3D printers in the operating room

In recent years, 3D prin­ting has become an impor­tant tech­no­lo­gy for medi­cine, espe­cial­ly in the field of pros­the­tics for den­tal or bone implants, but also for the sub­sti­tu­tion of ampu­ta­ted limbs or skin recons­truc­tion for burn vic­tims. More recent­ly, other medi­cal fields, such as car­dio­lo­gy, uro­lo­gy or neu­ro­sur­ge­ry have also star­ted to take an inter­est in addi­tive manu­fac­tu­ring. Moreo­ver, ongoing research seeks to improve bio­prin­ting of organs or tis­sues as a way to over­come the lack of organ donors. And the phar­ma­ceu­ti­cal sec­tor is trying to deve­lop medi­ca­tion with novel shapes or properties.

Cus­to­mi­sed prin­ting of medi­cal equipment

The great advan­tage of 3D prin­ting is its cus­to­mi­sa­tion capa­ci­ties : den­tal implants, hip, rib, ster­num or knee pros­theses. Hea­ring aids or ortho­pae­dic insoles can also be prin­ted as one-off objects, tai­lo­red to the needs of each patient. Ber­nar­do Inno­cen­ti, pro­fes­sor in bio­me­cha­nics at École poly­tech­nique of the Uni­ver­si­té Libre de Bruxelles and pre­sident of the Bel­gian com­pa­ny CAOS (Com­pu­ter Assis­ted Ortho­pae­dic Sur­ge­ry) works in col­la­bo­ra­tion with ortho­pae­dic sur­geons and, more spe­ci­fi­cal­ly, with spe­cia­lists in knee surgery.

He explains that the use of addi­tive manu­fac­tu­ring in sur­ge­ry is an inter­dis­ci­pli­na­ry field, which entails ongoing dia­logue bet­ween sur­geons, resear­chers and engi­neers. In his opi­nion, the inter­ac­tion bet­ween these pro­fes­sio­nals is the key to suc­cess for a bio­me­di­cal pro­duct and a patient’s reco­ve­ry after sur­ge­ry. “3D prin­ting is not only used to make implants, it also pro­vides the sur­geon with a maxi­mum of impor­tant infor­ma­tion on the organ before the sur­gi­cal procedure,”he explains.

Pre­pa­ring sur­gi­cal procedures

Indeed, in the preo­pe­ra­tive phase prin­ting a three-dimen­sio­nal repli­ca of the body part can help col­lect vital infor­ma­tion some­times impos­sible to obtain without this tech­no­lo­gy. The sur­geon can thus hold in his hand the bone or the joint, and gain pre­cise know­ledge on the shape, size, tac­tile cha­rac­te­ris­tics, and the extent of the damage.

“Today, by using dif­ferent colours and prin­ting mate­rials, we can tru­ly simu­late the bone and define areas of high or low bone den­si­ty to decide where to put the screws and plates,” states Ber­nar­do Inno­cen­ti. 3D prin­ting can also be used to make per­so­na­li­sed sur­gi­cal ins­tru­ments, gua­ran­teeing a cus­tom pro­ce­dure for each patient based on the dis­tinct posi­tion of their muscles and ten­dons. Sur­gi­cal tem­plates, for example, help the sur­geon to define the cut­ting tem­plate and inci­sion points.

In the post-ope­ra­tive phase

Addi­tive manu­fac­tu­ring could also prove use­ful in the post-ope­ra­tive phase, to moni­tor the growth of bone and prostheses/bone inte­gra­tion. Although, they are com­pe­ting with pre-exis­ting methods that are argua­bly less expen­sive and alrea­dy very efficient.

Ber­nar­do Inno­cen­ti insists that the use of addi­tive manu­fac­tu­ring in sur­ge­ry has huge advan­tages if all the steps are per­for­med with extreme pre­ci­sion, but also if you have the neces­sa­ry means and time. Indeed, the inter­ac­tions bet­ween doc­tors and engi­neers, as well as the desi­gn and the model­ling of the pros­theses or implants, all require addi­tio­nal delays, while the manu­fac­tu­ring and ins­tal­la­tion times during the sur­ge­ry are simi­lar to other techniques.

“Though it might take a few years for 3D prin­ting to become wide­ly accep­ted by prac­ti­tio­ners, we are alrea­dy seeing an impor­tant dis­se­mi­na­tion of know­ledge in medi­cal schools”, states Ber­nar­do Inno­cen­ti. “In the case of rare diseases, 3D prin­ting could even help to build a data­base to train young surgeons.”

Recent­ly, he even star­ted to work in the field of car­dio­lo­gy, ano­ther sec­tor in which the use of addi­tive manu­fac­tu­ring is on the rise. “As in the case of the ortho­pae­dic sec­tor, 3D prin­ting is not only used to manu­fac­ture pro­theses (valves and stents) but also because it is very pre­cise during the sur­ge­ry. Addi­tive manu­fac­tu­ring does not just upgrade equip­ment and medi­ca­tion, it also improves the­ra­py as a whole,” concludes Ber­nar­do Innocenti.