A Dutch university hospital has successfully given a 22-year-old woman a plastic skull, made with the help of a 3D printer. Utrecht University's UMC says the operation is a world first.
The woman needed the operation because her skull was becoming thicker, compressing her brain and damaging its function. Her cranium had become 5cm thick, while a normal skull is up to around 1.5cm.
Her medical team, led by neurologist Ben Verweij, decided to replace her cranium with a plastic one, produced by a specialist Australian firm. The operation took 23 hours but was a complete success, the hospital says.
‘Implants used to be made by hand in the operating theatre using a sort of cement which was far from ideal,’ Verweij said. ‘Using 3D printing we can make one to the exact size. This not only has great cosmetic advantages, but patients’ brain function often recovers better than using the old method.’
The procedure took place three months ago but the woman has now gone back to work and is symptom free, Verweij said.Source: http://www.dutchnews.nl/news/archives/2014/03/dutch_hospital_gives_patient_n.php
The hospital says the technique can be used with patients who have other bone problems or to help recovery after people have suffered serious skull injuries.
Other hospitals have placed skull implants successfully in patients but this is the first time a complete cranium has been replaced, the surgeon said.
Preparing DICOM images (CT/MRT) for 3d printing using Seg3D, Imagevis3D (University of Utah, CIBC) and Meshmixer.
Seg3D offers the advantage to apply filters, but it's not absolutely necessary. Imagevis3D can load DICOM stacks as well and the rendered isosurface may be exported as mesh directly. In this video I used the gaussian filter of Seg3D to smooth the model a little bit.
Software Downloads:
http://www.sci.utah.edu/cibc-software...http://www.sci.utah.edu/cibc-software...http://www.meshmixer.com/download.html
Vicknes Waran from the University of Malaya in Kuala Lumpur, Malaysia, and colleagues created the model using the latest generation of 3D printers, which can print plastic in a variety of textures, from rubbery to hard. By tweaking the printer's settings, they mimicked the consistency of skin, bone and membranes to build up the layers inside a skull. To reproduce a jelly-like tumour, plastic was injected into an anatomically accurate cavity created by the printer, based on scans from a patient. It was then coloured red to add realism.
The skull is an improvement over existing models that use a single material because it allows trainees to see, feel and even hear how each type of tissue responds. Patient-specific replicas can simulate different medical conditions, allowing students to rehearse an entire operation ahead of time.
The researchers also made models of the head. These can be reused, but the model brains with internal structure are custom-made for each practice session. Each costs about $600 to make, which makes it an affordable option.
The team has already created even more sophisticated model brains with cavities that students can probe. "It bleeds and has fluid for brain endoscopy," says Waran.
A handheld ‘bio pen’ developed in the labs of the University of Wollongong (UOW) will allow surgeons to design customised implants on-site and at the time of surgery.
The BioPen, developed by researchers from the UOW-headquarteredAustralian Research Council Centre of Excellence for Electromaterials Science (ACES), will give surgeons greater control over where the materials are deposited while also reducing the time the patient is in surgery by delivering live cells and growth factors directly to the site of injury, accelerating the regeneration of functional bone and cartilage.
The BioPen works similar to 3D printing methods by delivering cell material inside a biopolymer such as alginate, a seaweed extract, protected by a second, outer layer of gel material. The two layers of gel are combined in the pen head as it is extruded onto the bone surface and the surgeon ‘draws’ with the ink to fill in the damaged bone section.
A low powered ultra-violet light source is fixed to the device that solidifies the inks during dispensing, providing protection for the embedded cells while they are built up layer-by-layer to construct a 3D scaffold in the wound site.
Once the cells are ‘drawn’ onto the surgery site they will multiply, become differentiated into nerve cells, muscle cells or bone cells and will eventually turn from individual cells into a thriving community of cells in the form of a functioning a tissue, such as nerves, or a muscle.
The device can also be seeded with growth factors or other drugs to assist regrowth and recovery, while the hand-held design allows for precision in theatre and ease of transportation.
The BioPen prototype was designed and built using the 3D printing equipment in the labs at the University of Wollongong and was this week handed over to clinical partners at St Vincent’s Hospital Melbourne, led by Professor Peter Choong, who will work on optimising the cell material for use in clinical trials.
The BioPen will help build on recent work by ACES researchers where they were able to grow new knee cartilage from stem cells on 3D-printed scaffolds to treat cancers, osteoarthritis and traumatic injury.
Professor Peter Choong, Director of Orthopaedics at St Vincent’s Hospital Melbourne and the Sir Hugh Devine Professor of Surgery, University of Melbourne said:
“This type of treatment may be suitable for repairing acutely damaged bone and cartilage, for example from sporting or motor vehicle injuries. Professor Wallace’s research team brings together the science of stem cells and polymer chemistry to help surgeons design and personalise solutions for reconstructing bone and joint defects in real time.”
The BioPen will be transferred to St Vincent’s for clinical projects to be carried out at the proposed Aikenhead Centre for Medical Discovery in Melbourne.
“The combination of materials science and next-generation fabrication technology is creating opportunities that can only be executed through effective collaborations such as this,” ACES Director Professor Gordon Wallace said.
“What’s more, advances in 3D printing are enabling further hardware innovations in a rapid manner.”
Design expertise and fabrication of the BioPen was supported by the Materials Node of the Australian National Fabrication Facility, hosted at the University of Wollongong’s Innovation Campus.
