Three-dimensional (3D) surgical modeling is emerging as a powerful tool to enhance precision, improve outcomes, and support surgical planning across complex oncologic procedures. At The Ohio State University Wexner Medical Center, Kyle VanKoevering, MD, is leading a major research effort to broaden access to this technology and demonstrate its clinical value through rigorous prospective study.
A surgeon in the Department of Otolaryngology – Head and Neck Surgery and director of the Medical Modeling, Materials and Manufacturing (M4) Lab, Dr. VanKoevering has spent more than a decade advancing 3D printing in medicine. Trained as an engineer before becoming a physician, he recognized early that 3D modeling could dramatically refine operative planning, particularly for head and neck oncologic surgery. Since establishing the M4 Lab in 2021, he and a multidisciplinary team of engineers and clinicians have integrated advanced modeling into routine care at the Ohio State University Wexner Medical Center.
However, as early successes mounted, Dr. VanKoevering also recognized the limitations of innovation occurring solely in an internal laboratory setting. Because the M4 Lab operates outside of certain regulatory constraints, the team can develop customized modeling at a pace and scale not currently achievable within reimbursable clinical workflows. “Because we’re in-house, we’re able to do this work without having to follow some of the constraints you would in a regulated space,” he explains. Sustained, widespread adoption will require payer reimbursement strategies that do not yet exist—an issue the current study seeks to address.
Demonstrating positive outcomes
In late 2023, the M4 Lab initiated a major collaboration with Ricoh USA, Inc. and Stratasys Ltd., two industry leaders in 3D printing, to confront regulatory barriers and generate the clinical evidence needed to support broader insurance coverage. The prospective, randomized clinical study launched in summer 2024 with joint funding from both companies and includes multiple participating institutions, including the Ohio State Wexner Medical Center.
The trial compares two cohorts of patients with bony tumors: one undergoing surgery guided by both 3D-printed models and standard CT or MRI imaging, and another guided solely by imaging. “Because bones don’t change shape, we knew that looking at patients with bony tumors would be a particularly beneficial anchor point to reference intraoperatively while guiding surgery,” Dr. VanKoevering notes.
Preliminary evidence supports this approach. The M4 Lab published data in Oral Oncology in September 2025 demonstrating that 3D modeling in mandibular oral cavity malignancy resections increased the likelihood of margin-negative outcomes compared to conventional techniques. “That finding was significant because, up until now, all the research around 3D printing has focused on the reconstructive value,” he says. “But this showed a cancer-specific value with the removal and with the reconstruction. I think that combining that finding with what I hope we’re going to find through this prospective trial will open the door not only for reimbursement but also for looking with a much more focused lens on how this technology can be successful.”
The first patient was enrolled in June 2024; today, the study has enrolled 14 patients and is projected to continue through 2027. Investigators aim to evaluate whether custom 3D-printed models improve operative efficiency and safety—potentially reducing blood loss, shortening operative and anesthesia time, and lowering complication rates. Early internal analyses have been “very encouraging,” Dr. VanKoevering reports.
A digital path forward
Beyond its immediate surgical applications, 3D printing offers a transformative digital workflow with broad implications for the future of care delivery. Dr. VanKoevering envisions opportunities to integrate 3D modeling with tissue engineering, potentially enabling personalized organ replacement that circumvents the limitations of transplantation. “The key with 3D printing technology is that it’s a completely digital pathway, which means you can change it every time you make something, and make something specific for a patient overnight or in two days that you really just can’t do with conventional manufacturing or other techniques,” he explains. “The future is really exciting when you look 10 to 15 years down the road.”
“I see this work as a defining example of how engineering innovation, clinical expertise, and strategic industry partnership can reshape the surgical landscape” said chair of the department, James W. Rocco MD, PhD. “The M4 Lab’s efforts demonstrate how technology developed within an academic medical center can produce meaningful, measurable improvements in patient care—and how rigorous trials can pave the way for national adoption. By building the evidence base necessary for reimbursement and expanding equitable access to advanced surgical modeling, this work positions Ohio State as a leader in digital surgical transformation and embodies our mission to advance outcomes, precision, and patient-centered care”.