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外科医生的好帮手-3D打印技术助力医疗行业

关键词:3D打印技术,个性化医疗模型,医学成像

来源:互联网    2015-08-20

原文:英文

expert voices, 3d printing, Scott Dunham, SmarTech MarketsSurgeon's Helper: 3D Printing Is Revolutionizing Health Care printed heart A close-up of the 3D printed heart Credit: James Carlson/ OSF St. Francis Medical Center View full size image

Scott Dunham is a senior analyst for SmarTech Markets Publishing, which focuses exclusively on additive manufacturing and 3D printing. Dunham is a regularly featured speaker at 3D printing industry events worldwide, and he will be presenting at the Additive Disruption Summit on April 1 and the RAPID conference on May 19. He contributed this article to Live Science's Expert Voices: Op-Ed & Insights.

Health care is a constant topic of debate today — but health care is not all about politics. Innovations in treatment and technology are revolutionizing how we care for one another, though there are still practices that are remarkably outdated or fall short of the goal of improving, or saving, lives. Now, with the rapid evolution of additive fabrication — the increasingly popular technologies often referred to as 3D printers — the future of health care is advancing in ways both familiar and dramatically new.

While makers of professional 3D printers are specifically developing, and promoting, dental uses for 3D-printed technology, the universe of non-dental medical applications is now entering a phase of rapid growth.

Don't let the purple of her 3D-printed prosthetics fool you, she's a big fan of Captain America.Credit: Jen Owen, e-NABLEView full size image


3D printing: A model of personalized medicine

In the context of manufacturing, 3D printing for medical applications is actually quite unique when compared to other popular industries such as aerospace, automotive and others. Why? The obvious answer is the human element present in all health care applications, where often cost becomes a secondary concern to a successful outcome that saves a life or greatly improves the quality of one. [7 Cool Uses of 3D Printing in Medicine ]

But we recently produced a 10-year forecast for the field, and there is an unusually strong synergy among digital 3D design, medical imaging and 3D printing for medical applications. The three form a trifecta of medical problem-solving power, where physicians can use patient-specific data to capture, manipulate and ultimately apply physical solutions of all shapes and sizes through 3D printing. Without such technology, personalized medicine would be difficult, as patients will need unique parts that can be rapidly and simply manufactured.

There are two especially interesting areas where 3D printing has the potential to impact millions of lives through a variety of revolutionary medical solutions: surgery and the treatment of otherwise intractable health conditions.

Revolutionizing surgical practice

In today's operating rooms, 3D-printed applications in the operating room are generally limited to a relatively small number of procedure types, though physicians can easily apply the lessons from one surgery to many others. For example, pioneering case studies in the use of printed 3D medical models are rapidly increasing interest and use of the technology in cases such as 2-year-old Mina Khan and the cardiac model that allowed surgeons to build a custom implant to patch a defect in the ventricles of her heart.

Surgeons are finding that 3D-printing technology can reduce operating time, lower risks from errors or complications, and produce better outcomes for patients through the use of 3D-printed surgical models and tools — this is apparent in recent efforts to perform face transplants, for example.

Professional 3D printers now incorporate photo-curable resins of various textures, transparency and flexibility — so before procedures, surgeons can now plan complex surgeries with CT scan data of a patient's bones, blood vessels or other organs, converted to a 3D-printable digital file that can be manipulated and studied. And for operations involving cutting or drilling into skeletal structures — such as jaw surgeries, knee replacements and other joint-related procedures — 3D printing is also creating the perfect fit through printed custom guides and tools.

Using medical imaging and 3D-modeling technology, doctors can now also use 3D printers to create temporary tools that are affixed to the skeletal structure of the patient to provide a precise "blueprint" for reshaping bone structure to perfectly accommodate standard-size implants. Custom-printed drilling guides ensure that screws are placed precisely to ensure the best fit with a patient's body.

In 10 years, it's highly likely that 3D-printed medical models and custom surgical guides will be standard procedure for a variety of operations, including heart surgery, jaw surgery, knee replacements, hip replacements, cranial implants, shoulder operations, spinal procedures and many others.

A young Thor clutches Mj?lnir with his newly printed prosthetic.Credit: Jen Owen, e-NABLEView full size image

Bringing treatment to the untreatable

One of the most inspiring outcomes from the rapid expansion of 3D-printed medical solutions is the ability to help patients who previously had little hope for treatment. Whether due to financial obstacles or the unique circumstances of a condition, millions of people across the globe are unable to undergo critical surgeries. Now, in some cases, 3D printing is helping remove those obstacles.

