Paige Anne Carter

Many doctors these days are now including 3D printing as part of their many surgical procedures. Dr. Jamie Levine from NYU Langone noted that there is a paradigm shift when it comes to doing surgical procedure in terms of using and relying on 3D printing. A lot of hospitals all over the United States have already embraced 3D printing to create tools, models or craft tissues used for surgery. One of the hospitals that are leading the paradigm shift is the Institute for Reconstructive Plastic Surgery at NYU Langone. The surgeons from NYU Langone use special printers to create tools and 3D models that can save doctors from performing long and expensive surgeries. In fact, the hospital is able to save $20,000 to $30,000 for every reconstruction that the do. The use of 3D printing in medical technology is very promising. In fact, the Food and Drug Administration has already approved the creation of 3D printed pills and vertebrae. There are also many researchers all over the world working with 3D printed organs to be used in organ transplantation. Although medical-grade 3D printers still remain expensive, they can make infinite types of objects like surgical tools, anatomical models and other devices. Fortunately, there are now many companies that are developing cost-effective printers thus the cost is targeted to go down in the future. There is a wide potential for innovation when it comes to using the 3D printing technology. With this technology, it is no wonder if many hospitals all over the world will rely on 3D printing technology to treat different diseases.

Surgery on the anterior crucial ligament (ACL) is difficult. The standard surgical procedure involves drilling a tunnel on the tibia to remove the ligament and reconstructing it by using transplanted graft. In most cases, the affected area that has been treated has a good chance of re-tearing after being repaired. However, this technique has many limitations such as entering the knee through the tibia can make it difficult to reattach the ligament to the original attachment point. Having said this, Dr. Dana Piasecki and the other orthopedic surgeons from the OrthoCarolina Sports Medicine came up with a solution by creating their own 3D printed surgical tool which allows them to drill and follow the normal path of the ligament and attach to the femur. This new tool mimics the natural positioning of the ACL. The doctors turned to 3D printing to create a complicated tool but save costs on the production. The tool was made from a strong biocompatible metal to accommodate different knee sizes of different patients. The tool was finally manufactured by Stratasys Direct Manufacturing. The final tool is a low-cost device that is finally registered by the FDA as a Class 1 medical device. Currently, the new medical tool dubbed as Pathfinder has 95% success rate when it comes to anchoring grafts to the original ligament. This also made it easier for doctors to carry out ACL surgery. With this tool, many orthopedic patients in need of ACL surgery will have new hope that they will get the best possible treatment that medical science can provide.

Creating multicellular structures is a delicate procedure. For instance, the human heart is comprised of more than 2 billions of muscle cells that should be aligned and interact with one another to work properly. While 3D Bioprinting is a promising technology that allows scientists to create biological tissues, the problem remains—there is no single method available that uses a high level of precision to create multicellular structures that are functional, viable, and has good integrity. Researchers from the Carnegie Mellon, Penn State as well as MIT have developed the acoustic tweezers technology which is a technique that utilizes sound waves to trap as well as manipulate individual cells. This technology is also used to align, transport, separate, and pattern individual cells without causing any cellular damages. The acoustic tweezers created by the researchers come with a microfluidic device that uses sound wave generators to create sound waves along the edge of the device. The design of the device allows the researchers to manipulate and capture single cells. The device provides a precise level of control when manipulating cells in terms of their spacing and geometry thus allowing scientists to explore the creation of tissues with complex geometries and patterns. The results of the study provide a novel way for scientists to manipulate live cells in 3D without any invasive contact or biochemical labeling. This leaves the biological state during the manipulation in its original and unadulterated state. This can lead to new possibilities in research applications in fields like neuroscience, regenerative medicine, biomanufacturing, tissue engineering and cancer treatment.

A kidney transplant is a very sensitive operation and patients need to be compatible so that the organ recipient will not reject the donor organ. 3D printing paved the way for surgeons to be able to transplant an adult kidney to a toddler recipient. In Northern Ireland, a 3-year old toddler is the first child in the world to survive a kidney transplant using adult kidneys. The toddler suffered from heart failure which had dire consequences on her kidneys as they were robbed of oxygen. Instead of settling with regular kidney dialysis, her parents decided to have her undergo a kidney transplant. As stated by Guy’s and St. Thomas’ NHS Foundation, the kidney transplant was the first of its kind as it uses 3D printing to aid the transplant. The doctors used 3D printing technology to create a model of the patient’s abdomen. They also created a model of the donor’s kidney –the patient’s father –to see how everything fits. This minimizes the risks involved in the transplant. Transplant specialist Pankaj Chandak noted that the surgery is quite complex thus the use of 3D printing technology helped surgeons plan ahead of time to increase the success of the operation and minimize the risk to the patient and donor during the surgery. The operation was a complete success and doctors are excited to use this technology to treat different conditions, as well as help doctors, plan their course of action before the actual surgery. 3D printing has definitely made its way to mainstream medicine.

