3D printed models for kids’ operations

http://www.engadget.com/2015/08/01/boston-childrens-hospital-3d-printing/

Surgeons practice on 3D-printed models for kids’ operations

Surgeons at Boston Children’s Hospital started using 3D-printed copies of patients’ affected body parts to prepare for procedures last year. Now, that move has helped save the lives of four children aged two months to 16 years old who suffered from life-threatening blood vessel malformation in their brains. Their condition gave ride to distinctive anatomies that one of the hospital’s neurosurgeon, Edward Smith, said were really tricky to operate on. So, the doctors used a combination of 3D printing and synthetic resins to conjure up copies of the kids’ deformed vessels, along with nearby normal counterparts and surrounding brain anatomy. That gave them the chance to practice extensively beforehand and reduce possible complications on the operating table.

Smith said the models allowed them to “view [the formations] from different angles, practice the operation with real instruments and get tactile feedback.” It was especially beneficial for three of the four patients, as they had arteriovenous malformations (AVMs) — their arteries and veins were all tangled up – that required the surgeons to cut blood vessels as quickly as possible, and in a certain sequence. Thanks to their preparations, the surgeons managed to fix the kids’ distorted blood vessels and cut surgery time by 30 minutes each. Smith and his colleague Darren Orbach now plan to use 3D printing to train younger doctors and for even trickier cases in the future.

engadget.com

by Mariella Moon | August 1st 2015 At 3:33am

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3D printed prosthetic jaw!

http://www.abc.net.au/news/2015-06-20/melbourne-man-receives-titanium-3d-printed-prosthetic-jaw/6536788

3D printed titanium prosthetic jaw joint bone

Titanium, 3D printed prosthetic jaw implanted in Melbourne man in Australian first surgery

Surgeons have successfully implanted a titanium 3D-printed prosthetic jaw in a Melbourne man in an Australian-first operation.

It is hoped the success of the locally designed and tested part will lead to high-tech export opportunities.

The patient, 32-year-old psychologist Richard Stratton, was missing part of his jawbone including the left condyle, the joint to the skull.

He believed part of his jaw never grew properly after he received a bad knock to the jaw during childhood.

In the past few years, he has suffered increasing pain while chewing or moving his jaw and he has not been able to fully open his mouth.

Oral and maxillofacial surgeon Dr George Dimitroulis designed a prototype prosthesis that was refined and tested by experts at Melbourne University’s mechanical engineering department.

Dr Dimitroulis said that while there had been a handful of 3D-printed jaw operations worldwide, he was not aware of any that incorporated a titanium part and a 3D-printed plastic jaw joint.

“In terms of joint replacement specifically, what we call the TMJ – the temporomandibular joint – we suspect that this may be the first 3D-printed jaw joint in the world,” he said.

It was designed to protect the skull from a rubbing metal joint which would wear and erode into the cranial cavity.

“The beauty of this particular joint itself is that it was designed in Australia and manufactured [by an Australian firm] … and not just manufactured in the common sense, but 3D printed,” he said.

“It really makes the fit truly patient-fitted, truly customised, as opposed to ‘we’re close enough’ and it’s something that I think will become the norm in the future as technology [becomes] cheaper.”

Dr Dimitroulis said it was a great example of “smart Australia” and 3D printing would lead to “revolutionary” changes in jaw prosthesis surgery.

Richard Stratton before and after surgery

Sunrise of a whole new industry

Before the operation, Mr Stratton said he was excited to be “patient X on the Australian joint” and joked that he had put in an order for a “Brad Pitt” jaw.

He hoped many more patients would benefit from having their replacement joints 3D printed and personalised to them.

“It sounds a bit [like] science fiction … I don’t really understand 3D printing that much but it’s exciting,” he said.

“They have a 3D model of my skull and the fact that they’ve made the joint to fit that perfectly, I feel a lot safer in knowing that it’s not just a factory made, off-the-shelf joint.