One particularly fantastic example is in the case of prosthetic hands and transradial (below the elbow) prosthetics. The need for such prosthetics, in relation to the total market value, just doesn't add up for most medical device companies. Traditional transradial prosthetics are extremely expensive: usually $10,000 to $20,000 or more per device. The prosthetics can degrade from extensive use, and if the patient is young and still growing, a prosthetic solution simply isn't practical — especially if the patient has another fully functional limb to fall back on. Tens of thousands, if not hundreds of thousands, of people who could live measurably better lives with a transradial prosthetic simply don't have a viable solution. [3-D Printed Material Mimics Biological Tissue  ]

But 3D printing is changing this — and quickly.

In the last two years, there has been a revolution in the number of completely customizable, functional prosthetic hands that can be printed by even the most inexpensive 3D printers. Total cost (including materials) for these is often less than a few hundred dollars, as volunteer communities such as e-Nable connect those with printers and experience to those in need of a prosthetic.

This is a 3D printed model used in planning a face transplant surgery.Credit: RSNAView full size image


Even for people who don't own a printer, functional prosthetic hands have suddenly become a possibility — including children who would otherwise have struggled through childhood, as kids outgrow prosthetics in just months. Now, someone with a printer can print a child's new device in fewer than 24 hours. And, prosthetics can incorporate custom designs unique to each patient. A number of very happy children are currently using hands modeled after their favorite superheroes.

3D-printable implants of the hip and spine, while still a very small portion of the overall market for implants, are another great example of how the technology can bring treatments to people who may have been considered untreatable.

Specialty medical-implant providers are using industrial printers to create custom implants for patients who would be otherwise have great difficulty finding a traditional implant solution. The aging population continues to get heavier, and it isn't uncommon for people with bad hips and knees to have second or even third procedures as their bodies — and traditional implants — degrade. Specialty implants fabricated through 3D printing are often the only way to treat some of these patients with any hope of long-term success.

What's next?

In addition to proven solutions like models, surgical guides and implants, engineers are also exploring approaches that are much more experimental, but with the potential for life-changing consequences.

expert voices, op-ed If you're a topical expert — researcher, business leader, author or innovator — and would like to contribute an op-ed piece, email us here.View full size image

The status quo for fracture braces has been largely unchallenged for decades. The traditional fiberglass wrap requires specialists and significantly impacts everyday life because of its bulky design and restrictions for staying dry. That could soon be challenged by elegant, 3D-printable braces that can be snapped on and off in seconds, while allowing skin to breathe so it doesn't decompose, as with a traditional Fiberglass wrap. The ability to easily and quickly put on or remove the brace eliminates 90 percent of the appointment time a fracture patient spends with a specialist, saving on overall costs. And, the slim, form-fitting design allows the wearer much more freedom to carry on normal life while healing from injury.

Some 3D printable healthcare solutions are still a work in progress. While transradial prosthetics for the hand are taking off, prosthetics for leg amputees still pose significant 3D printing challenges: Most easily available printers and print materials simply can’t withstand the constant loading leg prosthetics require. Custom-made 3D printed "fairings" — essentially an aesthetic enhancement to a traditional metal leg prosthetic — are about the only area 3D printing has been able to improve for leg prostheses. But the potential for future innovations in these, and other, areas is growing. [The 10 Weirdest Things Created By 3D Printing ]

It is this willingness of innovators in medical design to think outside the norm with 3D printing is fueling the engine of change in health care. 3D-printed medical applications, whether in the most experimental of phases or on the brink of revolutionizing traditional medical practice, are all about three things: The ability to treat more people where it previously was not feasible; better outcomes for patients; and less time required under the direct care of medical specialists. This is the future of health care — 3D printing is enabling doctors to treat more patients, without sacrificing results.

Follow all of the Expert Voices issues and debates — and become part of the discussion — on Facebook, Twitter and Google+. The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on Live Science.


自动翻译仅供参考

外科医生的好帮手-3D打印技术助力医疗行业

特写的3D打印心脏信用:詹姆斯·卡尔森/ OSF圣弗朗西斯医疗中心查看原图

printed heart

斯科特·邓纳姆是一位资深分析师SMARTECH市场发布,而只关注添加剂的制造和三维打印。邓纳姆是在3D打印行业活动定期主讲人世界范围内,他将在添加剂中断首脑会议4月1日被提出,并于5月19日,他迅速会议促成了本文以住科学的专家声音:专栏文章与观点。


医疗保健是今天辩论的一个永恒不变的话题 - 但卫生保健是不是所有的政治。在处理和技术的创新正在彻底改变我们如何照顾别人,但仍然有一些是非常过时的或达不到改善或保存的目的的做法,住。现在,随着添加剂制造的迅速发展 - 日益流行的技术,通常被称为3D打印机 - 医疗保健的未来正在推进的方式既熟悉又大大新。


