3-D Printing and Patient Care: UA Surgeon Shares How the Technology can Saves Lives and Money in The Lancet

Using 3-D models for surgery planning before complex procedures and as a potential means to replicate surgical tools in low-resource areas, Dr. David Armstrong and his lab share with The Lancet, a prestigious UK medical journal, their vision of 3-D printing technology in medicine.

University of Arizona professor of surgery David G. Armstrong, DPM, MD, PhD, shared the potential and his lab’s current use of 3-D printing in medicine in a recently published article in The Lancet.

3-D printers are used to create three-dimensional objects by depositing material, commonly metal, plastic or ceramics, in successive layers to create a physical object from a digital file. The technology has been used to create car parts, smartphone cases, fashion accessories and even medical equipment and artificial organs.

The Lancet, a UK medical journal, asked Dr. Armstrong, professor of surgery and director of the University of Arizona Southern Arizona Limb Salvage Alliance (SALSA), to share his use and vision of 3-D printing technology in medicine.

The SALSA lab regularly uses 3-D technology to make models for surgical planning before complex operations. The technology allows the clinicians to examine and even touch complicated anatomy to plan strategy before complex surgical procedures. SALSA is a collaborative clinical and research alliance dedicated to advancing care of the diabetic foot and preventing amputations worldwide.           

“I’m evangelical about technology,’’ says Dr. Armstrong “But I’m always asking myself ‘how can we leverage it to help our people?’ If it doesn’t work I move on.”  

To understand and apply 3-D technology in medicine, Dr. Armstrong and his team bought a consumer-grade fused deposition manufacturing 3-D printer for about $2,000 and printed Army/Navy retractors, a surgical tool used to pull open shallow or superficial incisions. They printed the retractors with polylactic acid, one of the most basic and readily available filaments. The material cost for each retractor made with the 3-D printer was 46 cents, and when printed under sterile conditions, the team found they were safe  and strong enough for use in medical procedures. Dr. Armstrong assessed that the 3-D printed retractors could be used in low-resource settings, or inaccessible areas.

The Lancet article also features Jennifer Lewis, ScD, Hansjorg Wyss Professor of Biologically Inspired Engineering at the Harvard John A. Paulson School of Engineering and Applied Sciences, who describes her goal to print three-dimensional vascularized tissues and ultimately, organs. 

The U.S. Food and Drug Administration has cleared the design and manufacture of personalized, anatomically matched implants for use in surgery and in May 2016 issued generalized draft guidance, but the responsibility for appropriate long-term clinical evaluation rests with the individual surgeons and their institutions.

The article’s title is The Lancet Technology: 3D printing for instruments, models, and organs? To read the full article, please visit: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31735-4.pdf

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