— Take a CT scan. Doctors are going to order one of these anyway, so there’s a bunch of good data just waiting to be used. — Run the scan through OsiriX, a free application for viewing DICOM files (DICOM is a medical imaging file standard). This allows you to turn the layers from a CT scan into a 3D model. — Once there’s a 3D model of the bone structure, it can be manipulated in a program like Lightwave or Maya. A surgeon can basically do the surgery on the screen. — Make the model and practice the cuts with surgical saws.Dr. Giovinco’s specific process involves using a MakerBot to get the model just right before making the “practice” foot on another kind of 3D printer at Freeside, a hackerspace in Atlanta. In fact, the participating members at Freeside were so instrumental in the whole experiment that their names were included at the top of the paper when it was published in The Journal of Foot & Ankle Surgery. The most impressive part of this may not be how incredibly inexpensive the planning process was — it cost Dr. Giovinco and his team about $40, not the $1500 that some services charge for bone models — but how much time and money the ability to plan may have saved the patient and medical team. Having an anatomically correct model of the pre-operative foot and the post-operative foot means knowing exactly how this surgery will proceed without having to tinker around at all. Also, and this is huge, it let the team pre-assemble the Ilizarov construct (a cage thing that holds everything in place afterwards) beforehand, which takes at least an hour of surgery time on its own.
Get a load of this title: “How 3D printing built a new face.” Wired UK posted a slideshow and brief last week as a preview to an article in the upcoming July issue about the use of 3D printing for an inspiring face transplant, including bones! This is amazing, especially since the patient was able to speak afterwards. <Warning> Some of the links below may present some graphic pictures of surgery, but they’re not too bad, and definitely worth the read. And then I remembered Nicholas Giovinco, DPM, a MakerBot user who has made it his business to show others how a combination of 3D printing technologies can significantly increase the knowledge a surgeon takes into the operating room, and therefore significantly decrease the time a procedure takes. Down in Atlanta, Georgia, Dr. Giovinco, a foot and ankle surgeon, recognized the huge potential of using a MakerBot to get a good look at a bone structure before operating on it. This is hugely important in one particular kind of surgery he performs, Charcot Foot reconstruction. I’m not a doctor, so I’ll give you my best understanding of this and refer you to Nick’s own incredible documentation: basically this is a foot that has collapsed, and the patient doesn’t necessarily feel it because of neuropathy caused by other conditions like diabetes. Sufferers of the Charcot condition don’t give the surgeon a predictable operation. Their feet are all different, and just like in the case of the face transplant, it pays big time to know what that foot looks like before you have to cut it open. Here’s the procedure, and notice how remarkably inexpensive this is.
Two take-home points here. This is an inspiring example of how 3D printing more generally may play a huge role in bringing down the costs and risks of medical procedures. But closer to home, this is another in a long string of examples of people in the MakerBot community helping each other to make great things happen. Check out this exchange of Google Group messages that kicked things off:
And the rest is history. Now Nick is traveling the country discussing this work — all part of being a surgical resident, he tells us — and explaining to his colleagues how efficient a work flow like this can be. When you’re working with diabetic patients, it’s all the more important that surgery time be reduced as much as possible.
Our hats are off to Nick and the whole team involved in this work. It’s an excellent example of the DIY spirit improving — and maybe even saving — lives.