“Hopefully all the time they’ve spent on their computers and designing my new jaw, hopefully that will make the short-term recovery better for me and also the longer-term outcome is that it will last a lot longer and hopefully work a lot more efficiently.”

Port Melbourne firm 3D Medical used powdered titanium that was heated and fused one layer at a time to print the prosthesis.

Technicians also used CT scan images to print a 3D plastic model of Mr Stratton’s skull and then refined the titanium part to provide a perfect fit.

While this part was manufactured in New Zealand, future parts will be locally produced.

Company chairman Dr Nigel Finch said about 30 versions of the part had to be printed during the customisation process but he predicted that any future adaptation would take much less time.

“It really is the sunrise of a whole new industry,” he said.

“I think that greater support, better understanding by the regulators and better understanding by hospitals and the healthcare system, will see the adoption of 3D medical implants and other technologies starting to become mainstream.

“Most of the implants that patients receive now are generic sizing, and of course nobody really is small, medium or large.”

New 3D printed titanium jaw part for Richard Stratton attached to a 3D printed version of his skull.

On-demand printing the way of the future

Dr Finch said the cost of the technology had come down to a “truly competitive” price point compared with conventional manufacturing of parts.

The use of highly-automated machines also eliminated much of the labour cost that had traditionally made Australian manufacturing uncompetitive.

“One of the things that’s really personally exciting for me is this whole idea about bringing a manufacturing base back to Australia and focusing around the digital aspect of it,” Dr Finch said.

“We currently have a model where the hospitals are carrying inventory of generic implants, and this is very costly on the hospital’s balance sheets, very costly on the healthcare system and I can see a future where we’re manufacturing parts on an as-required basis so we’re printing on demand.”

Melbourne University biomedical engineer, Dr David Ackland, said it was “quite unusual and unexpected” to be approached by an oral and maxillofacial surgeon with a design prototype as computer simulations had mostly been performed on knee, shoulder and hip joints in the past.

“It’s very very important before you put an implant into the human body that you know that it’s going to be able to withstand the normal forces, the internal forces in the human body,” he said.

“We performed computer simulations [on the jaw prosthesis] to determine the joint loading and the loading on the implant and the screws, which of course the prosthesis would be subject to during biting and chewing.

“So we’ve done quite a comprehensive set of musculoskeletal modelling studies … to make sure that it doesn’t fail.”

Dr Ackland said 3D printing technology was still in its infancy so there were not a lot of customised components being developed or placed inside the human body.

“It’s incredibly exciting and there’s enormous potential for use of 3D printing technology to develop customised, patient-specific joint replacements and prosthetic components for a range of patients with different musculoskeletal disorders,” he said.

‘The excitement was unbearable’

Just after completing the five-hour operation, Dr Dimitroulis said he was “very proud” that three years of hard work had paid off.

“The excitement was unbearable I think, just at the last minute we thought it just wasn’t going to fit in but it just slid in nicely,” he said.

Dr Dimitroulis said patients with severe osteoarthritis of the jaw would benefit from the new implant and two patients had already signed on to receive one.

Mr Stratton said he found the pain and swelling confronting in the first few days after surgery but one month later and he was already able to open his mouth wider than before the surgery.

“The physiotherapist is really impressed and she works with these joints every day, and she says the range of movement … is a lot more than other patients that she’s worked with,” he said.

As for the “Brad Pitt” look, Mr Stratton has been clearly amused by his new chiselled jawline.

“People have have been really politely saying that it’s a huge improvement,” he laughed.

“I didn’t notice that I didn’t have a chin before, but people are now saying, ‘Wow, you’ve got such a great chin!'”

X-ray front shot

abc.net.au

by Stephanie Ferrier | 22 Jun 2015, 4:45am

3D printing used to save a toddler’s mind

3D printing is used for “one of the most challenging operations in pediatric epilepsy surgery.”

The concept of using 3D printing for ‘practice runs’ or simulations on risky procedures is catching on and gaining in popularity!

http://www.theverge.com/…/doctor-turns-to-3d-printers-in-a-…

Gabe suffered from terrible seizures known as “mind erasers.” But doctors used a 3D printed brain to pioneer a medical breakthrough and give him a normal life.