3D bioprinters are able to print living tissues for medical transplants and testing to name a few. However, recreating human tissues require a combination of human cells, biogels as well as different types of bioink materials aside from the nutrients and oxygen needed by the cells to survive. Specialized 3D bioprinters do not come cheap and they can cost between $100,000 and a million dollars depending on their specifications. With the aim of developing an affordable 3D bioprinter, inventors Jemma Redmond and Stephen Gray combined their expertise on nano-bioscience and biochemistry to create an innovative bioprinter. The result of their hard work is the Ourobotics Revolution 3D bioprinter which is a low-cost device that can print using 10 materials in the same device. The printer also has a heated enclosure to provide ambient temperature to the growing tissue. To date, no 3D bioprinter has the ability to print 10 materials in a single bioprinted structure. However, the inventors of this bioprinter said that they can add more materials in the future. What makes the bioprinter astounding is that it can retool itself; thus it can be used from laser and UV projectors to 3D printers. It can also handle different materials like gelatin, collagen, chitosan and alginates to name a few. With the features of this new 3D bioprinter, you can build complicated tissues, create custom pills or combine inorganic and organic materials. This 3D printer will no longer be limited to creating prosthetics, customized medical tools as well as medical models as it can be used to print live tissues for transplant.

3D printing is becoming an important feature in the field of medical science and its wide recognition in improving medical technology made it possible for many doctors all over the world to come up with innovations in treating their patients. Speaking of innovation, the Collegiate Inventors Competition encourages students to use 3D printing in redefining the way scientists use this technology. The recent competition was attended by 14 finalist teams from all over the United States. One of the finalists that caught the attention of the judges is the group of students from the University of Pennsylvania who created the 3D printed eyelids that are driven by small motors. This invention will be implanted on patients who are unable to blink such as those suffering from dry eye disease. To create the synthetic eyelids, the students used plastic chips with microfluidic channels to stimulate the growth of human cells. Jeongyun Seo, one of the proponents of the study, noted that they created this technology without the need for animal or human models. For now, the proponents see the need for the blinking 3D printed human lid as an accurate model that can be used in medicine, academe and even in the cosmetic industry. Although they did not win the competition, the team was ecstatic to receive the recognition for the first organ-on-a-chip technology that they were able to develop. This innovation created a leverage in biomicroengineering thus it is possible in the future to completely remove animals as human surrogates for clinical testing.

3D printing technology is becoming mainstream in many first world countries. Unfortunately, poor countries are not able to benefit from this innovation. 3D printing is a technology that could have benefited many patients from poor countries especially those who are in need of quality prosthetics. London-based 3D printing company 3D LifePrints was able to provide 3D prosthetics to amputee patients from poor and developing countries. It was estimated that more than 15 million amputees from the poorer regions in the planet do not have access to sufficient medical care thus, this humanitarian act provides relief for a lot of patients. To provide many amputees with 3D prosthetics, 3D LifePrints has been relying on the generosity of a pool of medical experts, technologists, social entrepreneurs, and academic researchers to raise funds and at the same time do more research on developing better 3D prosthetics. The 3D prosthetics provided by the company are deemed very helpful for all amputees, but there are several problems encountered by the company. To date, the main supplier of prosthetics is the International Committee of the Red Cross, but they are still expensive that even ordinary people cannot afford it. The challenge by 3D LifePrints is to make prosthetics that are cheaper, more comfortable as well as more functional than they used to be. Making 3D prosthetics available to poor patients in the third world countries can help not only improve their lives but also uplift their morality as it gives them the chance to be able to live normal lives.

Taiwanese surgeons have been using the 3D printing technology to perform complex surgical procedures in order to reduce the surgery time as well as its risks. One of the complex surgical procedures that 3D printing technology was used on is the complex orthognathic procedure which is a corrective jaw or cheek reduction surgery. Conventional surgery is an arduous task not only for the surgeons but also to the patients. In this case, patients who undergo facial skeletal surgery may develop skeletal or even dental irregularities. Moreover, it can also lead to permanent facial paralysis if not performed properly considering that the face has a lot of delicate nerves that can accidentally be severed during the operation. However, with the use of 3D printing technology, surgeons were able to create a model of the patient’s skull so that they have more time to assess and plan their strategies before the operation. Surgeons Jiang Hou Ren and Xie MingJi developed a technique using 3D printing technology to create an actual model of the patient’s skull by using images obtained from CT scan and X-rays. Surprisingly, the new strategy resulted to better and faster recovery time without any risks at all. 3D printing used in cosmetic surgery can help optimize the facial features of the patients and also help doctors carry out the surgical procedure more effectively. With this technology, doctors will be able to provide better healthcare to its patients. With this procedure, doctors can also perform other surgical procedures on the face to improve the aesthetics as well as the function of the patient’s facial features.

