Ask Us Anything About… 3D Printing in Healthcare

3D printing has a unique place in healthcare — from revolutionizing how surgeries are carried out to the increased benefits of manufacturing prostheses and implants. We learn more from Dr. Randy Haluck, vice chair for innovation and technology at Penn State Health, and Matt Briddell, consulting lead, Clinical Innovation Group in the Center for Medical Innovation at Penn State College of Medicine.

August 28, 2018 Penn State Health News
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Transcript

Description – The video begins inside a research lab at the Penn State College of Medicine’s Biomedical Research Building. Three people are standing next to each other next to a 3D Printer. From left to right is, Dr. Randy Haluck, Scott Gilbert and Matt Briddell.

Scott Gilbert – From Penn State Health, this is Ask Us Anything About 3D Printing in Healthcare. I’m Scott Gilbert. Well, a lot of these interviews, we’ve done 30 some, are typically about a medical condition of some sort, right? We talk about symptoms, we talk about treatment, we talk about, you know, the steps you should take if you feel that you have that illness. We’re going a different path this time. This is some really interesting innovative stuff when we talk about 3D printing in healthcare. 3D printing has a unique place in the healthcare spectrum. You know, from revolutionizing how surgeries are carried out, to the increased benefits of manufacturing prosthesis, and other things. So here to talk with us through that is Dr. Randy Haluck. He is vice chair for Innovation and Technology here at Penn State Health. And also with us is Matt Briddell, he is the lead for the Clinical Innovation Group within the Center for Medical Innovation here at Penn State College of Medicine. So thanks to both of you for being part of this. In order for all of us to get on the same page, and to bring our viewers with us, I would like to talk a little bit about what is 3D printing. So, Matt, can you kind of give us an overview of what it entails and how it works?

Matt Briddell –  Sure. So 3D printing is the process of developing a three dimensional object through the addition of layers. So as you can see in this skull here, there are layers that are built up over time by the printer, one after another. They are very fine, and they can be in different colors and different materials that in the end produce an object that couldn’t be produced by any other means. So traditional manufacturing is usually reductive, where you’re taking a large block of steel or plastic and machining it down. This is about building it up from nothing.

Scott Gilbert – And when we think about printing, we think about — I mean, most of us have printers that print with ink. But you mentioned that this obviously is not a — it’s not on standard material or resin. Rather, 3D printing can happen with a range of materials, right?

Matt Briddell –  That’s right. They’re adding new materials every day, but a lot of materials are polymers, plastics that are used in 3D printing. 3D printing can also be used with metals, and a lot of that is present in the medical space now. And Penn State does a lot of research into the actual development of new materials for 3D printing.

Scott Gilbert – Dr. Haluck, 3D printing has been around for nearly 30 years at this point. When did it first occur to somebody that it could have applications in healthcare, and help to save lives?

Dr. Randy HaluckWell, really, from the very beginning of 3D printing people realized that this technology can print incredibly intricate and complex structures, or at least have that potential. Which, of course, organs, anatomy, structures are very complex structures that, as Matt mentioned, would be very difficult to build through traditional machining methods. So right from the bat people had that vision. It’s just that the technology has taken some time, really decades, to emerge. And now we’re really seeing this come to fruition and really taking off where the technology is starting to meet our needs for the medical space.

Scott Gilbert – That’s exciting stuff. And when you say it’s taking off, what are some of the most common ways in which 3D printing is used today in healthcare?

Dr. Randy HaluckWell, in healthcare a lot of is used for prototyping of new devices. As we’re developing new implants, new devices for patient care, we — we print them out and test prototypes for that. It’s also used for direct patient care in surgical planning. So we might print a model of a very difficult complex case, and we may look at that model and decide where we’re going to make our incisions, where we’re going to put the implant, and how we’re going to approach the surgery. We may also devise certain guides or jigs that help us do the operation in the operating room. And where — what we’re right on the cusp of is actually patient specific implants. So if you need a hip replacement, you’re not getting a generic one off the shelf, you’re getting one specifically designed for you. That’s not exactly available today, but we’re right on the cusp of doing exactly that.

Scott Gilbert – Very interesting. You’re watching Ask Us Anything About 3D Printing in Healthcare from Penn State Health and Penn State College of Medicine. I’m Scott Gilbert, alongside Matt Briddell and Dr. Randy Haluck. We welcome your questions and comments. Just add them to the comment field below this Facebook post, whether you’re watching this interview live, or on playback, and we’ll make sure that we get your answers to the questions here. Because I’m sure I’ll forget to ask some questions. It’s a fascinating topic, it’s a broad topic. You know, Dr. Haluck, you mentioned anatomical models and their use. I know we actually have some great examples over here. Matt, you’ve shown us one. Show us some of the other things we have over here, and kind of explain what we’re looking at.