Come along with The Verge for the second season of Detours. We’ve traveled across the country to find the people, groups, and companies that are solving America’s problems in new and unconventional ways.

On a Tuesday last summer, Erin Mandeville was at a CVS buying medicine for her five-month-old baby, Gabriel. Close to 4PM, she noticed her infant’s eyes roll back in quick succession. It was the first of Gabriel’s many episodes of infantile spasms that would follow.

Spasms or epileptic seizures can be catastrophic for young children. Doctors at Boston Children’s Hospital tried every route and medicine to help Gabriel as his seizures progressed aggressively.

“He was missing huge milestones in his childhood,” said Mandeville.

Doctors eventually suggested a hemispherectomy, a complicated operation that disconnects the healthy half of the brain from the one causing seizures. “I didn’t know how invasive it would be,” Gabriel’s mother said. “But, if it was going to make him have a better life, it was an easy choice to make.”

Mandeville’s choice was made easier knowing that Gabriel would be the first infant whose brain would be replicated by a 3D printer for a practice run prior to the operation.

“THIS IS A PRINTED VERSION THAT THE SURGEON CAN HOLD, CUT, MANIPULATE, AND LOOK FOR THINGS.”

A hemispherectomy is “one of the most challenging operations in pediatric epilepsy surgery,” says Dr. Joseph Madsen, director of the epilepsy program at Boston Children’s. A dress rehearsal is beneficial even for the most highly experienced surgeons. “This is a printed version that the surgeon can hold, cut, manipulate, and look for things,” he says, holding Gabriel’s printed brain in his hand. For surgeons-in-training, the simulation is a blessing. “No one wants to be the first person to get a hemispherectomy from a surgeon, ever,” he adds.

The 3D print of Gabriel’s brain was developed by the Simulator Program at the hospital. The model is printed in soft plastic with a precision of 16 microns per layer; blood vessels are set in contrast color for easier navigation. Gabriel’s parents were privy to the process and anticipated complications. Gabriel’s subsequent surgery earlier this year took close to 10 hours, and went according to plan.

“Surgical preparation via simulation allows surgeons to hit the ground a lot faster,” says Dr. Peter Weinstock, director of the Simulator Program. “We can’t be prepared for every possibility, but we can chop off a large number of complications.”

Though medical simulations are nothing new, the Simulator Program surpasses conventional systems with next-generation mannequins and 3D printing. The team behind the program includes surgeons, specialists, radiologists, and engineers, and is currently gathering data to validate its implications on surgical times, anesthetic times, and patient safety.

“WE CAN CHOP OFF A LARGE NUMBER OF COMPLICATIONS.”

Within a year of its inception, the project has developed close to 100 prints — 20 percent of those have made their way into operating rooms. Dr. Weinstock suggests that in the future, on-demand anatomy printing could make its way into emergency rooms to meet the needs of trauma cases.

“The technology is coming,” he said. “The question is: how do we develop and make use of the technology that will have an immediate effect on how we take care of children?”

Gabriel, now 18 months, is seizure-free. Challenges can be expected. “But, kids’ brains are so resilient,” his mother says. “He’s already re-wired himself. He’s starting to hit the milestones he missed — he wakes up smiling every day.”

THEVERGE.COM
by Mona Lalwani | September 3, 2014 11:41 am

3D printing – further progress in medicine

Another good deed achieved through 3D printing!

http://www.nydailynews.com/…/chinese-doctors-3d-printing-re…

CHNOUT

A 46-year-old farmer identified only as Hu suffered a head injured when he fell from the third floor of a building. Doctors recently rebuilt the missing section of his skull with titanium mesh produced by a 3D printer.

They will rebuild him: a staff member at a hospital in Xi’ an, Shaanxi province, displays the titanium mesh produced by a 3D printer prior to the man’s surgery.

A Chinese man recently underwent a potentially life-changing operation thanks to something created by a 3D printer.

