Revolutionizing the Medical Field utilizing 3D Printing
Max Fritzhand 
April 23, 2016
Max Fritzhand
April 23, 2016 Section 1: A Brief Introduction
Meet 5-year-old, Mia Gonzalez, she’s a special case for cardiovascular surgeon, Dr. Redmond Burke. She suffers from a congenital heart defect known as a double aortic arch. Her defect caused a vascular ring to wrap around her trachea, which restricted her airflow and caused labored breathing. For Dr. Burke, Mia Gonzalez’s case was a rare version for the normal procedure done for the vascular rings. Nearly one hundred percent of the time, surgeons perform this operation by entering through the left side of the patient’s chest. However, in Mia Gonzalez’s case, this was not so. Excellent MRI Imaging showed Dr. Burke and his surgical team that the vascular ring could only be seen and therefore repaired by placing her on her left side and entering through the right side of her chest.
To really understand how to perform such an intricate procedure and even visualize it, Dr. Burke used a 3D-printed model of Gonzalez’s heart. Burke claims that the “3D printed heart made the difference before Gonzalez’s successful procedure” (Burke). The intersection of 3D printing and medicine is a new frontier. Major medical areas for 3D printing research include re-imagining medical imaging. An example of that is with 3D printers used to create replicas of internal organs, just like Mia Gonzalez’s heart, giving them true-to-life representations of organs they need for operating on before seeing the real thing in an operating room. Other major research includes replacing tissues and organs and designing human-centered medicines.
Section 2: Rationale/Essential Questions
I have always had a fascination with technology. I was always that individual who had the latest gadgets. My father is a Doctor with his own practice, and has been one for over 20 years. He tells various stories about how some hospitals he works at are getting unique technology he would have never thought of using when he first started. One of those unique technologies is a 3D printer. Now you may be wondering why am I interested in 3D printers in the first place. Well to answer that question, 3D printing is essentially the next big thing coming along in the next decade. It will be at households and will simplify life entirely. You can make your imaginations come to life with just a 3D printer. Along with 3D printing, there’s various models out now that can print food, plastic, and metal. Although those models seem appealing, my interest is more towards 3D printing for the medical field.
With 3D printing I am looking at how it is going to revolutionize the medical field. As in looking more into depth into re-imagining medical imaging, I am curious as to how a normal MRI or CT can be improved through 3D printing, to benefit the surgeon. Questions, I had in mind regarding medical imaging. How can an old, but reliable image, such as mammogram be approved by 3D Mammography to better treat cancer? How can 3D printing be used to reimage a cell scan, to better study and treat diseases?
Replacing tissues and organs is new area of exploration paving the way for scientists and companies. 3D printing organs is a new area for hospitals to explore. Instead of taking an organ out of a human, they can just 3D print it, and use that printed organ to place in an individual. I am looking into how 3D printing can assist in cosmetic surgery and replicate a visible body part, such as the face. In addition I am also looking into how 3D printing can play a big role in reducing the deaths in people that are waiting for an organ transplant. How can 3D printing create a virtual version of a body, including the bones, incase for a later use?
With designing human-centered medicine, some questions come to mind. How can 3D printed drugs impact how drugs are distributed? How can drug companies reduce the number of drugs taken to benefit the patient? How can the drug companies use 3D printing to improve the drug’s delivery to the body?
Section 3: Establishing Ethos and Credibility
Anthony Atala is the director of the Wake Forest Institute for Regenerative Medicine, where his work focuses on growing and regenerating tissues and organs. His team engineered the first lab-grown organ to be implanted into a human — a bladder — and is in the process of developing experimental fabrication technology that can “print” human tissue on demand. Atala has extensive research in tissue engineering and printable organs. He has numerous accolades in his field. Having performed on TED Talk, has a published book, been featured on Time Magazine as well as Discover Magazine for his work. Much of his research is listed publications as well as discussed thoroughly in his Ted Talks.
Doctors tend to be real busy, with patient care and office duty. I was lucky enough to land an interview with Dr. Steve Pearlman, Radiologist at Jewish Hospital. I was able to do so, by calling around to different offices asking to speak with the Doctor. The majority of Doctors were unable to be of assistance to me. I decided to focus on Doctors with a specialization for technology and x rays, so I called local Radiologists. Dr. Steve Pearlman was able to help and be of great assistance. He told me all about what he did, and about 3D Mammography. He reconstructs mammograms and makes them into 3D images. It helps to detect cancer earlier, which translates to a higher cure rate.