Matt Briddell –  Sure. So 3D printed models can be made of almost any material. And depending on the quality and size of the printer, you can print very accurate patient specific models that actually mimic real tissue and bone. As in the case here, where you have soft tissue for lungs, different colors for different parts of the anatomy. And then hard tissue to simulate bone. That’s a very expensive printer, and a very expensive process, but it also yields excellent results for the clinician who needs it for planning a surgery. And the other end of the spectrum here is a very inexpensive model of a spine that can be done for under a dollar. So there’s a lot of opportunity to utilize these different technologies and different materials for different purposes. This is an example of a biomedical device that’s been prototyped on the printer right over there, that’s a heat exchanger. And in — and Penn State and the College of Medicine use this to essentially invent new devices, either for internal use or research. And outside of the university are using this to actually develop new products.

Scott Gilbert – Now, Dr. Haluck, for you as a clinician, obviously you’re a surgeon in addition to your role with the — for Innovation and Technology here at the health system. What it is like for you to be able to put this kind of thing to use, you and your colleagues? I know we were talking before about mandible reconstruction is a good example. Can you talk about how this technology comes into play right here in Hershey in that regard?

Dr. Randy HaluckSure. Absolutely. This technology is an incredible benefit to clinicians and patients. First of all, once we have these models in our hand, just as you’ve seen, we get to understand the patient’s disease and condition better. We get to communicate that better to the patient. We’re able to teach the physicians of tomorrow in a more robust fashion where they can understand all of this in a better fashion. And in the case you mentioned earlier, our colleagues here in plastic surgery and [inaudible], for example, in craniofacial reconstruction, they can print the actual defect or the skull or the bone, then that guides them towards their bone substitutes or plates. They can bend the plates before the actual operation. They can plan for the bone substitute they’re going to use. And it can save an hour, maybe several hours, in the operating room. And what that means is, better outcome for the patient, better reconstruction, and less anesthetic time, just as a few examples as of a benefit to the patient.

Scott Gilbert – Gives the surgeon some practice so they —

Dr. Randy HaluckAbsolutely.

Scott Gilbert – — know even better what’s going on?

Dr. Randy HaluckAbsolutely. They’re — the surgeons are going into the OR much better prepared. They’ve rehearsed the operation, in essence, prior to actually doing it.

Scott Gilbert – Very good. You’re watching Ask Us Anything About 3D Printing in Healthcare from Penn State Health. If you enjoy this interview, as we hope you do, please share it on your Facebook page. We would love to help get the word out about this fascinating technology that, again, is happening right here in Central Pennsylvania. You know, one of the examples how 3D printing is used here in Hershey is at Penn State Children’s Hospital, and you might have heard of last week’s big news out of the Children’s Hospital, the Giant has donated $280,000 to Children’s Miracle Network to help fund the heart — the 3D heart model printing program for patients and families. And as Dr. Haluck was saying, those models are used by clinicians, but also to show parents, here’s an example of your child’s heart. Here’s an exact replica, actually. And here’s what we’re going to be doing. That must be reassuring to the parents, to the patients.

Dr. Randy HaluckAbsolutely. And, you know, the — you know, here we — at Penn State Health Hershey Medical Center, we take care of complex patients. We do highly specialized surgery. And it’s — you know, the understanding of these operations for all that are involved is not exactly straightforward. So being able to have that model in our hands so that everybody can understand, you know, including the families and the patients, you know, here’s what’s going on, here’s what we’re going to do, is a tremendous benefit, and I think comfort to the families and the patients.

Scott Gilbert – So there’s a question in my mind about this whole process of creating a 3D heart model, for example. I mean, that’s an organ inside of somebody’s body, and we’re going to make an exact replica of it. How does that work? How do you begin? How do you get good enough scans and pictures, if you will, to make that happen?

Matt Briddell – Well, it’s — started really with the same scans that a physician would use to look at your anatomy anyway, so a CT scan or an MRI scan. There are different versions of that that work better or not so good for 3D printing. But those scans are taken from the patient, and then we call it segmented, where you’re actually going through slice by slice from the scan, and creating the model of the specific piece of anatomy that will then be turned into a file that’s readable by a 3D printer. And so based on that, that file is sent to the printer and the model is printed.

