3D Printing Reshapes Healthcare

Printed livers, ears, hands, and eyes? 3D printing can change and save lives.

3D printing can improve the quality of patients' lives -- even save the lives of some people lucky enough to take
advantage of the new technology.

Healthcare has been slow to adopt electronic records and messaging apps, but it's been quick to embrace 3D printers and
their specialized materials. In fact, the 3D printing market for healthcare will generate more than $4 billion by 2018,
according to a January 2014 report by Visiongain.

Medical professionals increasingly explore 3D printing because it cuts costs and improves healthcare. "Customized
orthopedic implants, for example, perform much better, and their use dramatically reduces surgery times," said Jennifer
Taylor, pharmaceutical industry analyst at Visiongain, in an interview."In addition, 3D-printed medical models can
reduce surgery times. Surgery costs $100 per minute. As well as resulting in substantial cost-savings, the use of 3D-
printed medical implants reduces the risks associated with anesthesia during long surgeries."

Customization is another reason 3D printing fits naturally into modern treatment, said Shahid N. Shah, chair of the
HealthImpact Conference and blogger at HealthcareGuy.com, in an interview. "The interest is very high because 3D
printing allows personalization and customization to the extreme -- and there's nothing that requires more customization
or personalization than devices connected to or replacement parts of any human body," he said.

As the bodies of patients -- especially children -- change, tailoring 3D-printed parts is much simpler, faster, and less
expensive than other approaches, said 3D designer Marius Kalytis, CEO of CGTrader, a 3D marketplace for computer
graphics and 3D printing. New materials, or "inks," are advancing 3D printing's capabilities. "Printed implants can be
made of fenestrate surface, which will let tissue grow with the implant more easily," he said.

The technology is only at its nascent stages. Researchers are exploring where else we can use 3D printing to improve
patients' health. Some promising experiments haven't left the lab. 3D bioprinting, where living tissue is printed, won't be
commercially available for the next 12 to 18 months, but hospitals will provide 3D printing of skin grafts within the next
decade, said Visiongain's Taylor. Adoption in this area has been hindered by technological limitations and prohibitive
costs, added Kalytis.

Currently, many hospitals don't have -- and don't need -- 3D printers, and regular general practitioners won't be installing
them any day soon, experts said.

"At present, it won't influence the work a 'normal' doctor does -- only for those people working in these specific, very
special fields, and only for those who can innovate," said Liang-Hai Sie, a retired general internist, in an interview. "I
think it's a good thing to have these efforts concentrated in a few well-equipped facilities so we [can] learn [how] it is to
be used, for what situations, long-term side effects, etc. before it is taken further afield."

It's a different story at larger healthcare organizations. IT departments and senior staff must ensure equipment is available
and meets legal and safety rules, while making sure those rules don't stifle innovation, said HealthGuy's Shah. Major
research hospitals and health systems should "immediately start to purchase 3D printers," he said. "We need to make sure
physicians have access to these sophisticated 'personal manufacturing' capabilities provided by 3D printers," he added.

Delve into our slideshow and take a closer look at what 3D printing can do for patients.

Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet
Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek,
Baseline Magazine, Redmond Channel ... View Full Bio

Broken bones
Forget that heavy plaster cast. No need to wrap it in plastic when you shower, or grab a back scratcher for an
inconvenient itch. That's the plan, at least, of Jake Evill, designer of the Cortex Cast, which uses the patient's x-ray and a
3D scan of the injured limb to generate a 3D cast that meets the individual's specifications. One side of the exoskeletal
cast is open so the patient can put it on. Once secured, built-in fasteners hold it in place. Currently, a 3D cast takes about
three hours to print. Although old-fashioned plaster casts take less than 10 minutes for a doctor to prepare, they do take
up to 72 hours to set, Evill told Dezeen. Cortex is seeking funding.
Organs
In January, Organovo delivered its first 3D-printed liver to a third-party lab for experimentation and testing. It plans to
launch liver printing commercially and begin generating revenue via a services model by December 2014. The company
is also developing 3D kidney tissues and breast cancer tissues. Wake Forest Institute for Regenerative Medicine is
conducting similar work. Ten years ago, the institute's director, Dr. Anthony Atala, engineered a young patient's bladder
in a similar way. Now his team is exploring 3D printing's potential in areas such as the skin and liver.

The eventual ability to deliver customized, printed organs could resolve the quandary of long waiting lists for organ
donations and ethical issues about who should receive scarce organs first.

