A scientist, doctor, artist, traveler, musician, activist, runner and animal-lover.
Pediatric surgery, trauma, medical education, women in surgery, women in science, health technology, robotics, everyday science.
3D printing blend creativity, innovation and surgical precision. Anything is possible!
For rehabilitation: printing custom prosthetics and parts.
For Surgeons: rehearsal of innovative surgical procedures. Simulation for education and experimentation. Customise anatomical implantables, prosthetics, external fixators, splints and cutting guides.
For the fine detail: smart regenerative medicine tailored to each patient. Printable medicine dose-adjusted for children. Generating a scaffold for stem-cell regeneration and specific organ repair.
Abstract: Created over 30 years ago, three dimensional printing (3DP) has recently seen a meteoric rise in interest within medicine, and the field of Physical Medicine and Rehabilitation is no exception. Also called additive manufacturing (AM), the recent increase in utilization of 3DP is likely due to lower cost printers as well as breakthroughs in techniques and processing. This thematic narrative review serves to introduce the rehabilitation professional to 3DP technology and how it is being applied to orthoses, prostheses, and assistive technology (AT). The basics of the technology as well as the benefits and challenges of using it within the rehabilitation framework are described. Proponents of the technology suggest that 3DP offers not only a better way to make devices, but a better way to make improved devices. However, the strength of this claim has not been properly tested by the current literature. This narrative review evaluates the evidence and provides a discussion of possible implications for the rehabilitation professional.
Pub.: 19 Jul '16, Pinned: 11 Apr '17
Abstract: Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes.Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans.227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure.3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.
Pub.: 23 Oct '16, Pinned: 11 Apr '17
Abstract: 3D printing is a relatively new, rapidly expanding method of manufacturing that found numerous applications in healthcare, automotive, aerospace and defense industries and in many other areas. In this review, applications in medicine that are revolutionizing the way surgeries are carried out, disrupting prosthesis and implant markets as well as dentistry will be presented. The relatively new field of bioprinting, that is printing with cells, will also be briefly discussed.
Pub.: 28 Oct '16, Pinned: 11 Apr '17
Abstract: Biological materials can actively participate in the formation of bioactive organs and can even control cell fate to form functional tissues that we name as the smart regenerative medicine (SRM). The SRM requires interdisciplinary efforts to finalize the pre-designed organs. Three-dimensional (3D) printing, as an additive manufacturing technology, has been widely used in various fields due to its high resolution and individuation. In SRM, with the assistance of 3D printing, cells and biomaterials could be precisely positioned to construct complicated tissues. This review summarizes the state of the SRM advances and focuses in particular on the 3D printing application in biofabrication. We further discuss the issues of SRM development and finally propose some approaches for future 3D printing, which involves SRM.
Pub.: 15 Oct '16, Pinned: 11 Apr '17
Abstract: Three dimensional (3D) printing involves a number of additive manufacturing techniques that are used to build structures from the ground up. This technology has been adapted to a wide range of surgical applications at an impressive rate. It has been used to print patient-specific anatomic models, implants, prosthetics, external fixators, splints, surgical instrumentation, and surgical cutting guides. The profound utility of this technology in surgery explains the exponential growth. It is important to learn how 3D printing has been used in surgery and how to potentially apply this technology. PubMed was searched for studies that addressed the clinical application of 3D printing in all surgical fields, yielding 442 results. Data was manually extracted from the 168 included studies. We found an exponential increase in studies addressing surgical applications for 3D printing since 2011, with the largest growth in craniofacial, oromaxillofacial, and cardiothoracic specialties. The pertinent considerations for getting started with 3D printing were identified and are discussed, including, software, printing techniques, printing materials, sterilization of printing materials, and cost and time requirements. Also, the diverse and increasing applications of 3D printing were recorded and are discussed. There is large array of potential applications for 3D printing. Decreasing cost and increasing ease of use are making this technology more available. Incorporating 3D printing into a surgical practice can be a rewarding process that yields impressive results.
Pub.: 17 Jan '17, Pinned: 11 Apr '17
Abstract: As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.
Pub.: 17 Jan '17, Pinned: 11 Apr '17
Abstract: While early and intermediate results of Fontan palliation have greatly improved the survival and quality of life of patients with single ventricle physiology, late complications remain concerning, and leave room for further improvement. In addition to recent advances in surgical techniques and post-operative care, advances in Medical Imaging and related technologies can further improve pre-surgical planning and post-operative management of these complex patients. Novel technologies including advanced MRI, computer aided design, three-dimensional printing, Virtual Surgery and Computational Fluid Dynamics may provide better patient-specific surgical plans, and continue to improve long-term outcomes.