Dr. John Meara, Plastic Surgeon, is an early adopter of 3D printing technology, and has used it on some of his procedures. He put his 3D printing skills to use, with his patient, Violet, a toddler who was diagnosed before birth with a rare, complicated skull and facial defect. Using CT images, he was able to build a series of plastic 3D models of Violet’s skull and rehearse her surgery, months before the actual procedure. Using 3D models has helped Meara a lot. It allowed him a new insight in his line of work; he can see and feel the trajectory of where he would have to make certain cuts during his procedure.
Section 4: Research and Findings
Images are central to practicing medicine; 3D printers can take imaging to a whole new level. Using data from CT and MRI scans to produce liquid plastic models, such printers can replicate the size and density of organs and anatomical parts for surgeons to rehearse on 3D models. These 3D models assist surgeons before he starts. With 3D printing, surgeons are finally able to create and hold in their hands a replica of a patient’s heart, brain, skull or any organ or body part in need of operation. It’s a great tool to help doctors prepare for complex procedures, as 3D printed models can accurately capture the unique anatomy and fine details – details that traditional imaging technology would miss and that may be critical during complicated surgeries – of each individual.
3D models can also be powerful diagnostic tools. 3D mammography, or digital breast tomosynthesis, for example, provides radiologist a clearer view of over overlapping layers of breast tissue, leading to life-saving earlier cancer detection. Researchers at Perelman School of Medicine at the University of Pennsylvania found, “41 percent more invasive cancers when women were screened with tomosynthesis plus digital compared to digital mammography alone. The use of tomosynthesis also reduced the number of women called back for additional testing by 15 percent”(Penn Medicine) Allows for 3D reconstruction of the breast tissue, giving radiologists a clearer view of the overlapping slices of breast tissue. According to findings of a large, prospective screen trial published in Radiology, “screening with 2D mammography plus 3D mammography significantly increased detection of invasive breast cancers by 40 percent and reduced false-positive rates by 15 percent”(Radiology).
Printing cells could lead to better ways of studying diseases in the lab and developing therapies. For example, researchers have printed ovarian cancer cells onto a gel in a lab dish and tested the effectiveness of drugs on them before administering on real cancer patients. Reimage a cell scan with 3D printing to study disease and make research more effective .
3D technology will allow drugs to be manufactured where they are needed most, in hospitals, clinics. They can be made where the sickest patients are, like in 3rd world countries. 3D technology in medication may shift from mass production in a factory to smaller production delivery medication with minimal transportation cost. 3D printing of medicine could also allow manufacturers to shift production and distribution processes closer to consumers, say hospitals or pharmacies, which also increases compliance. This can also be a boom for the developing world: AIDS patients in Sub-Saharan Africa, for example, could print their own antiretroviral drugs at a low cost.
Aprecia Pharmaceuticals has a unique way of using 3D printing technology to allow pills to instantly dissolve on the tongue with a sip of liquid, a boon for those with trouble swallowing pills.Their drug, SPRITAM is the world’s first FDA approved 3D printed tablet for the public. Its also located right nearby in Blue Ash, Ohio. This solution is perfect for young kids and the elderly that have difficulty swallowing pills. Since it instantly dissolves via contact with liquid, it enhances the customer’s experience with medication so that, patients and caregiver can experience a rapidly disintegrating, taste-masked,and convenient way to take or administer medicine. Able to print medication in a controlled manner at commercial scale, so large quantities, rather than personalized pills.
Patients with long-term illness or older people often have to take up to 20 tablets a day. According to research by Jennifer K. Bussell, MD, “50% of them do not take their medication correctly, which can seriously diminish the effectiveness which can seriously diminish the effectiveness of the treatment and even cause side effects”(Bussel). Scientists at the Nottingham University are working on a new, 3D-printed solution that could help reduce the number of tablets from 20 to 1.
Using a simple 3D printer, scientists are printing tablets that have different ingredients in each of their nozzles, which the printer precisely fills in with tiny drops of each material. Some ingredients are coated in special materials to delay the release of the drug and give the scientists a precise control over how the tablet works after the patient has taken it. The hope is that in the future a combination of treatments specific to each person becomes a norm. Each patient has a unique condition, so treating by combining all elements of current drugs the users take into just one will surely take time. It may be years before patients are treated with highly personalized 3D printed tablets due to serious regulation in medicine. On the other hand, these technology developments can be applied to less potentially harmful tablets, like vitamins and supplements.
