3D printing & medical applications: Carsten Engel at TEDxLiege

3D printing & medical applications: Carsten Engel at TEDxLiege

Translator: Hajar Ben Tahaikt
Reviewer: Claire Ghyselen 3D printing is not a dream. It is not a toy. It hasn’t been invented two weeks ago. In fact, it is already
a production technology. 3D printing has a big impact
on a lot of markets, especially for the medical sector. Can 3D printing really be the rebirth
of current medical practice? Medical practice has changed
a lot over the years. Let me show this to you. This is a picture of how an operating
theater looked like 100 years ago. Exactly 100 years ago. What you can see on this picture is that the surgeons
are operating on the patient amongst the classroom
with all the students. What you can notice as well is that nobody is wearing a mask or wearing gloves. So it’s not a very sterile environment
such as we would know it today. What we can notice as well is that there is very few,
nearly no technology involved at all. This is how an operating theater
actually looks like today. It’s a picture that I took from Google. It’s a German operating theater. And what we can see there is that today there is
a lot of technology involved. If you’ve been there already, for your work or as a patient yourself, you would have noticed
that there’s a limited amount of staff: one, maximum two surgeons,
an anesthesiologist, a couple of nurses, maximum two. Maybe a technician but that’s it.
Maybe an intern, of course. There are nearly more screens
than medical staff today. Over the years,
new technology has been introduced to operating theaters
and in medical practice. Surgeons and doctors have
always been very careful about introducing new technology. And with 3D printing, a lot is happening. We will see this together
during my presentation. The future might look like this. What you can see on this picture, would be one surgeon with his patient, no other staff, and one 3D printer. What you can see as well is there’s something happening
with the 3D printer. It’s a bit like your home printer
or your paper printer, when there are two papers
being printed at once or missing ink, for example. You know this as well. With this organ or 3D bio-printer,
there is an issue, a technical problem. A lot of organs are coming
out of this printer while the surgeon wanted only one. This might be what the future
will look like. What is 3D printing?
Let me explain this to you a bit. 3D printing is a process, a technology, where a 3D file is first sliced into a thousand, a couple of thousands,
even tens of thousand of 2D slices. They are interpreted
by the technology itself, and reproduced layer by layer. We can use ceramics, metals, and polymers, all kinds of materials, to recreate a highly complex object. In fact, it is that complex that we can customize a product entirely. And for the medical practice,
this has a huge impact: being able to customize a product gives you the possibly to create
something that is patient-specific. One example in the current practice today: did you know that the hearing aids
produced today, 96% worldwide of those hearing aids
are produced by 3D printing? This represents yearly
about more than 10 million parts produced on those technologies. You can already think of this technology
as a real production technology. This is how it looks like. This is one of the hearing aids
as it is printed today. The material here is a liquid resin. It has to be cleaned afterwards, and a couple of support tractors
have to be removed. Then, it’s transferred to the specialist who use it for their own patients, so there is a little marking
as well on the product. It’s patient-specific. If you look at the people
sitting next to you on your left, on your right, you notice that we’re all different,
we are all individuals – except if we are
perfect twins, of course, then the anatomy of our skulls
would be the same – but in most cases, that’s not the case. This product, the hearing aid,
is custom-produced for your ear. Another example: 3D printing has enabled the reduction
of surgery time for the medical practice One powerful example is that
In the past, in 2001 and 2002, – it’s not a technology
invented two weeks ago – surgery time has been reduced
from 97 to 23 hours. This is amazing. Let’s have a look at this case study. Those little Siamese twins are bound
to one another by their skull. Of course we would like
to separate them to give them a healthier life,
and maintain them alive. As you might imagine,
this is a highly complex procedure. Such a procedure is very rare. It doesn’t happen and occur very often. When surgeons are
confronted to such cases, they have to either improvise
or work 97 hours straight in order to bring a solution to this case. 3D printing helped reducing surgery time to bring an easier solution