Pub.: 18 Aug '16, Pinned: 11 Apr '17
Abstract: Three-dimensional (3D) printing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides, templates, and more recently customized implants. Surgeons report beneficial impacts using 3D-printed biomodels as a preoperative planning aid as it generally provides for a better representation of the patient’s anatomy than on-screen viewing of computed tomography or magnetic resonance imaging. Furthermore, it has proven to be very beneficial in surgical training, and in explaining complex deformity and surgical plans to patients/parents. This paper reviews the historical perspective, current use, and future directions in using 3D printing in complex spinal surgery cases. This review reflects the authors’ opinion of where the field is moving in light of the current literature. Despite the reported benefits of 3D printing for surgical planning in the recent years, it remains a highly niche market. This review raises the question as to why the use of this technology has not progressed more rapidly despite the reported advantages—decreased operating time, decreased radiation exposure to patients intraoperatively, improved overall surgical outcomes, preoperative implant selection, as well as being an excellent communication aid for all medical and surgical team members. Increasingly, the greatest benefits of 3D-printing technology in spinal surgery are custom designed drill guides, templates for pedicle screw placement, and customized patient-specific implants. With applications such as these, 3D-printing technology could potentially revolutionize health care in the near future.
Pub.: 01 Sep '16, Pinned: 11 Apr '17
Abstract: Three-dimensional printing has rapidly become an easily accessible, innovative and versatile technology, with a vast range of applications across a wide range of industries. There has been a recent emergence in the scientific literature relating to its potential application across a multitude of fields within medicine and surgery; however, its use within anaesthesia has yet to be formally explored. We undertook a systematic review using MEDLINE and EMBASE databases of three-dimensional printing in anaesthesia. We identified eight relevant articles. Due to the paucity of studies, we also completed a narrative review of the applications of three-dimensional printing pertinent to anaesthetic practice that our department are currently exploring, and suggest potential future uses for this technology relevant to our speciality.
Pub.: 28 Jan '17, Pinned: 11 Apr '17
Abstract: Prosthetic mask restoration of the donor face is essential in current facial transplant protocols. The aim was to develop a new three-dimensional (3D) printing (aka Additive Manufacturing, AM) process for the production of a donor face mask that fulfilled the requirements for facial restoration after facial harvest.
Pub.: 05 Oct '16, Pinned: 11 Apr '17
Abstract: The first medicine manufactured by three-dimensional (3D) printing was recently approved by the Food and Drug Administration (FDA). The advantages of printing as a manufacturing route enabling more flexibility regarding the dose, and enlarging individual treatment options, have been demonstrated. There is a particular need for flexible drug delivery solutions when it comes to children. Printing as a new pharmaceutical manufacturing technology brings manufacturing closer to the patient and can easily be adjusted to the required dosing scheme, offering more flexibility for treatments. Printing of medicine may therefore become the manufacturing route of choice to provide tailored and potentially on-demand treatments for patients with individual needs. This paper intends to summarize and discuss the state of the art, the crucial aspects which should be taken into account, and the still-open questions, in order to make 3D printing a suitable manufacturing route for pediatric drugs.
Pub.: 13 Jan '17, Pinned: 11 Apr '17
Abstract: Craniomaxillofacial reconstructive surgery is a challenging field. First it aims to restore primary functions and second to preserve craniofacial anatomical features like symmetry and harmony. Three-dimensional (3D) printed biomodels have been widely adopted in medical fields by providing tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. Craniomaxillofacial reconstructive surgery was one of the first areas to implement 3D printing technology in their practice. Biomodeling has been used in craniofacial reconstruction of traumatic injuries, congenital disorders, tumor removal, iatrogenic injuries (e.g., decompressive craniectomies), orthognathic surgery, and implantology. 3D printing has proven to improve and enable an optimization of preoperative planning, develop intraoperative guidance tools, reduce operative time, and significantly improve the biofunctional and the aesthetic outcome. This technology has also shown great potential in enriching the teaching of medical students and surgical residents. The aim of this review is to present the current status of 3D printing technology and its practical and innovative applications, specifically in craniomaxillofacial reconstructive surgery, illustrated with two clinical cases where the 3D printing technology was successfully used.
