Aug 3, 2016 | By Tess

Medical training practices are some of the most arduous and detail oriented training practices that exist, and with good reason. If you’re undergoing surgery, would you not want the doctor operating on you to have had extensive practice and training for the procedure? Typically, surgical training is conducted on preserved cadavers, which maintain the feel, look and textures of human bodies, but which are difficult to store, cost lots of money, and can be hard to come by at times. Other alternatives, such as foam models, have stood in for real bodies, but have failed to meet the textural feel of a real human body, which detracts from the training experience. Recently, however, 3D printing technologies have stepped in and have presented a solution to the problems posed by both cadavers and foam models.

That is, 3D printing is being increasingly used by medical device companies and medical practitioners to create life-like and patient specific surgical training models. Using data taken from MRIs or CT scans, custom 3D models can be generated, which can in turn be 3D printed from a variety of materials to be used as either surgical guides, or even as training devices. To go into the process more in depth, let us take a look at a recent research project undertaken by a team from the Carnegie Mellon University’s College of Engineering.

The research team, led by Professor Kenji Shimada, have developed what they call a “medical phantom model”, which uses 3D printing to create a realistic looking and feeling hands-on training model for surgeons. By combining a hard bone-like material with a softer gel material, the researchers have found a way to mimic the feel of human tissue and bone, which could have wide applications for orthopedic surgery training practices. So far, the research team has used their 3D printing method to focus on one particular type of surgery: clubfoot correction surgery.

Clubfoot, or Congenital Talipes Equinovarus (CTEV), is a congenital deformity that affects 1 in 1,000 children in the United States alone (the rate is much higher in developing countries). The condition, which is distinguished by one or both feet being turned inwards and upwards, can result in serious mobility problems if left untreated. Shimada’s research paper dealing with Clubfoot was recently published in 3D Printing and Additive Manufacturing under the title “A Patient-Specific Flexible 3D Printed Orthopedic Model for Training and Teaching of Clubfoot Correction Surgery.”

Ying Ying Wu, a biomedical engineering Ph.D. alumna who worked on the research project explained, “Focusing on clubfoot may seem niche, but it’s truly needed in order to increase the quality of life of young children with this birth defect.”

 As can be seen in the photos, the medical phantom models of the Clubfoot afflicted feet look like real human skeletons encased in clear skin and tissues. The rather uncanny training models were made with the help of 3D printing service Shapeways, which additively manufactured the interconnected foot skeleton from a white, strong, and flexible plastic material (closely resembling the texture and strength of bones). The skin shell was also 3D printed out of the same material. According to the researchers, the printing process took about 2 weeks, but would only take days if the 3D prints were done in-house.

To achieve the soft, malleable texture of human muscle tissue, the research team used a clear ballistic gel, a 10% synthetic nonfouling gel material typically used for testing ammunition and to simulate bullet wounds. Once set, the gel was coated with GOOP glue, to increase the model’s overall tensile stress.

As the research explains, “Our implemented clubfoot model is patient specific, with rigid foot bones suspended independently in a transparent gel matrix. The gel matrix both mimics the density and viscosity of human muscle and reveals the internal skeletal structure. Unlike current rigid skeletal models, our flexible model enables us to recover the normal foot shape from the deformed clubfoot, while also being able to illustrate how the bones shift during correction. We combine the advantages of both rubber and skeletal models to develop a model that is more similar to a real foot in terms of tactile feedback.”

With the success and potentials demonstrated from Shimada’s 3D printing research experiment, him and his team are now looking to expand the applications of their research beyond just clubfoot treatments. Their ongoing goal is to advance and ameliorate training tools and devices through a number of projects, such as finding a way to recreate the complex internal structure of bone so that drilling through the training model feels more real.

Boyle Cheng, director of research for the Allegheny Health Network Neuroscience Institute and adjunct professor in the biomedical engineering department said of the endeavor: “This is a really nice example of how the technology from CMU can be transferred to medical education. We often think of treatment as direct-to-patient care. But this technology is about making better surgical residents, which makes for better patient care. It’s important to remember that innovation can infiltrate the healthcare system in many different ways as long as we keep an open mind about it.”

 

Source & Images credit: Carnegie Mellon University

 

Posted in 3D Printing Application

 

 

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