3-D printing revolutionising the medical industry, say experts

One of the biggest areas of impact felt by the rise of 3-D printing is in the medical industry.

Be it in surgical planning by using models of a human structure to help guide surgeons, or using 3-D printed organs and bodies to replace cadavers in the medical classroom - the industry has become more important to the medical field every year.

The technology is helping doctors deliver more precise, faster treatment with better control, while bio-printing of titanium replacement joints is helping delay the need for a second surgery as humans live longer.

Dr Nizar Zein was among the first physicians to recognise the potential for 3-D printing to help reduce the risk of complications during surgery.

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Since 2012, he has led a long-term project at Cleveland Clinic to create 3-D printed replicas of individual patients’ livers, accurate enough to use for detailed surgical planning.

“When we operate on the liver, one of the biggest risks comes from not knowing the exact locations of major blood vessels or bile ducts, and inadvertently cutting through one of them,” said Dr Zein.

“We typically use a CT scan to come up with a surgical plan for the patient, but there is no sense of depth, and even a 3-D scan will still be viewed on a 2-D screen.

“With a 3-D printed replica, we solve that problem, and it has the advantage of being tactile – we can pick the model up and examine it in the real world, and reassess our planning based on what we see.”

The models are printed to be transparent, and components within the organ can be printed as separate pieces – held together by magnets – so surgeons can pull them apart and examine them individually.

Each model is created at actual scale and takes about 48 hours to print, down from around six weeks for the original experimental model in 2012, which was printed at 75 per cent of actual size.

Abedi Al Ilah Husseini, director of 3-D Middle East, said a body scan similar to an x-ray can now be used to build a model organ, almost identical to that on which surgeons can operate.

“On a kidney with a tumour for example, doctors can look at a replicated model to plan the surgery,” he said.

“Dental implants are also now available for 3-D printing, they are custom made and non-toxic.

“Titanium grade 23 powder can be used in 3-D printing of replacement joints. The process helps control the porosity, so the joints can become patient specific and should last longer.”

In 2017, for the Cleveland Clinic’s third face transplant procedure, doctors turned to emerging 3-D printing technology to improve the chances of success.

They first practised with a 3-D printed replica of the face before going ahead with surgery.

“A face transplant involves connecting a number of different types of tissue, including bone, muscle and blood vessels, and we not only have to make these function, we have to create a successful fit between the donated face and the patient’s head and neck – all of which are unique,” said Dr Francis Papay, who was part of the surgical team to perform the United States’ first face transplant in 2008.

“Unlike a transplanted organ, the results are visible as this face will be the first thing anyone will see when they look at the patient.

“The more accurate and complete all these connections can be, the better the results in terms of function and appearance.”

Using 3-D scanning and printing, doctors can plan and practice the procedure using accurate, individualized models, which significantly improves the outcome for the patient.

“I don’t think you can ever totally mimic a cadaver when training students,” Dr Papay said.

“In teaching, virtual reality can help to understand relationships and dynamics between tissue, but cadavers remain very useful.

“Biomodelling will continue, but there is something about the rarity, anomalies and haptics of manipulating tissue that is hard to mimic.”