Introduction
Implementing a three-dimensional (3D) planning and printing lab in hospitals can offer multiple benefits for both healthcare professionals and patients. The aim of this master’s thesis is to support the initiation of a 3D lab in the Albert Schweitzer hospital through three topics: a workflow proposal for development of anatomical models, a survey study investigating the added value of these models in collaboration with the department of orthopedics and a business case outlining three potential scenarios of implementation.

Methods
A hospital-specific workflow was established by incorporating existing literature and identifying the key stages, materials, hardware, software, roles and responsibilities for development and 3D printing of anatomical models. A survey study was conducted using a questionnaire containing Likert and categorical scales. Anatomical models for orthopedic cases were produced and utility of each model was evaluated with the participation of orthopedic surgeons. The business case included a cost-benefit analysis for the three scenarios: in-house 3D printing of anatomical models (scenario 1), 3D printing of orthopedic surgical guides for total knee arthroplasty (scenario 2) and 3D printing of orthognathic anatomical models and wafers (scenario 3).

Results
A 15-step workflow was created covering all stages from image acquisition to delivery of the anatomical model. 30 orthopedic cases were included for the survey study. A total of three orthopedic surgeons participated in the study and agreed that 3D printed models provide additional information during the process of preoperative planning (rated 3.4/5), might enhance surgical outcomes and efficiency (rated 3/5 and 3.2/5, respectively) and can reduce average operative time with several minutes. These advantages were particularly evident in hip revision and ankle/foot cases, whereas conventional hip cases benefited the least. Cost-benefit analyses in the business case demonstrated cost-savings in scenarios 2 and 3 for in-house planning and printing over outsourcing of these tasks, considering a 5-year period.

Conclusion
This work presents a clear and implementable workflow for the development of 3D printed anatomical models. These models can function as a valuable tool in the process of preoperative planning of orthopedic surgery and hold potential for other applications. To optimize financial benefits, it is recommended to initiate a 3D lab with the in-house production of orthopedic surgical knee guides. Future work should explore the demand for 3D printing in other departments to further optimize the usefulness of a 3D lab in this hospital.