How 3-D Printing is Revolutionizing Medicine

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Jerome Groopman of the New Yorker wrote a piece on how 3-D printing is changing medicine.

In February of 2012, a medical team at the University of Michigan’s C. S. Mott Children’s Hospital, in Ann Arbor, carried out an unusual operation on a three-month-old boy. The baby had been born with a rare condition called tracheobronchomalacia: the tissue of one portion of his airway was so weak that it persistently collapsed. This made breathing very difficult, and it regularly blocked vital blood vessels nearby, including the aorta, triggering cardiac and pulmonary arrest. The infant was placed on a ventilator, while the medical team set about figuring out what to do. The area of weak tissue would somehow need to be repaired or replaced—a major and dangerous operation in so small a patient. The team consulted with the baby’s doctors at Akron Children’s Hospital, in Ohio, and they soon agreed that they had just the right tool for this delicate, lifesaving task: a 3-D printer.

As its name suggests, a 3-D printer prints ink not on a flat substrate, such as paper, but in three dimensions, in successive layers; the ink is substrate and substance in one. The first 3-D printers were developed in the nineteen-eighties, by an American engineer named Charles Hull. The “ink” was an acrylic liquid that turned solid when exposed to ultraviolet light, typically from a laser beam. Makers of cars and airplanes could design complicated parts on a computer and then print out prototypes for manufacture; now they often print the part, too. Three-dimensional printers have become inexpensive and ubiquitous. Staples and Amazon now offer 3-D printing services, and the list of 3-D-printed products generally available includes nuts, bolts, earbuds, eyeglasses, athletic cleats, jewelry, cremation urns, “Star Wars” figurines, architectural models, and even entire houses. In the United States, debates have erupted over whether citizens should be allowed to 3-D-print handguns at home, which the technology makes possible. Today’s printers print in plastics, and also in silver, gold, and other metals, along with ceramics, wax, and even food. (NASA is working on a zero-gravity 3-D printer that can make pizza for orbiting astronauts.) For a small fee, you can upload a photograph of your face and receive back your likeness in the form of a 3-D-printed bobblehead doll.

The medical procedure at the University of Michigan worked on a similar principle. The researchers began by taking a CT scan of the baby’s chest, which they converted into a highly detailed, three-dimensional virtual map of his altered airways. From this model, they designed and printed a splint—a small tube, made of the same biocompatible material that goes into sutures—that would fit snugly over the weakened section of airway and hold it open. It was strong but flexible, and would expand as the boy grew—the researchers likened it to “the hose of a vacuum cleaner.” The splint would last for three years or so, long enough for the boy’s cells to grow over it, and then would dissolve harmlessly. Three weeks after the splint was implanted, the baby was disconnected from the ventilator and sent home. In May of 2013, in The New England Journal of Medicine, the researchers reported that the boy was thriving and that “no unforeseen problems related to the splint have arisen.”

This sort of procedure is becoming more and more common among doctors and medical researchers. Almost every day, I receive an e-mail from my hospital’s press office describing how yet another colleague is using a 3-D printer to create an intricately realistic surgical model—of a particular patient’s mitral valve, or finger, or optic nerve—to practice on before the actual operation. Surgeons are implanting 3-D-printed stents, prosthetics, and replacement segments of human skull. The exponents of 3-D printing contend that the technology is making manufacturing more democratic; the things we are choosing to print are becoming ever more personal and intimate. This appears to be even more true in medicine: increasingly, what we are printing is ourselves.

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