Kirill Kaem, VP and Executive Director of the Biomedical Technologies Cluster at the Skolkovo Foundation. Kaem’s company has printed an organ, transplanted it into a mouse, with the thyroid working, producing hormones. Organovo is perhaps one of the best known. It was the first company ever to commercialize 3D bioprinted human tissue for pharmaceutical and drug testing, and has been working with Yale University to develop 3D bioprinted tissues for organ transplantation research. 3D bioprinter should be able to 3D print human organs in 15 years time. “More than 123,000 people in the United States are currently on the waiting list for a lifesaving organ transplant and every 10 minutes, a name is added to the national transplant waiting list”(American Transplant Foundation). This is a staggering number for of people on the waitlist. Top scientists are still working on progressing 3D printed human organs. Which should not take long, since 3D printed organ transplants have already happened. “One of my young patients, Luke Massella, received an engineered bladder 10 years ago”(Anthony Atala). A date could not come soon enough, regardless of which country or company that leads the way.
The human embryonic stem cells are used, however it is not allowed to let it known that these stem cells are coming from the abortions being performed throughout the United States, because of the amount of controversy that it would cause would most likely shut down the entire operation of 3D printing. Scientists have also proposed mixing human stem cells with canine muscle cells to create enhanced organ tissue. Printing cartilage is still the most realistic type of bioprinting, and printing whole organs is still many years away, but 3D printing is growing in medicine quite rapidly. Conversations about the moral, ethical, and legal issues surrounding bioprinting have started, but they will inevitably cause a lot more controversy as it becomes more commonplace.
As of right now, 3D printing in the medical industry is booming by storm with various devices. To keep up with the demand and supply of drugs, pharmaceutical companies are turning towards 3D printing tablets, instead of having it machine pressed made. 3D printing pills, allows a faster process of drugs to be produced, thus allow pricing to also drop.
The process for creating an ear cartilage starts with taking a small sample of cartilage from a patient and placing it into an incubator, where the cells will grow and multiply over the course of several weeks, until they are ready to be combined with a liquid formula that will create a jelly-like structure. That jelly-like material is then used to 3D print the missing body part, such as an ear or nose, using scans taken from the patient. The printed part is then strengthened with reagents and placed back into the incubator, where it is given nutrients that will enable the cells to grow and form their own cartilage. The hearing aid industry boasts perhaps the highest ‘installed base’ of customized final consumer devices that were produced using 3D printers.
Some questions to consider when investigating 3D printing, especially in the medical industry. Will 3D printing treatments be safe? Should these treatments only be available to those who can pay the additional cost? If the technology can be used to develop replacement organs and bones, couldn’t it also be used to develop human capacities beyond what is normal for human beings? For example, should we consider replacing our existing bones with artificial ones that are stronger and more flexible, less likely to break Should only the rich be given access to this? Are we playing God by doing this? In the end, saving lives tends to trump all objections. The cost had yet to be determined for treatment, but expect it to be quite pricey.
Section 5: Conclusion and Analysis
One of the most exciting scientific developments in medicine is 3D printing, or more precisely bioprinting, and the long-awaited possibilities of growing human tissue and organs. 3D printing as we have heard about, is an amazing feat of technology. We can do many things with it, like medical technology related. Being able to create organs, medical tools, medicine. The opportunities in the medical sector is endless for innovation. Additional topics that could be explored with continued research: 1.) Cloning to see if it is feasible. 2.) Creating ‘super’ organs/tissues to fight disease and injury. 3.) 3D printing a brain- which could have enormous benefits. 4.) Next generation body customization, right now the modern customization for your body is a tattoo.
I see it possible that 3D printed cosmetic surgery would be a new modern customization. So basically you can look like any individual you’d want to be, or get that feature add to your body. For example, you could get Kylie Jenner’s lips. The medical field is always expanding and looking for new innovations. 3D printing has combined science and technology- to bring future progress arrive now. The realm of 3D printing in medicine is vast. Assisting in surgery like it did for Mia Gonzalez for heart defect is just the beginning. I am excited to learn more about what this exciting field brings.
Citations~
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Max Fritzhand
I have always loved to write and am a thoughtful writer. It's one of my many creative outlets - right next to cooking and gardening.