The apparent simplicity of 3D printing, from art projects to DIY guns, belies its enormous promise in healthcare. 3D printing  –also known as additive manufacturing– historically refers to the process whereby material is sequentially deposited onto a powder bed with inkjet printer heads. It’s not new: it has been used in industrial design since the 1980s, however in the last decade, 3D printing has become adapted for medical application inspiring enthusiasm across the healthcare community.

3-D printing can offer the healthcare industry numerous solutions:

• For making models of anatomically complex patients can guide surgeons in preoperative strategies. This has helped in decision making in complicated cardiac surgery (1) and neurosurgery (2); and also for clinical/surgical planning or in medical education and research (3)

• For creating bespoke biomechanical parts. Health conditions that stem from biomechanical issues (like broken and misaligned bones, and aging joints) tend to have great anatomical variance. Using scans to determine exact dimensions, bespoke 3D printed products will fit any anatomy with greater intricacy than those manufactured using traditional methods (without requiring retooling). The specificity of 3D printing to the patient’s anatomy also makes it potentially very useful for dental implants and hearing aids

• For producing structures critical for repairing complex and delicate organs like the heart valves, blood vessels and nerve tissue. A recent study demonstrated how 3D printed flexible silicon scaffolds (containing biochemical growth cues) could act as nerve guides to repair sciatic nerve damage in rats(4); moreover, the nerve had a complex morphology (Y-shaped) demonstrating non-linear regeneration. Implants can even be made from bioresorbable materials so that they effectively break down after they have performed their function (5)

• For use with living tissue: initially layering numbers of cells (albeit very thin and only temporarily viable), the hope is to be able to create larger viable sections in the future, looking toward 3D printing of implantable liver tissue and ultimately replicated organs.

• For manufacturing medical equipment on-site, which may be pertinent in poorer countries or warzones. In fact, this feature has been demonstrated by printing stethoscopes in Gaza after a blockade on medical supplies was imposed (6). Looking further into the distance, a solar-powered 3D printer has been developed for space stations in Mars!

3D Printing affords design freedom with rapid creation of specialised and complex products with complex anatomical geometries –allowing a concept to be directly translated into an end product in a convenient, cost-efficient manner.

Its potential value in healthcare is illustrated by the growth in research in this field: already to date in 2015, there have been more scientifically published reports of 3D printing than in all of 2014, which have increased more than a 4-fold since 2011. Of course, this is wonderful for research, but will 3D printing actually impact healthcare in the long-term, or will it be confined to niche markets? Hopefully, savings from eliminating development time, production, assembly lines, delivery, and warehousing of parts, and the subsequent savings made from using fewer materials and labour should lead to a real reduction production costs. Wide-ranging and longitudinal studies on large samples are necessary to assess the real impact of this technology in surgical procedures and healthcare as a whole.

If you would like to comment on any of the issues raised by this article, particularly from your own experience or insight, Healthcare-Arena would welcome your views.

References

• Schmauss D, Gerber N, Sodian R. Three-dimensional printing of models for surgical planning in patients with primary cardiac tumors. The Journal of thoracic and cardiovascular surgery. 2013;145(5):1407-8. Epub 2013/01/15.
• Spottiswoode BS, van den Heever DJ, Chang Y, Engelhardt S, Du Plessis S, Nicolls F, et al. Preoperative three-dimensional model creation of magnetic resonance brain images as a tool to assist neurosurgical planning. Stereotactic and functional neurosurgery. 2013;91(3):162-9. Epub 2013/03/01.
• Naftulin JS, Kimchi EY, Cash SS. Streamlined, Inexpensive 3D Printing of the Brain and Skull. PloS one. 2015;10(8):e0136198. Epub 2015/08/22.
• http://onlinelibrary.wiley.com/doi/10.1002/adfm.201501760/abstract.
• Zopf DA, Hollister SJ, Nelson ME, Ohye RG, Green GE. Bioresorbable airway splint created with a three-dimensional printer. The New England journal of medicine. 2013;368(21):2043-5. Epub 2013/05/24.
• http://www.huffingtonpost.com/entry/tarek-loubani-3d-printing-stethoscope-gaza_55f2f570e4b077ca094ec2f5.