Pub.: 02 Jan '17, Pinned: 11 Apr '17
Abstract: Liver surgery is widely used as a treatment modality for various liver pathologies. Despite significant improvement in clinical care, operative strategies, and technology over the past few decades, liver surgery is still risky, and optimal preoperative planning and anatomical assessment are necessary to minimize risks of serious complications. 3D printing technology is rapidly expanding, and whilst appliactions in medicine are growing, but its applications in liver surgery are still limited. This article describes the development of models of hepatic structures specific to a patient diagnosed with an operable hepatic malignancy.Anatomy data were segmented and extracted from computed tomography and magnetic resonance imaging of the liver of a single patient with a resectable liver tumor. The digital data of the extracted anatomical surfaces was then edited and smoothed, resulting in a set of digital 3D models of the hepatic vein, portal vein with tumor, biliary tree with gallbladder, and hepatic artery. These were then 3D printed.The final models of the liver structures and tumor provided good anatomical detail and representation of the spatial relationships between the liver tumor and adjacent hepatic structures and could be easily manipulated and explored from different angles.A graspable, patient-specific, 3D printed model of liver structures could provide an improved understanding of the complex liver anatomy and better navigation in difficult areas and allow surgeons to anticipate anatomical issues that might arise during the operation. Further research into adequate imaging, liver-specific volumetric software, and segmentation algorithms are worth considering to optimize this application.
Pub.: 31 Jan '17, Pinned: 11 Apr '17
Abstract: Three-dimensional (3D) printing for preoperative planning has been intensively developed in the recent years. However, the implementation of these solutions in hospitals is still difficult due to high costs, extremely expensive industrial-grade printers, and software that is difficult to obtain and learn along with a lack of a defined process. This paper presents a cost-effective technique of preparing 3D-printed liver models that preserves the shape and all of the structures, including the vessels and the tumor, which in the present case is colorectal liver metastasis.The patient's computed tomography scans were used for the separation and visualization of virtual 3D anatomical structures. Those elements were transformed into stereolithographic files and subsequently printed on a desktop 3D printer. The multipart structure was assembled and filled with silicone. The patient underwent subsequent laparoscopic right hemihepatectomy. The entire process is described step-by-step, and only free-to-use and mostly open-source software was used.As a result, a transparent, full-sized liver model with visible vessels and colorectal metastasis was created for under $150, which-taking into account 3D printer prices-is much cheaper than models presented in previous research papers.The increased accessibility of 3D models for physicians before complex laparoscopic surgical procedures such as hepatic resections could lead to beneficial breakthroughs in these sophisticated surgeries, as many reports show that these models reduce operative time and improve short term outcomes.
Pub.: 02 Feb '17, Pinned: 11 Apr '17
Abstract: Three-dimensional (3D) printing (3DP) is a rapid prototyping technology that has gained increasing recognition in many different fields. Inherent accuracy and low-cost property enable applicability of 3DP in many areas, such as manufacturing, aerospace, medical, and industrial design. Recently, 3DP has gained considerable attention in the medical field. The image data can be quickly turned into physical objects by using 3DP technology. These objects are being used across a variety of surgical specialties. The shortage of cadaver specimens is a major problem in medical education. However, this concern has been solved with the emergence of 3DP model. Custom-made items can be produced by using 3DP technology. This innovation allows 3DP use in preoperative planning and surgical training. Learning is difficult among medical students because of the complex anatomical structures of the liver. Thus, 3D visualization is a useful tool in anatomy teaching and hepatic surgical training. However, conventional models do not capture haptic qualities. 3DP can produce highly accurate and complex physical models. Many types of human or animal differentiated cells can be printed successfully with the development of 3D bio-printing technology. This progress represents a valuable breakthrough that exhibits many potential uses, such as research on drug metabolism or liver disease mechanism. This technology can also be used to solve shortage of organs for transplant in the future.
Pub.: 06 Feb '17, Pinned: 11 Apr '17
Abstract: Virtual surgical planning (VSP) has recently been introduced in craniomaxillofacial surgery with the goal of improving efficiency and precision for complex surgical operations. Among many indications, VSP can also be applied for the treatment of congenital and acquired craniofacial defects, including orbital fractures. VSP permits the surgeon to visualize the complex anatomy of craniofacial region, showing the relationship between bone and neurovascular structures. It can be used to design and print using three-dimensional (3D) printing technology and customized surgical models. Additionally, intraoperative navigation may be useful as an aid in performing the surgery. Navigation is useful for both the surgical dissection as well as to confirm the placement of the implant. Navigation has been found to be especially useful for orbit and sinus surgery. The present paper reports a case describing the use of VSP and computerized navigation for the reconstruction of a large orbital floor defect with a custom implant.