Researches have been made on advancing the applications of 3D bioprinting. Thru this healthcare professionals are able to address complicated injuries and illnesses. The process of 3D bioprinting is utilized to generate tissues or living cells that help sustain growth and cell function within the printed cell or tissue. Patent on bioprinting was filed last 2003 and by 2006, it was then approved. It paved the way to more researches and encouraged hospitals and other research groups to continue experimenting on this type of process. Positive feedback are being received and it is a promising method to aid in reconstructive surgery and medical testing. 3D bioprinting started in different areas, however, Baltimore Maryland is now being seen as a hub for this type of method. This is due to a breakthrough research done at Johns Hopkins University’s Grayson Lab. Apart from that, it is also in Baltimore where you can find the world’s first 3D printing lab, called BUGSS or Baltimore Underground Science Space. It was created in 2012, by and for professional, citizen and amateur scientists and artists. This lab is their space and for them to further explore as well as learn more about the biotechnology world. The BUGSS have three 3D bioprinters. They make use of live stem cells from plants on their experiments and researches. Ryan Hoover, an artist and faculty member at the Maryland Institute College of Art is responsible for taking care of the lab and maintaining on-site bioprinters. Hoover is also using 3D bioprinters to experiment on plant material in order to create solutions wherein plant cells are able to recognize and merge into living tissues. The experiments and researches on bioprinting done at BUGSS are positive occurrences that will encourage forward the technological world of 3D bioprinting.

A lot of people have heart problems and there is a long list of those seeking transplant because unlike other parts of the body, tissues of the heart do not repair or regenerate on its own. Fixing heart ailments often requires surgical procedures and these surgeries are often difficult and risky. There may be an answer to these challenges thru a process known as 3D bioprinting. This method has been advocated to remedy the need for transplanting of tissues and organs. The process on 3D bioprinting makes use of self-supporting materials for regeneration of the nerves to create a 3D heart in preparation for surgery. In a delicate process such as 3D bioprinting, it also involves some challenges when using soft tissues since these replicated tissues are not being supported by the other layers of tissues. However, a team known as the Regenerative Biomaterials and Therapeutics Group discovered the use fibrin and collagen in bioprinting of coronary arteries and hearts. These groups are led by Adam Feinberg who is an associate professor of Carnegie Mellon University on Biomedical Engineering and Materials Science and Engineering. The team of Professor Adam Feinberg discovered the use of open-sourced software and hardware making 3D printers affordable on a consumer-level. The technique they are using requires printing a gel inside another gel. This approach is known as Freeform Reversible Embedding of Suspended Hydrogels or FRESH. According to Feinberg, gels collapse just like any Jell-o; therefore they developed a technique of printing one gel inside of another gel to provide support. In this manner, they are able to position precisely the soft material as they undergo the process of 3D printing on a layer per layer basis. In order to create the printed designs of the artery tissues and heart, MRI images are taken then through the 3D printer, layers of the second gel are injected inside the translucent support gel. When you submerge the support gel in a body-temperature medium like the human body, it melts but it leaves the bioprinted living cells undamaged and intact. After which, heart cells are integrated into that printed form to assist in the creation of the contractile muscle.

The creation of stem cells using 3D printers can bring a lot of changes in the world particularly in the field of medicine. One important application for stem cells is drug testing. Millions of laboratory animals will be spared if 3D printing can create stem cells. Collaboration between the researchers from Tsinghua University in China and Drexel University in Philadelphia developed a way of growing embryonic stem cell structures. To create the stem cell structures, researchers used an extrusion technology to create grid-like structures that encourage the growth of the stem cells. The cell structures were able to divide and organize into living tissues but the viability of the tissue is only up to a week. Researchers were astonished that the new embryonic cell structures were able to last for a week. Liliang Ouyang, one of the proponents of the study, noted that the embryoid body is homogenous and can be a good starting point for tissue growth. While the common method of printing cells is using suspension method, it does not result to cell uniformity thus cells become viable for up to a few days. The new method that the researchers developed is capable of becoming into different cell types of the body. The researchers are hopeful that the new technique can quickly proliferate into different embryoid bodies so that they can be used for tissue regeneration and drug testing on living tissues. For now, the researchers are finding ways on how they can change the size of the embryoid bodies so that they can create different cell types.

