3D Printing at the Hospital – 24-7 ... The surgeons' new favorite tool?!

3D Printing – A medical innovation? Additive manufacturing (AM) or 3D printing was invented more than three decades ago and became established primarily in industry. In medicine, though, this technology has only been picking up speed for a few years.

However, the advantages in the medical treatment process are gigantic: Before a patient is treated in the operating theatre (OR), the surgeon / doctor already holds the individual anatomy of his patient in his hands: "Touch to comprehend" [1].

Improving the Quality of Care and Reducing Costs ...

Complex pathologies can be easily 3D-illustrated to within a millimeter, if needed in multi-color and with multi-materials with specific properties (eg biocompatible, transparent, flexible, rigid ...).

This increases the quality of the surgical procedure, the operation time can be shortened significantly, the surgeon is better prepared. In many complex operations the outcome is more predictable and better than traditionally, because surgeries can now be precisely planned in 3D on the computer and by the help of Virtual and Augmented Reality in combination with 3D printing. Patient-specific implants made of 3D-printed high-performance materials (for example, PEEK/PEKK or titanium) individually stabilize or replace bone defects.

The implants can be precisely adapted to the anatomical situation and biomechanical requirements and mimic nature. In the future, even smart implants will be available that have special "intelligent" properties. They have functional surfaces, measure forces or slowly dissolve until the patient's own body has had time to replace the injured tissue itself.

Human spare parts from the 3D printer – perfectly fitting "Smart Implants"

In the near future, it will even be possible to print and replace cartilage, bone, tendons and other human tissues.

Medical 3D printing is excellent for medical education, simulation and training. Using individual 3D models, the patient can be shown very realistically where operations will be performed and what is important to know and understand in the further course of treatment. 

Until recently, most of the hospitals have had to rely on outside vendors to produce medical 3D models. It's a process that can be expensive and time-consuming – but we can't wait for weeks when a patient has suffered an accident and needs to be operated, can we?

For this reason, our mission is to introduce and establish Point-of-Care Manufacturing and promote Medical 3D Technologies in the Hospital.

The University Hospital Basel is internationally already quite advanced: with the 3D Print Lab on the campus, founded many years ago, and the associated Swiss MAM research group at the Department of Biomedical Engineering of the University of Basel ... and, of course with our associated institutions and partners.

We print 7 days a week, 24h a day, if necessary. In emergency cases, we can produce a 3D anatomical model from the CT data set within a very short time (< 2 hours for smaller anatomical models). Remotely via highspeed-internet, we can start 3D printing on one of the numerous 3D printers in the hospital or in the research center so that an anatomical model of the individual injury (for example, a broken mandible or damaged orbit) is available before the patient is brought to the operating room. When larger models need to be printed quickly, we use a "trick". 3D models are printed in 4 or 6 parts on different 3D printers, this can reduce the printing time to 25% or 17% of the original time – with a cost-effective and environmentally friendly printing technology (FDM). This allows us, for example, to have complete 1:1 pelvis models in our hands within a few hours. We work on improving "Time to OR" and continuously optimize our processes.

What is your opinion? What are the trends and exciting topics of medical 3D printing in the future? There are still many questions open. The regulatory challenges are immense ... how do you fund and reimburse this innovation? So far, the Swiss healthcare system does not see this useful technology as a standard of care and reimbursement is a big effort. I am looking forward to an exchange.

The Future is Now!

References:

1) Petzold R, Zeilhofer HF, Kalender WA. Rapid protyping technology in medicine--basics and applications. Comput Med Imaging Graph. 1999 Sep-Oct;23(5):277-84. doi: 10.1016/s0895-6111(99)00025-7. PMID: 10638658.

2) Printing the Future (video and article): https://www.dhirubhai.net/posts/unispital-basel_printing-the-future-with-florian-thieringer-activity-6755756625673363457-0_3t

3) A list of our recent publications: https://bit.ly/FTpubmed