NEWS
LASER PRINTED TRACHEAL SPLINTS IMPLANTED IN LIFE-SAVING SURGERY
An adolescent girl has received novel, 3D printed tracheal splints to treat a congenital breathing condition called tracheobronchomalacia. She joins three baby boys and a baby girl who
previously underwent similar operations. All five patients continue to thrive, as their collapsed airways now function normally thanks to the surgical procedure. Tracheobronchomalacia is a rare condition
whereby the tracheal cartilage is soft, leading to the collapse of the patient’s windpipe. The procedure to treat the condition was
pioneered by Dr Glenn Green – a paediatric otolaryngologist in Michigan – and his surgical team from CS Mott Children’s Hospital, who joined forces with Dr Scott Hollister, professor of biomedical engineering and lead researcher at the University of Michigan. Dr Hollister commented: ‘Even if a market is
relatively small, it doesn’t diminish the human need to be treated. It is estimated that one in every 2,000 children worldwide is affected by this life-threatening condition. ‘When I started designing my own
porous scaffolds for anatomic reconstruction, I realised that 3D printing would be ideal for creating the complex geometries I had in mind. It is now pretty automatic to generate an individualised splint design and print it; the whole process only takes about two days now instead of three to five.’ The university team uses patient data
from MRI or CT scans to examine the defect to be repaired, then creates computer models of the anatomy. Engineers are able to use a CAD system to design splints with a highly compliant, porous structure of interconnected spaces
Two of the University of Michigan’s 3D-printed tracheal splints, made of polycaprolac- tone using EOS technology, on a model of a trachea
that will slowly expand with the maturing airway. Finally, the splint is produced in the EOS Formiga P 100 system. After fabrication, researchers measure the splint dimensions and mechanically test them. Following the operation, the splint-
supported trachea expands and functions immediately, so when patients are weaned off oxygen they are able to breathe normally. Kaiba Gionfriddo, the first baby to benefit from the procedure, is now nearly four years old. The boy’s own tissues have successfully taken over the job of the implant, which has been almost completely reabsorbed into his body. Polycaprolactone (PCL) was found to be
the perfect material for additively manufacturing a tracheal implant. First, it has a long resorption time, which is very important in airway applications as the implant needs to remain in place for at least two years before it is resorbed. Second, PCL is very ductile, so if it fails it will not produce any particles that might puncture tissue. PCL can be readily processed and fabricated on an EOS additive manufacturing system. Dr Hollister and the University of
Michigan purchased an EOS Formiga P
100 in 2006 to aid research into scaffolds and biomaterials. He continued: ‘I chose EOS because we were looking for a system that was flexible and allowed us to change parameter settings such as laser power, speed, powder bed temperature and so on, which we needed to do to customise our builds. ‘Also, because
Kaiba Gionfriddo was the first child to receive 3D-printed tracheal splints, which helped keep his airways open, restored his breathing and saved his life. The boy’s own tissues have successfully taken over the job of the implant, which has been almost completely reabsorbed by his body
of the machine to best process the PCL material.’ Additive manufacturing expertise was given on
is relatively small, it doesn’t diminish the human need to be treated
biomaterials can be expensive and implants and scaffolds are typically not so big, we wanted a more limited build volume that didn’t use a lot of material. The Formiga P 100 fitted the bill for both of these requirements. ‘EOS even gave us
access to software patches to enable us to change the
range of parameters 6 LASER SYSTEMS EUROPE ISSUE 31 • SUMMER 2016 Even if a market
site by EOS, who helped the team in their laboratory, advising how best to prepare the material for production. While the company offers a wide variety of proprietary plastic and metal materials, the use of PCL was a first in this case. To treat patients either with birth
defects or following illnesses or accidents, Dr Hollister’s group is also developing craniofacial, spine, long bone, ear and nose scaffolds and implants, and additively
manufacturing them using a material with characteristics that promote reconstruction and regrowth. He concluded: ‘I see a time soon, probably
within the next five years, when many hospitals and medical centres will print their own devices specifically for their own patients and not need to get them off the shelf. ‘If we can expand the number of biomaterials
used in additive manufacturing, we can tackle a tremendous number of problems in all fields of reconstructive surgery and make enormous strides for the benefit of patients.’
@lasersystemsmag |
www.lasersystemseurope.com
Leisa Thompson Photography / University of Michigan Health System
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