The Smart Magazine About Medical Technology Innovations
3D Printing in Surgery
The future is definitely now. Beyond the ability to produce any kind of prosthetic or implant, the promising 3D printing technology—also called additive manufacturing—represents a huge advance in surgical planning by improving our understanding of anatomy. In this issue you will also read about cartilage regeneration and how 3D printed living tissues can survive outside the laboratory. Already tested in mice, it will not be long before bioprinted muscle, cartilage and bone will be implanted in human patients.
The rise of 3D printing represents a huge advance in surgical planning by improving our understanding of anatomy. One London hospital to recognize the potential of this promising technology is Charing Cross, which has an active surgical research laboratory.
James Duncan, clinical research fellow and the rest of the...
Never a dull moment in the 3D printing and bioprinting field, scientists are moving forward on cell-friendly bioinks. On board for discussion during the 3D Medical Expo at MECC in Maastricht, The Netherlands in late January: cartilage regeneration and biomimetic scaffolds.
During her presentation, “BioPrinting Cartilage,” she spoke of “bioinks based on regulatory-compliant polysaccharides being developed which undergo cell-friendly gelation and yield a strong, ductile material.” They’re now makingbioinksmore tissue-specific and bioactive by adding micronized extracellular matrix particles to the mix.
The bioink supports proliferation and deposition of matrix proteins. This versatile bioprinting method can produce patient-specific cartilage grafts with good mechanical and biological properties.
Mixing Cells with Bioink
“We’re working on facial reconstruction,” Zenobi-Wong explained her team’s current research on bioprint solutions for those missing a part of their ear or nose from trauma or cancer. The steps begin with a biopsy of the patient’s tissue.
You need to start with cells from the patient. Isolate the cells from the biopsy, put them in culture in order to have a large number and then mix them with, what we call, bioink. The shape would be based on the CT.
Lorenzo and his team focused on 3D printing scaffolds without the use of cellular materials in the bioprinting process. They printed the scaffolds with EnvisionTEC’s 3D bioplotter, considered a bioprinter for cellular materials. However, they did not use cellular materials, but polymer based mixtures that are biodegradable and biocompatible.
80 People Walking, Literally, with 3D Printed Knee Constructs
“There have been more and more clinical translations for smart implants with additive manufacturing technologies,” Moroni told MedicalExpo in an interview at MERLN Institute. “Enough knowledge has been created over the last ten years or more in terms of how to optimize the implant structural and surface properties to have a proper interface with cells.”
For bioprinting and the different applications, we will have to wait at least another five to ten years before we see the first number of clinical cases being tested.
Courtesy of 3D Printer
Thirteen years ago, Moroni and his collaborators began working on an implant project to 3D-print scaffolds for knee cartilage. After 3D printing the scaffold, he and his team at CellCoTec strategically plant a patient’s cells and watch the cartilage grow.
The first four years, they gathered research and focused on creation; this was then taken up by the CellCoTec team. This step was followed by four years of developing the application to make sure it was up to industrial standards.
The project has been in clinical trial since 2010 and is on the market; clinical data is still collected to support reimbursement for this novel treatment. “There are about 80 people that are walking with those implants.”
The Wake Forest Institute for Regenerative Medicine reported in mid-February in Nature Biology successfully printing tissue with a custom-designed 3D printer, called ITOP (Integrated Tissue and Organ Printing System). The structures proved to be functional when implanted in animals. MedicalExpo talked to Dr. Anthony...
What is the Internet of Things (IoT)? This expression has been used many times in several different sectors, but what are the concrete implications in healthcare? Ken Kleinberg, a managing director at the Advisory Board Company, talked to MedicalExpo before his speech at the HIMSS Conference in Las Vegas in early March.
According to Kleinberg, the IoT refers to “the trend of connecting devices, beyond the typical computing devices such as laptops, smartphones and tablets, also including sensors, monitors, cameras and everything else that can have some computing capabilities.” The goal is to collect “a much broader amount of information than we ever collected before” in order to “analyze it and take action on it.”
It can be medical devices measuring patient blood pressure, temperature and respiration rate, or sleep trackers attached to the wrist.
At home, you can also have items like a scale, a smart toilet, or even a floor that can measure how someone is walking and whether they might have a problem with their balance.
“There are many types of devices, sensors and monitors, including cameras that can look at someone’s face to see if they’re depressed,” Kleinberg added. “These devices have all started to become more miniature and more affordable.” Some hospitals are equipped with smart beds which transfer collected information wirelessly to electronic medical records for analysis to alert caregivers to problems.
These monitoring systems give doctors the ability to watch their patients more closely.
But there has to be some filtering of this information and only the relevant information gets passed on to the doctors. So you have to have analytic capabilities, filters and rules to determine what’s important and what’s not.
The Rise of Intelligent Machines
There are some circumstances where the computers could be better than the humans. It’s something that is a little scary but also inevitable.
Kleinberg explained that the IoT gives rise to a new concept: machines with artificial intelligence. This might be a computing system that can examine several tumor images and determine how many different types of cancers there are, without being explicitly told what to look for. “These types of machines are becoming very prevalent now.
“The word “machine” does not necessarily refer to a physical machine – it can be a software, Kleinberg said. An example of a system that has been used to identify different forms of disease is Ayasdi.
Courtesy of atelier.net
According to him, clinical decision support is also one of the most sophisticated ways to use artificial intelligence in healthcare. The computer would look at all the patient’s symptoms, medical history and the types of drugs being taken, and then try to determine what might be wrong and prescribe treatment over a given period.
“Certainly, it’s hard for some physicians to believe that a computer could do what they do, because they’ve trained themselves for many years and they know that over decades their experiences matter.” The also may be concerned about losing their jobs.
On the other hand, “the number of studies and advances are coming so fast and with so much volume that even the dedicated doctors could not keep up with everything.”
Also, there are some things that computers are very good at: they don’t forget things, they don’t make mistakes when they calculate things, they don’t make mistakes like humans when they are too tired because they are overworked.
So the goal is “to take what humans do best and what computers do best and combine them together.” He added: “But there are some circumstances where the computers could be better than the humans. It’s something that is a little scary but also inevitable.”
A combination of radiology, computer-aided design (CAD), and additive manufacturing technologies have made it possible to create patient-specific models, implants, or tools to aid in surgeries worldwide. Spinal implants, cutting guides, and replicas of patients’ hearts are just a few of the ways in which digital manufacturing processes have improved the medical industry.
As the techniques for implementing additive manufacturing technology for medicine are refined, there looms a crucial problem, which is a problem of access. While the FDA is slowly approving some uses of additive manufacturing, most of them are still in a holding pattern, and as such are not eligible for insurance reimbursement.
If we can demonstrate that this process is intrinsically sterile, we would hypothetically be able to create patient-specific parts at an incredibly low cost.
This problem is compounded by the tremendous cost of industrial additive manufacturing technologies so far the only kind of technologies that can print in autoclavable materials. These machines generally have tremendous footprints, andexpensive proprietary material. The significantly more affordable hobbyist machines, while alleviating the issues of cost and size, are not able to print in autoclavable materials.
The scientists started from scratch by laser-scanning a skeletal hand and then 3D-printing artificial bones to match. Those complex pieces were held together by a series of artificial ligaments made of high-strength Spectra strings. Laser-cut latex sheets replicated the soft tissue.
The new robotic hand is able to very closely mimic a wide variety of grasps when controlled by a remote manipulator. The user can grab coins, CDs, bills, keys, coffee mugs, dental floss, cell phones, credit cards, and more.
According to the researchers, their hand could also be used as 3D scaffolding for limb regeneration research.