The 3D printing technology has proven itself a very useful innovation in the field of medical technology. In fact, this technology is no longer restricted to making medical models to help surgeons plan their operation but progress has been made such that construction of delicate tissues is now possible. One of the most intriguing things that can be created with 3D printers is the knee cartilage. Scientists from the Texas Tech University and Texas A&M University were able to develop a way to create knee cartilage from a 3D bioprinter. Led by Dr. Jingjin Qiu, the 3D printed cartilage can be used to repair the injured meniscus among patients suffering from arthritis and mechanical damage caused by injuries and sports. The cartilage of the knees protects the connecting bones of the legs against friction as well as absorbs shock when you engage in extreme activities. However, the cartilage can break down and become inflamed, thus patients are required to undergo surgery called meniscectomy to repair the meniscus. To create the 3D printed meniscus, researchers used hydrogels but added a gel-like substance called alginate. The addition of the alginate to the hydrogel increases the viscosity of the bio-ink. The material also restricts the cartilage from pulling out under stress. The problem with conventional meniscectomy is that the removal of the meniscus can result to the risk of osteoarthritis later in life. Moreover, transplanting knee cartilage from a donor can also bring up a host of complexities including rejection and biocompatibility issues. The development of the 3D printed meniscus removes all these complexities thus it can help many people suffering from a lot of knee problems.

Blessing Makwera is the Zimbabwean man who was the recipient of Operation Hope, a California organization that offers surgical care and procedures to individuals in developing nations. Makwera was only 15 years old when he figured in a tragic accident that left his upper and lower jaws severely disfigured due to an exploding land mine. Although he survived the accident, he had to live with his misshapen face for eight years before becoming the happy recipient of the Operation Hope. Makwera needed several surgeries through the collaboration of Dr. Joel Berger who was a maxillofacial and oral specialist and 3D systems that was there to help in visually mapping out the surgical procedure via their Virtual Surgical Planning (VSP) services. The man behind 3D systems VPS services was Mike Rensberger. Makwera needed a fibula free flap operation which comprises of taking vessels, tissues, and bone from the fibula (a bone in the lower leg), and then restructuring as well as re-configuring these to form jaw bones that are linked to the neck’s blood vessels. Rensberger commented that although they have experience dealing with the same surgery, but the time-sensitive operation was placing a huge challenge for the team. They only had four days to prepare before the surgery. Eventually, Rensberger’s team was able to create two sets of maxillae and mandibles to be used as a time saving replica in the operating room and the other set as a reference point in the actual operation. The models helped the surgeons to familiarize themselves with the unique anatomy of the patient and fortunately for Makwera, all the needed jaw composition for the operation arrived on time. The surgery took 12 hours to perform and it was a success, thanks to the power of 3D printing.

Canadian Surgeon Dr. Ivar Mendez is the head of surgery at the University of Saskatchewan. Dr. Mendez reported that he always prepares before a brain surgery via the use of computer simulations. Given the fact that brain surgery is a very sensitive operation wherein it involves opening the skull and toe brain folds are inserted with electrodes. A miscalculation on the part of the surgeon can cause irreversible damage depending on the specific part of the brain involved. That’s why the meticulous doctor always studied the patient’s brain and the targets he needed to access. Now, Dr. Mendez wanted to try out 3D printing the patient’s brain as a model instead of using computer simulations. It took 7-months and several experts from neuropsychologists, MRI specialists, radiologist, and engineers to create the first rubber prototype. However, Dr. Mendez was not satisfied with the model because it did not display the important and smaller features of the brain. Now, the team and Dr. Mendez have a more detailed and larger brain model wherein the Dr. Mendez can actually practice the surgery. Dr. Mendez was more than satisfied with the brain replica because it mimics the consistency of an actual brain. He further elaborated on the possibilities of 3D printed medical innovations like the same principles can be applied on creating 3D brain models of patients with brain tumor, helping neurosurgeons to better grasp the extent of the effects of the tumor or lesion removal. And this is something that cannot be easily seen with the use of digital models.

Surgical transplantation procedures such as heart transplants can be very difficult to work with and this is the reason why patients have to join a long waitlist, along with other patients, in the hopes of getting a transplant. However, researchers from the Carnegie Mellon University want to improve the chances of getting a transplant early by developing a method for 3D bioprinting soft tissues. Currently, the 3D printing technology uses materials like titanium and silicone to create flexible plastic models used only for surgical planning. Unfortunately, replicating soft tissues can be difficult until today. The research is led by associate professor Adam Feinberg and it aims to demonstrate a new method of creating synthetic hearts and arteries using natural materials like fibrin and collagen. With their years of extensive research, they were able to accomplish printing soft tissues using a consumer-level 3D printer. The technique of creating soft tissues was called Freeform Reversible Embedding of Suspended Hydrogels (FRESH) which involves printing gel in gel. This allowed the researchers to position the soft materials precisely inside the gel so that they can create it layer by layer. To create anatomically correct heart and artery tissues, researchers rely on MRI images of patients. The printer then uses a small syringe to inject the layers of the second gel inside the transparent support gel. The support gel serves as the scaffold of the soft tissues. The support gel then melts away when immersed in ambient-temperature water, thus, leaving behind the living cells intact. Now, the researchers need to perfect the next step which is to incorporate the printed tissues in vivo.