead for the Workplan rollout, Marian Burns, has
recently been working on the delivery of the program within
Ramsay’s Victorian and West Australian hospitals.
Throughout the implementation, Ms Burns has received
positive feedback about the improvements being made
at a local level.
“I have had a great response from staff using the program so
far, especially around its useability and the positive effect it has
had on rostering within departments. Staff have been really
engaged in training sessions and are able to successfully use
the program on a daily basis for great benefit”, Ms Burns said.
Further projects are underway as part of the Evolve program
which will also contribute to the continuous improvement of
Ramsay Health Care’s Australian Hospitals.
Ramsay Health Care Australia has implemented one of its largest continuous improvement
programs, as part of an ongoing commitment to actively seek new ways of doing things better.