for the surgery. As you can see, the problem here was not only that their skull
was bound together, but the veins bringing the blood
were merged together too. In order to separate them, surgeons had to decide what tools
to use, where and how to cut. Being able to rehearse
the procedure before the operation, this was a real game changer
for this case study. This is an example
of what has been 3D printed. It’s a patient model of the skull. You see that there are
three different colors. The translucent and white one
are the skull, the anatomy. The blood vessels are represented in red. This model enabled the surgeons
to rehearse the operation before the surgical act, reducing the time
from 97 hours to 23 hours. Imagine working 97 hours straight, with the same concentration
you would have from the first minute to the last minute. So this is actually amazing. 3D printing may bring a solution
when there is no other solution, especially in the medical field. For this case study, this was a very old patient
and she had bone cancer on the jaw. The surgeon came to the conclusion
that the current technologies and practice was not bringing any solution
to help his patient. What we did is to recreate an entire jaw in order to provide
a solution for the surgeon. As you can see, it’s patient-specific.
That’s one thing. It also matches exactly
the functions and the weight of the previous jaw, the bone. This one has been printed in titanium. So, how does it work? This is a video showing how the patient is inserted
in a PET/CT scanner. From the CT scanner you obtain
2D files of the skull and soft tissue. You can retrieve from that information the skull structure, the bone recreate a 3D file progressively, and then have it printed
either for rehearse function like this skull,
which is in polymer, or print the patient-specific implant. And you can scale it up or down,
you can have markings on it, or you can cut it as well
to have only a portion of it. So this is very interesting
for the surgeons. Another application:
this is exactly what we did on this one. This is a skull printed from a patient
who has suffered from a bike accident. No helmet. Think about this. The solution, as you can see, is that it is highly complex to produce
an implant that is patient-specific. With this technology,
3D printing enables– – actually this is a PEEK implant – to provide a solution that is
patient-specific and that fits perfectly. Another thing is that 3D printing
is actually saving lives. For this case study, this was done in Michigan
on this little boy, 20 months old. His problem was his bronchus. He suffered from a rare disease. His bronchus wouldn’t stop collapsing. Basically, he couldn’t breath.
This was happening again and again. Doctors actually thought
he wouldn’t come out of the hospital. What 3D printing could do for this
little boy was to provide an implant that matches exactly the anatomy
of this bronchus. It’s a splint that has been produced
in a biodegradable material. This implant was put on the patient, on this little baby here, and will disappear progressively in time, saving the life of this baby. This is where we’re heading for. We can print today with metals, ceramics, polymers, biodegradable materials. 3D printing technology,
it is a tool, a powerful tool. It enables surgeons to rehearse,
to pick the correct instruments, the correct way and procedure
to operate on the patient, save lives, bring a solution
when there is no other solution. But it can go a bit further. Currently, researchers are working on bio-printing, as it’s called,
or organ printing. The idea is to use
the patient’s own stem cells, to combine them with growth factors, and construct them, for example,
on a biodegradable polymeric scaffold in order to recreate organs. One of the first pictures I showed before, is this idea: progressively introducing bio printing and
organ printing for the medical practice. This is good news
for big smokers or heavy drinkers. They could endlessly drink
and smoke, do both together, without thinking about the consequences, and live on and on for 200 years. Is this the idea we want to [promote]
about technology and the medical practice? Or shall we use it for specific cases
such as the case of the little baby? When, where, with what technology
and what materials? The real question with this technology
especially, would be actually how far can we go? Thank you. (Applause)

11 thoughts on “3D printing & medical applications: Carsten Engel at TEDxLiege

  1. I have one doubt ..that 3D printed bronchi will work for how many yrs.. Once the baby grown up then their will be a issue of size of bronchi according to body size.. Is it possible that the printed brochi will also increase in size?

Leave a Reply

Your email address will not be published. Required fields are marked *