Doctors at a hospital in Xi’an, Shaanxi province, used a 3D-printed titanium mesh implant to rebuild a section of Hu’s skull.

The 46-year-old farmer suffered a head injury in October when he fell from the third floor of a building, according to local media. A large portion of his skull was crushed and needed to be removed.

Since the accident, Hu has also had trouble with his vision and speech.

Doctors said they hoped the titanium mesh would help recreate the original shape of his skull and reduce surgery trauma.

NYDAILYNEWS.COM
by  | August 29, 2014, 5:11 PM

3D systems medical modeling

A must-read for all medical enthusiasts!

See how 3D printing is fast cementing its reputation at the forefront of medical technology; An operation on a newborn child that would have taken another 6 years of waiting time with traditional methods, as well as an overview of how 3D printing has advanced the field of surgery

http://3dprint.com/10195/3d-printing-operating-room/

med-2

During the recent 3D Systems’ 2014 Investor & Analyst Day, one of the key issues addressed was the new frontiers in medical technology. At 3D Systems, healthcare appears to be the fastest growing market. The management team stated its plans to build up its leadership in this field. The company plans to invest and expand its virtual surgical planning (VSP®) capabilities, broaden its range of implants and surgical tool manufacturing and develop new personalized medical devices, such as the recently introducedbespoke scoliosis brace.

In April, 3D Systems announced the acquisition of Medical Modeling, a leading provider of personalized surgical treatments and patient specific medical devices, including virtual surgical planning (VSP®). The VSP is a service-based approach to personalized surgery that combines expertise in medical imaging, surgical simulation and additive manufacturing. It allows for planning maxillofacial surgical procedures in a virtual environment and transferring that plan to the patient using innovative models, templates and surgical guides manufactured with 3D printers. Recently, it was used by Dr. Oren Tepper, Assistant Professor of Surgery at New York’s Montefiore Medical Center and a pioneer in virtual surgical planning. He performed surgery on a 3-week-old girl named Jayla Vargas who had difficulty breathing due to her tiny jaw. Traditionally, in such cases, she would have had to wait 6 years until she was large enough for the operation. However, with the help of VSP technology, Dr. Tepper successfully fixed Jayla’s jaw.

At the Investor & Analyst Day, Dr. Oren Tepper was the guest speaker and he discussed the current uses and future applications of 3D printing in plastic surgery. Dr. Oren Tepper explained how technology is important in plastic surgery as creativity and innovation are involved in building, restoring and renovating the human body. Therefore, practitioners embrace this technology. Over the last several years, training and skills have been the key points in technical innovation related to plastic surgery. Advanced techniques have been used and cutting edge technology has been incorporated. For the moment, all of these advancements are focused on the operating room itself. Nonetheless, this technology is bringing greater planning and precision to operating rooms, enabling surgeons to perform successful operations that were previously impossible.

At the moment, 3D Systems and Medical Modeling has had a tremendous impact on bone reconstruction, but it is still a relatively small impact in the field. The untapped potential, especially in soft tissue reconstruction, is enormous.

“This technology eliminates surprises, minimizes complications and improves the precision of surgery.”

According to the doctor, the first real advancement was the CT scanner, which allowed plastic surgeons to look at bodies via the CT scans. Next, the skull was 3D printed so it could be used as a reference. The process started building stereolithographic models of the skulls so it was possible to study them in any direction and to practice surgery. That was the first generation, just printing the existing anatomy of the patient. Now, it is possible to plan a surgery on a computer for surgical simulation. Therefore, surgeons can move the bone structures where they want them to be and they can develop on the computer and 3D print guides and jigs which they sterilize and bring to the operating room.

The first study about virtual surgical planning and printing was published 5 years ago. Regarding facial fractures, Dr. Tepper used an example at the conference of a lower jaw fractured in multiple pieces, on a young woman named Jayla. Due to limited exposure of the surgeon and the lack of reference points, it was difficult to put the jaw back together. The phases to follow during the process of reconstruction are:

  • Phase 1. Virtual planning: Reduce fracture and establish occlusion on the computer.
  • Phase 2. Modeling: Create jigs and guides that can be taken to the operating room.
  • Phase 3. Surgering. Place the 3D printed jigs on the patient in the operating room and use them to put the facial fractures together.
  • Phase 4. Analysis: Achieve what doctors have automatically set out to do surgically.

