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Doctors On 3D Printing
3D printing in medicine [Source: Pewtrusts]

3D printing has done some pretty great things for the medical industry, but what do doctors think of it?

Doctors’ Opinions Of 3D Printing In Medicine

First off, how is 3D printing incorporated into the medical workflow and what is it used for?

Usually, products will be created by shaping a material through processes like carving, grinding, or molding. 3D printing, though, is an additive manufacturing technology, which is literally the opposite of these subtractive techniques. A computer guided file will likely be used to design and 3D print a final product which is comparatively inexpensive and less time consuming to create than in the market. As the medical industry is one with complex tools that often need to be customized to a patient’s needs, one would assume that doctors would find this technology helpful in their industry.

But as it would turn out, professionals argue in favor of as well as against taking 3D printing to the hospitals.

Two orthopedic surgeons both have somewhat different things to say about 3D printing in their line of work.

3D Printing Is Not Always Medically Necessary

Dr. Craig J. Della Valle is a professor and chief of adult reconstruction at Rush University Medical Center in Chicago. He puts forward the suggestion that 3D printing is simply “not necessary for straightforward cases”.

He claims that although it is used occasionally to understand complex situations, it is not required in most hip revision situations where planning and execution are rather straightforward. He concedes that there are sometimes unique cases where it can help to have a tangible model to help better prepare for a surgery, but firmly conveys that this isn’t always the case for every revision, especially in terms of preoperative planning. He stresses that complicated cases that are difficult to handle without 3D printing are the minority and that in these cases, the technology may aid surgeons in deciding when to refer cases based on their competency and available information. He continues to explain that even from an implant perspective, most hip revisions may be handled with standard implants, but restates that there are specific situations in which 3D printing aids in taking care of highly complex situations. 

From this, he concludes:

“So again, I think that both from a planning and execution perspective, in terms of the implants themselves, for the majority of revisions, I don’t think you need that technology. There are some complex cases where 3D printing can help you understand the problem better and the 3D technology has allowed us to have implants that we could not have made without the 3D printing technology.”

3D Printing Has Its Place In Medicine

Another doctor — Dr. Melvyn A. Harrington Jr., professor, residency program director, adult reconstruction fellowship director and vice chair for diversity and inclusion in the department of orthopedic surgery at Baylor College of Medicine in Houston — counters this argument with one of his own. He believes that 3D printed models have their place in all cases.

As a growing technology in the orthopedic field, 3D printing is often used by implant companies to manufacture implants and by surgeons to aid preoperative planning. He believes that the “utility is growing as the technology becomes more affordable and widely available”. He brings up the example of arthroplasty, where 3D modeling is predominantly used for acetabular revision cases.

He claims that although we have traditionally depended on multiplanar X-rays and CT scans with 3D reconstruction to analyze bone loss when preparing for cases that do not involve a custom made implant, as the technology becomes more available, models can easily be created for all cases. He proposes that the advantage that a 3D printed model offers in terms of accurate bony anatomy allows surgeons to accurately assess implant placement, need for supplemental fixation, need for a custom prosthesis, and overall situation in comparison to using radiographs or a 3D CT.

He also thinks that 3D printing technology allows surgeons to fully prepare for the implantation prior to entering the operating room by providing them with details such as how and where the implants need to be positioned and inserted, hence reducing the operative time (even if they don’t account for challenges presented by soft tissue). His final argument for using 3D printed models is being able to educate surgeons and teams on how to improve the execution of complex cases. Models may help trainees hone their skills and understanding of both anatomical structures and surgical techniques. It can also be used to “educate the patient and help them to understand the complexity of their situation”.

He summarizes by saying:

“In conclusion, 3D printing is a rapidly expanding area that can positively impact the planning and execution of revision total joint arthroplasties.”

My Opinion

I am by no means as qualified as a doctor, but I can understand both perspectives. From what I have understood, I agree that 3D printing definitely has a place in the medical industry.

While it may not always be the solution, it definitely helps in three distinct tiers: education, customizability, and accuracy. In terms of education, 3D printing makes it way more accessible. Students have time to get accustomed with different tools and anatomical structures on a nearly perfect model before working with actual patients. Additionally, products can be printed with intentional defects or abnormalities to encourage trainees to be able to handle and be prepared for all situations. 3D printing offers free rein as the designer can customize a model to their specific needs before printing it. The main argument brought forward by the doctor claiming that 3D printing is not always necessary was that often times, surgeries are straightforward and don’t need customization. Yet, like the second doctor said, as utilities like these becoming increasingly cheap, customization can offer patients a unique and more pleasant experience. Finally, the accuracy piece also ties in with education — when models are made, each step of the way is planned thoroughly, so the doctor knows approximately what to expect in the operating room, making their work more efficient, planned, and hence accurate.

Personally, I agree that even though 3D printing is not necessary in some cases, it offers benefits wherever used in these three tiers as well as in terms of cost, efficiency, and the improvement of the overall workflow.

Via Healio

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