Scott Gilbert – You make it sound so simple, but I’m sure to get to this point, though, it’s really — it’s been an amazing process, I’m sure.

Matt Briddell – It is not a simple process. It takes a lot of skill. A lot of skill, of course, from clinicians and physicians, but also from technologists behind the scenes, particularly in our radiology department here that are actually doing a lot of that work to develop the model that you’re seeing here today.

Scott Gilbert – And, Matt, I know that there are efforts that are continuing not only to use this technology today, but to figure out ways of using it in the future with patients in the healthcare setting here in Hershey, and those practices that can be picked up elsewhere. This goes beyond the medical centers who I know your colleagues up at University [inaudible] and elsewhere throughout the Penn State University system are also involved, right?

Matt Briddell – Yes. They certainly are. And part of what we’re doing here is developing an advanced clinical technologies program to really integrate all the components of Penn State and their expertise in material science and engineering, in additive manufacturing, with a focus on medicine, particularly in clinical care and patient education, and biomedical research.

Scott Gilbert – At the risk of asking a leading question, Dr. Haluck, how excited are you as a clinical to see where this is headed, where this technology is headed, and what this could mean for patients in the future, too?

Dr. Randy HaluckWell, of course, I’m very excited, and I hope that comes through in our discussion here. What we haven’t touched on, and where this is going, is through the — through regenerative medicine, and the development of tissues and organs. The holy grail and what everybody is working toward, and it’s a very complex problem, is can we now generate living tissue in the lab that we can bring to the OR for implantation, and from stem cells, so it’s literally the patient’s own tissue, can we build their own organs. Can we take, again, your cells, your stem cells, cultured in a lab, and build an organ prior to implantation in the operating room. Of course there’s many issues around transplant surgery and need for organs. The need for organs for transplantation. And ultimately we want to be able to take 3D printers into the operating room, and print tissue while you’re asleep in the OR. So if you need skin, or if you need liver tissue, a printer would just be laying down that tissue, printing the actual organ during the operation. And, again, that’s a very, very difficult problem. We hear about 3D printed organs, very challenging problem, still years away. But that’s where we’re going with this.

Scott Gilbert – Exciting nonetheless. So how are things done currently? I mean, I guess we’re talking about skin grafts, and that’s the current standard of care?

Dr. Randy HaluckThat’s the current standard of care, is basically, you know, harvesting of tissue, either your own tissue or another person’s tissue, and banking that. And then using it at the appropriate time.

Scott Gilbert – Now, we’re standing in front of a giant machine. I want to see if we can make room for the cameraman to check this out here. What are we looking at here, Matt?

Matt Briddell – This is an industrial grade Fused Deposition Modeling printer, made by a company called Stratasys, that creates 3D printed models, very durable, and reliable ones, using a process of laying down filament. So it has two extruders, it lays down the hard white filament that you see there to create a realistic representation of anatomy. In this case a hip. And the second extruder lays down a support material that is dissolvable in water. So based on that, and after about 15 hours or so for a print the size of the one you’re looking at now, the technician can take that out, clean off the support material, and then hand that to the physician who is essentially using it to plan, in this case a hip revision, so a hip reconstruction.

Scott Gilbert – And as Dr. Haluck was saying, this could be the future of bone and joint replacement?

Matt Briddell – Yes. The machine would look different, but, you know, in a sense that’s what it would be. Yep.

Scott Gilbert – Very interesting stuff. Well, anything else you guys have? Any other closing thoughts or anything about 3D printing in healthcare as we bring things to a close?

Dr. Randy HaluckWell, I’ll just say, it’s very exciting. The — even though the technology is several decades old, it’s just getting to that point where it’s really starting to take off. It’s really starting to be meaningful to us. The tools, such as printers, software, are really coming together for the benefit of patients.

Matt Briddell – Yeah. And we’re very excited about the future here. And we have an ambitious five year road map for how we’re going to integrate [inaudible] manufacturing 3D printing into the standard of care here. And hopefully can offer, you know, our patients things that they cannot get elsewhere. And also contribute to the furthering of medicine, you know, within this particular specialty, you know, worldwide.

Scott Gilbert – Lots of great stuff to come. I’m sure lots of great news for patients to come as well. Thank you both for your time today. Dr. Randy Haluck is vice chair for Innovation and Technology at Penn State Health. Matt Briddell is lead for the Clinical Innovation Group in the Center for Medical Innovation at Penn State College of Medicine. And thank you for watching Ask us anything about 3D printing in healthcare from Penn State Health.

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