Pub.: 17 Feb '17, Pinned: 11 Apr '17
Abstract: The aim of this paper was to study the feasibility of manufacturing a customizable trocar-cannula system for vitreoretinal surgery utilizing commercially available three-dimensional (3D) printing technology.A digital model of a trocar-cannula system for vitreoretinal surgery was created using computer-aided design (CAD) software and printed utilizing a laser-sintering 3D printer in modified ABS thermoplastic material. The trocar-cannula prototypes were tested in pig eyes.A customizable digital model was created using commercially available CAD software. Three trocar-cannulas were printed. The smallest cannulas that could be printed had dimensions between 21 and 22G. The trocar-cannulas were inserted in pig eyes after performing sclerotomies with a commercially available 20G MVR blade. One cannula broke during insertion.This study demonstrates the feasibility of printing a transconjunctival vitrectomy trocar-cannula system with commercially available 3D print technology. The 3D printer and build material used resulted in trocar-cannulas with functional limitations including a minimum size achievable and mechanical resistance.
Pub.: 02 Mar '17, Pinned: 11 Apr '17
Abstract: Three-dimensional (3D) printing is a manufacturing process in which an object is created by specialist printers designed to print in additive layers to create a 3D object. Whilst there are initial promising medical applications of 3D printing, a lack of evidence to support its use remains a barrier for larger scale adoption into clinical practice. Endovascular virtual reality (VR) simulation plays an important role in the safe training of future endovascular practitioners, but existing VR models have disadvantages including cost and accessibility which could be addressed with 3D printing.This study sought to evaluate the feasibility of 3D printing an anatomically accurate human aorta for the purposes of endovascular training.A 3D printed model was successfully designed and printed and used for endovascular simulation. The stages of development and practical applications are described. Feedback from 96 physicians who answered a series of questions using a 5 point Likert scale is presented.Initial data supports the value of 3D printed endovascular models although further educational validation is required.
Pub.: 03 Mar '17, Pinned: 11 Apr '17
Abstract: Advanced percutaneous and surgical procedures in structural and congenital heart disease require precise pre-procedural planning and continuous quality control. Although current imaging modalities and post-processing software assists with peri-procedural guidance, their capabilities for spatial conceptualization remain limited in two- and three-dimensional representations. In contrast, 3D printing offers not only improved visualization for procedural planning, but provides substantial information on the accuracy of surgical reconstruction and device implantations. Peri-procedural 3D printing has the potential to set standards of quality assurance and individualized healthcare in cardiovascular medicine and surgery. Nowadays, a variety of clinical applications are available showing how accurate 3D computer reformatting and physical 3D printouts of native anatomy, embedded pathology, and implants are and how they may assist in the development of innovative therapies. Accurate imaging of pathology including target region for intervention, its anatomic features and spatial relation to the surrounding structures is critical for selecting optimal approach and evaluation of procedural results. This review describes clinical applications of 3D printing, outlines current limitations, and highlights future implications for quality control, advanced medical education and training.
Pub.: 23 Mar '17, Pinned: 11 Apr '17
Abstract: Bone regeneration is currently one of the most important and challenging tissue engineering approaches in regenerative medicine. Bone regeneration is a promising approach in dentistry and is considered an ideal clinical strategy in treating diseases, injuries, and defects of the maxillofacial region. Advances in tissue engineering have resulted in the development of innovative scaffold designs, complemented by the progress made in cell-based therapies. In vitro bone regeneration can be achieved by the combination of stem cells, scaffolds, and bioactive factors. The biomimetic approach to create an ideal bone substitute provides strategies for developing combined scaffolds composed of adult stem cells with mesenchymal phenotype and different organic biomaterials (such as collagen and hyaluronic acid derivatives) or inorganic biomaterials such as manufactured polymers (polyglycolic acid (PGA), polylactic acid (PLA), and polycaprolactone). This review focuses on different biomaterials currently used in dentistry as scaffolds for bone regeneration in treating bone defects or in surgical techniques, such as sinus lift, horizontal and vertical bone grafts, or socket preservation. Our review would be of particular interest to medical and surgical researchers at the interface of cell biology, materials science, and tissue engineering, as well as industry-related manufacturers and researchers in healthcare, prosthetics, and 3D printing, too.
Pub.: 25 Mar '17, Pinned: 11 Apr '17
Abstract: Head and neck reconstructive microsurgery is constantly innovating because of a combination of multidisciplinary advances. This article examines recent innovations that have affected the field as well as presenting research leading to future advancement. Innovations include the use of virtual surgical planning and three-dimensional printing in craniofacial reconstruction, advances in intraoperative navigation and imaging, as well as postoperative monitoring, development of minimally invasive reconstructive microsurgery techniques, integration of regenerative medicine and stem cell biology with reconstruction, and the dramatic advancement of face transplant.
Pub.: 28 Mar '17, Pinned: 11 Apr '17