The Impact of 3D Printing on Healthcare
My Introduction to 3D Printers
A few years ago I was working for a company in the healthcare marketplace. One of my responsibilities was to plan and execute trade shows. The biggest trade show we exhibited at each year was the Medical Group Management Association. Another responsibility was to generate foot traffic at the exhibit booth. I developed a contest drawing that included three different technology products to give away at the end of the conference, and I used email as the way to connect and promote the contest. The products for the giveaway included a 3D printer, a drone, and a GoPro camera.
I began to read articles about 3D printing and its impact on medicine and health. I became more interested in these devices and their practical applications in medical technology. 3D printers use software that can produce custom models of orthotics, dental implants, and even pharmaceuticals in the form of drugs.
The FDA and 3D Printing
According to The Food and Drug Administration (FDA), the process of 3D printing is a "type of additive manufacturing," which can be used interchangeably with 3D printing. The process of 3D printing creates layers from raw material into a three-dimensional object. The benefit of this allows designers to make changes based on fit, and anatomy due to the unique patient.
The role of the FDA in 3D printing is to provide guidance in two areas. The first area is Design and Manufacturing Conditions. This includes technical considerations and Quality System requirements for a device based on its regulatory classification for manufacturing. The second area is Device Testing Considerations. This area deals with premarket notification submissions, humanitarian device exemptions, and investigational device exemption.
Due to time constraints, patient matching, and medical incidents, it would be impossible to submit every 3D model for approval by the FDA. However, the FDA does provide specifications for minimum and maximum wall thickness, and the sharpness of a curve to ensure device performance based on the proposed use.
3D is Better Than 2D
The historical use of 2D technology in pre-surgical planning will eventually be replaced by 3D models. The 2D imagery from MRI and CT images do not provide enough patient-specific detail to identify unusual physiologies. Daniel Crawford, Founder of formlabs has one goal, and that is "to provide the healthcare sector with custom medical models that improve the experience of both doctors and patients." A full-scale anatomical model can give physicians and surgeons never before seen insights into the immediate needs of their patient. This leads to a more accurate diagnosis, and may even change the type of medical treatment.
3D can improve surgical outcomes
Pre-operative planning gives surgeons time to map out the surgery and order the exact tools they will need for the procedure. Access to 3D models gives surgeons the ability to try new techniques before they touch the patient. This can reduce the amount of time a patient is under anesthesia and may even reduce the amount of time they spend in physical therapy. According to a white paper by Stratasys and Quorum, there are three applications for using 3D models of patient anatomy.
- Plan: 3D models allow clinicians to become familiar with unique anatomies which may reduce operating time and costs.
- Practice: the use of 3D patient-specific models gave clinicians the opportunity to refine precise surgical techniques.
- Determine: access to patient-specific models is valuable in complex procedures because it allowed for an appropriate intervention strategy.
Models created by 3D printers have already proven beneficial to hospitals, physicians, and patients. In the case of a planned surgery, noninvasive images are taken of a patient's anatomy, using scans from a CT or MRI and converted by software into a 3D image. The 3D printed model is used to make patient-specific medical devices, because "one size does not fit all."
Dr. Adnan H. Siddiqui, M.D. is Chief Medical Officer at Jacobs Institute and Director of Neurosurgical Stroke Services for Kaleida Health. Dr. Siddiqui uses 3D technology for complex, elective surgeries. The 3D printed model gives this vascular surgeon the opportunity to perform what he calls, a dry-run procedure. The benefit of the dry run is that they can map out the best way to perform surgery and to minimize the risk of complications. This also reduces the amount of time spent in the surgical suite, which saves money for the hospital and the patient.
The Precision of Robotic Surgery
Robotic surgery is typically used through tiny incisions and is considered to be minimally invasive. This type of surgery reduces healing time and causes less trauma and scarring. Miniature surgical instruments are mounted on robotic arms which allow the surgeon to operate with precision while looking through a high-definition monitor. The surgeon guides the miniature instruments with his fingers, and each movement is exactly replicated by the robot.
Precision models of a patient's anatomy allow a physician to show a patient exactly what they are trying to repair or replace with surgery. Physicians at Nuada Medical, in London, use 3D images to explain the diagnosis and treatment options to their cancer patients. These models have also assisted with robot-assisted surgery.
Which of the following are benefits of robotic surgery?
3D Printing Saves Time and Money
3D Printing and Cosmetic Dentistry
In 2016, I had my first experience with a 3D printed, porcelain crown. I had developed a small cavity under an existing crown and the dentist recommended that the crown should be replaced because of the gap in the tooth. My past experience with having a crown produced was time-intensive and expensive. The process began with creating an impression of my tooth. The impression was then shipped to a specialty lab that would produce a new crown. If the lab was local, they would call me to schedule an appointment so that I could compare color swatches. The chosen color swatch would match the surrounding teeth. When the new crown was completed, it would be shipped back to the dentist, and require a follow-up visit to install the new crown.
During this particular visit, I discovered that the dentist actually had a 3D printer on site, and could make the new crown in less than an hour. Implanting the crown went very smoothly, and there were no problems. However, additional work was required to ensure that the new crown was correctly aligned with my other teeth when I eat. The bite was initially off, but the dentist was able to correct the fit.
I have not experienced any problems with the new crown. There is more than one benefit for having an on-site 3D printer. One is that it saved me money because it did not require an expensive lab to manufacture my porcelain crown. It also saved me time because I did not need a follow-up visit.
The Future of 3D Printing and Healthcare
Advances in 3D printing may become the greatest accomplishment of the 21st century. A process called Tissue Engineering may soon lead to the development of human tissue in the form of tissue and organs. This is also called 3D bioprinting and has already been successfully used in vascular grafts, tracheal splints, skin, and bone.
The goal of 3D printing in medicine is to save and improve lives. Imagine if burn victims could heal months faster from imprinted tissue. Imagine the millions of people around the world that could benefit from inexpensive, yet fully custom prosthetics. Perhaps someday soon, the long wait will end for people that are on a transplant list to receive a heart, liver, eyes, kidneys, and other organs from organ donors.
© 2017 Michelle Orelup