Regarding Jayla’s operation, Dr. Tepper emphasized that the procedure used was safer and cheaper than the traditional practice, a tracheostomy, which is a surgically created opening in the windpipe to allow proper breathing. However, virtual surgical planning is only used on a small percentage of operations today. When asked about the challenges he faced and the solutions that he came up with, Dr. Tepper highlighted four reasons why 3D printing was so useful to him in the operating room:

  • The device size. He wasn’t sure if the device was small enough that it would fit under the lower jaw but this technology solved that problem.
  • The underdevelopment of the patient’s bone. Jayla’s bone was so under developed that he needed to place the device exactly at the same parallel vector. Again, thanks to this computer technology he could perfectly do just that.
  • The critical structures. The lower jaw is not just simply made of bone. Thanks to the computer, it was possible to identify the different structures and stay away from those critical structures.
  • The bone width. This technology allowed him to predict the size of the bone so he knew exactly where to place the device.

Dr. Tepper believes in the technology’s future growth potential as it will make the existing infrastructure better and faster and it will represent a tremendous opportunity in expanding markets. At the moment, there is no communication between plastic surgeons and 3D printing companies. On the contrary, it is an opportunity for real time communication so that companies like 3D Systems could have a role in the operating room. Dr. Tepper affirmed that surgeons will one day look back on non-VSP procedures as crude and primitive.

How long will it be before this type of technology is commonplace within the operating room?  Let’s hear your thoughts in the 3D printing and surgery forumthread on 3DPB.com.

3DPRINT.COM
by  | JULY 27, 2014

3D printed replica of tumour

A team of Spanish surgeons 3D printed an exact replica of a 5-year old’s tumour so that they could practice removing it, after having failed to remove the real thing twice. The third procedure was a success and they now expect the boy to make a full recovery without further operations.

The hospital is so impressed with this use of 3D printing to help simulate complicated procedures that two new models have already been commissioned for patients.

http://www.cnet.com/…/3d-printing-helps-surgeons-save-5-ye…/

A practice surgical procedure on a 3D-printed tumor has helped surgeons successfully remove the tricky real one from a 5-year-old boy in Spain.

The boy was diagnosed with neuroblastoma, a common form of cancer in children that typically occurs around the stomach. Because of the locations of these types of tumors, surgery to remove them requires copious skill to not slice an artery and put the patient’s life in danger. After two unsuccessful attempts to remove the child’s tumor, it appeared inoperable.

“We tried the surgery twice but we failed because we could not access,” head surgeon Jaume Mora said at a press conference Wednesday. “Instead of surrendering, we tried to find a solution.”

Mora and his team at the Hospital Sant Joan de Deu in Barcelona turned to the CIM Foundation at the Polytechnic University of Catalonia to create a 3D-printed replica of the boy’s tumor so they could perfect their technique ahead of the surgery.

The team used a multi-material 3D printer to print hardened arteries and organs surrounding a translucent, soft resin so they could practice removing the tumor without damaging the boy’s innards. They also built a tumor-free replica of the child’s insides to see what he should look like once the cancer had been removed.

After undertaking a practice run a week and a half before the scheduled surgery, the surgeons successfully removed the tumor from the boy’s body. And they’re happy to report that they expect him to fully recover without the need for additional surgeries. In fact, the team and the hospital were so impressed with how the procedure went, they’ve commissioned 3D-printed models for two other patients.

This case represents one of the first times a personalized, 3D-printed organ has been used to successfully simulate a surgery, though it almost certainly won’t be the last. And it’s once again excitingto see that technology commonly used to print jewelry, figurines, and iPhone cases can also help medical professionals save lives.

CNET.COM

by | July 3, 20141:39 PM PDT