虽然专业的3D打印机制造商专门开发和推广,牙科用途的3D打印技术,非牙科医疗应用宇宙正进入快速增长阶段。不要让她的紫色3D打印假肢愚弄你,她的队长America.Credit的忠实粉丝:仁欧文,电子NABLEView原图


3D打印:个性化医疗的模型


在制造业的背景下,相对于其他热门行业,如航空航天,汽车和其他3D打印技术医学应用实际上是相当独特。为什么呢?答案显然是存在于所有的医疗应用中,往往成本成为次要关注的一个成功的结果是救命还是极大地提高一个质量的人的因素。 [3D打印医学杂志7酷用途]


但是,我们最近制作了一个10年的预测领域,有中数字化三维设计,医学成像和3D打印为医疗应用异常强大的协同作用。这三种形式的医疗解决问题的能力,在那里医生可以使用患者具体数据获取,处理和最终申请通过3D打印各种形状和大小的物理解决方案的三连胜。如果没有这样的技术,个性化药物将是困难的,因为患者会需要唯一零件,可以迅速和简单地制造。


有两个特别令人感兴趣的区域,其中三维印刷有通过各种革命性医疗解决方案的冲击数百万人的生命的潜力:手术和否则顽固性健康状况的治疗。


革命性的手术实践


在今天的手术室,在手术室三维印刷应用一般仅限于相对少数的程序类型的,虽然医生可以从一台外科手术容易的经验应用到许多其他问题。例如,在使用打印三维医学模式的创业案例研究正在迅速增加的情况下,如2岁的米娜·汗和心脏模型,允许外科医生建立一个自定义植入修补缺陷感兴趣的技术和使用在她的心脏的心室。


外科医生们发现,三维印刷技术可以通过使用3D-印刷外科模型和工具减少操作时间,从错误或并发症风险较低,并且产生对患者更好的结果 - 这是在最近的努力明显以执行面部移植,为例子。


专业的三维打印机现在结合各种质地,透明度和柔韧性的可光固化树脂 - 因此程序之前,外科医生现在可以规划复杂的手术用的患者的骨骼,血管或其他器官的CT扫描数据,转换为三维打印的数字文件可以操作和研究。而对于涉及切割或钻入骨骼结构的操作 - 比如下巴手术,膝关节置换术等联合相关手续 - 三维打印还通过印刷定制指南和工具创造了完美的结合。


使用医疗成像和三维建模技术,医生们现在还可以使用3D打印机来创建贴到患者提供了精确的“蓝图”重塑骨骼结构完美地适应标准尺寸的植入物的骨骼结构的临时工具。定制印刷钻孔导向确保螺钉放置精确,以保证最佳拟合与患者的身体。


10年来,这是很有可能的3D打印医疗模式和定制手术导板将成为标准程序,适用于各种操作,包括心脏手术,下颌手术,膝关节置换,髋关节置换手术,颅骨植入物,肩部操作,脊柱的程序和许多其他。
?一位年轻的雷神离合器MJ lnir与他新印prosthetic.Credit:仁欧文,电子NABLEView原图瞻治疗,在治愈的其中一个从3D打印医疗解决方案的快速扩张最鼓舞人心的结果是帮助谁以前没有什么希望接受治疗的病人的能力。无论是由于财务上的障碍或条件的特殊情况,数百万世界各地的人都无法接受的关键手术。现在,在某些情况下,三维打印帮助消除这些障碍。


一个特别神奇的例子是在假肢的手和桡动脉(低于肘部)假肢的情况。需要这样的假肢,相对于总市值,只是不加起来对大多数医疗器械公司。传统的经桡动脉修复术是非常昂贵的:通常是$ 10,000到$ 20,000以上每个设备。该假肢可以从大量使用会降低,而如果患者年轻,还在成长,一瓣瓣的解决方案根本是不现实的 - 特别是如果病人有另外一个功能齐全的肢体依傍。数万,如果不是数以十万计的人谁可以与经桡动脉修复可测量生活更美好的生活,根本就没有一个可行的解决方案。 [3-D打印的材料模仿生物组织]


但3D打印正在改变这一点 - 并快速。


在过去的两年中,出现了可以通过即使是最便宜的3D打印机打印的完全可定制的,功能性假肢手数的一场革命。总费用(包括材料),这些往往超过几百美元以下,为志愿者群体,如电子Nable连接那些与打印机和经验,给那些有需要的假体。

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