A 7-year-old boy with a complex, chronic rectal–gluteal fistula—unresolved after multiple surgeries and six months of recurrent infection—was successfully treated using 3D-printed anatomical modeling and a tailored dual-approach surgery at Children’s Hospital of Fudan University.
The boy sustained severe pelvic trauma in a truck accident, requiring emergency hemostasis, pelvic fixation, iliac artery bypass, and ileostomy/cystostomy. Though life was saved, persistent infection led to a fistulous tract extending from the rectum to the left groin—a deep, pus-filled tunnel resistant to conventional therapy.
By the time he arrived at CHFU, his pelvic anatomy was severely distorted: malunited fractures, dense scarring, and a life-sustaining iliac artery graft lying perilously close to the infected tract. Removing the fistula without damaging the graft posed an extreme risk of fatal hemorrhage.
To map the anatomy precisely, the team performed enhanced CT, fistulography, and enteroscopy—yet 2D images failed to clarify spatial relationships. The solution is a 1:1 3D-printed pelvic model. It revealed the exact location of the graft relative to the fistula, fracture deformity, and surrounding structures—turning an ambiguous “3D maze” into a clear surgical roadmap.
A multidisciplinary team (general surgery, orthopedics, radiology, urology, anesthesiology) used the model to plan a two-stage procedure:
1. Laparoscopic release of adhesions and sigmoid colostomy to isolate infection;
2. Combined transsacral–perineal resection of the entire sinus tract—spared the graft and preserved urethral tissue for future reconstruction.
The surgery proceeded as planned. Blood loss was minimal. No vascular injury occurred. Infection resolved completely within weeks. At discharge, the gluteal sinus and anal wound were fully healed. For this child, it was not just healing—it was a second chance.
3D printing technology has been routinely used in orthopedic treatment, but it is rarely used in the field of soft tissue diseases. The general surgery team is the first to apply 3D printing technology to the preoperative evaluation of complex fistula in children in China, and has successfully performed resection of 2 children so far. This technology is like a pair of fluoroscopy eyes and a navigator for the doctor, which not only greatly reduces the risk of surgery, but also allows those who were originally considered impossible or high risky surgery to become feasible and controllable.