Skull
When one patient needed 75% of his skull replaced, doctors used a 3D-printed prosthetic by Oxford Performance
Materials. Made of a high-performance polymer, OsteoFab implants are created, or grown, layer-by-layer from a CAD
file. They can be shaped to match an individual's anatomy, the company said.
Ears
Most hearing aids are manufactured using 3D printing, at least one industry executive claims. That's saving vendors time
and money, and providing customers with models that fit and work much better. An audiologist scans the ear, creating up
to 150,000 points of reference, then sends the scan to the technician who creates the impression. The manufacturer prints
a shell out of resin, and fits it with the necessary electronics and vents, according to Forbes magazine.

More excitingly, researchers are printing ears. Cornell University bioengineers and physicians used 3D printing and
injectable gels from living cells to make flexible ears that grew cartilage. British consultancy Fripp Design & Research
uses photogrammetry to create an editable CAD model, then cross-references data with CT scans and MRI data to make
a custom-fit ear or nose. To create another replacement, just hit print.

Hands
When Richard van As lost four fingers in a woodworking accident, he decided to create a mechanical digit to replace his
missing fingers. After some trial and error, van As formed Robohand and used donated MakerBot 3D printers and open-
source software to create a mechanical hand. The first hand was fitted free on five-year-old Liam (pictured). After a
successful Indiegogo campaign raised more than $10,000, Robohand has donated hands to more than 200 people. Earlier
this year, Robohand trained people in the Sudan on its system, hoping to help the many amputees created by the region's
civil war.

Trachea
A collapsed bronchus that blocked air flow to the lungs threatened the survival of baby Kaiba -- until doctors at the
University of Michigan designed, printed, and surgically implanted a tracheal splint into the infant's airway. Over 36
months or so, the child's developing body will absorb the polycaprolactone splint. Dr. Glenn Green, associate professor
of pediatric otolaryngology, and Scott Hollister, professor of biomedical engineering and mechanical engineering and
associate professor of surgery at the university, used high-resolution imaging and CAD to copy a CT scan of Kaiba's
trachea and bronchus. They then used a laser-based 3D printer to produce the finished trachea. Three weeks after the
surgery, staff took Kaiba off a ventilator for the last time. He continues to do well.
Eyes
Researchers at the University of Cambridge printed living retinal eye cells from adult rats, a step that could eventually
help cure blindness. Using an inkjet printer, professor Keith Martin and his team in the neuroscience department
separated cells from the retina system, a big step toward treating retinal diseases such as glaucoma and macular
degeneration. Organizations also use 3D printers to create prosthetic eyes. In late 2013, Fripp Design disclosed that it can
make 150 eyes per hour at a fraction of the cost of eyes usually made by hand.

Joint replacement
Hip replacements have been around for a long time, but they don't help every patient. The Mayo Clinic uses 3D printing
to customize new hips for people with severe impairments who wouldn't get relief from standard hip replacement
surgery. British hospitals are saving thousands of pounds and improving patient care by using 3D-printed plastic models
of CT scan images that surgeons view pre-operation. A model produced the old way cost almost as much as surgery. It
was difficult to justify creating one. With 3D printers, doctors are more likely to use models for hip replacements and
other surgeries.
Pelvis
A British orthopedic surgeon 3D-printed and installed a pelvis in a male patient who needed half his pelvis removed
because of chondrosarcoma, a rare type of cancer. Dr. Craig Gerrand's staff scanned the man's biological pelvis to decide
how much bone needed removal, then used a 3D printer to map his replacement pelvis. A laser fused the titanium powder
together and medical staff at the Newcastle Hospitals NHS Foundation Trust coated the metal with a mineral that
allowed the patient's remaining bone cells to grow, reported Health Point Capital. Three years later, the patient is healthy
and can walk with the aid of a cane.

Hips
Dental professionals are using 3D printing for everything from toothbrushes to bridges. Dental 3D systems combine oral
scanning, CAD/CAM software, and 3D printing to create dental stone models and various orthodontic devices. Results
are typically faster and less expensive. Because many offices bring these services in-house, they have more control over
quality.
Feet
They're not prosthetics or implants, but Sols's 3D-printed customized shoe insoles aren't your parents' Dr. Scholl's.
Customers use a smartphone app to scan their feet. The information goes to the company's database. There, it's quickly
converted into a 3D model of consumers' feet and prints out customized insoles in their choice of colors. The nylon
insoles are coated in antimicrobial protection to reduce odor. They are priced competitively, according to the vendor.

Musculoskeletal diseases
Nemours's Pediatric Engineering Research Laboratory designs many products, including the Wilmington Robotic
EXoskeleton (WREX) to help children with skeletal dysplasia, scoliosis, or cerebral palsy raise and move their arms. To
adapt WREX for smaller patients, Nemours 3D-printed parts of WREX on a Stratasys printer in plastic and attached it to
a jacket, along with metal bars and resistance bands. New "magic arms" allowed 23-pound patient Emma (pictured) to
play with blocks and reach for candy for the first time. As she grows, Nemours prints out a larger version.