Printing in three dimensions (3D) is now a reality in medicine. This technology is rapidly being developed in the sector and already is being used in different areas: to reproduce artificial organs for study or practice, to create personalized instruments for the patient, or in titanium prosthetics. Most hospitals will soon have a 3D laboratory and we will see doctors and engineers working side by side to replicate bones, organs and tissues by means of a “simple” printer.
It still seems like a thing of the future but it isn’t. 3D printing, as explained by Rubén Servando, professor of Architecture at Universidad Europea de Canarias, “is an additive digital manufacturing technology that makes it possible to create physical objects starting from three-dimensional digital models.” Thanks to this, a machine creates layer by layer the object that has previously been designed on the computer and in the material that has been chosen (plastic, titanium…). Naturally, this technology offers endless possibilities in the world of medicine: exact replicas of bones, low-cost stethoscopes for countries without financial resources, titanium thoraxes adapted to the structure of the patient, and even the printing in 3D of stem cells.
With this potential, advances in 3D printing are unstoppable: this practice is becoming an essential tool for the diagnosis and treatment of disease. At the Gregorio Marañón Hospital in Madrid, for example, they use this technology to analyze and understand what is the best way to remove a tumor. They make a scan or resonance of the patient and create a virtual model in three dimensions. With this piece they study how to best proceed and at the same time use it to explain to the patient the technique that will be followed during the operation. In this way the medical team comes to the operating table with much more information and better prepared. This intermediary step also reduces the length of the procedure and presents fewer risks for the patient, in addition to improving precision and saving money. In addition, the Gregorio Marañón Hospital is also using 3D technology to create personalized instruments for the patient and surgical guides.
3D replicas to “practice” before an operation
With the same aim of preparation and study, Universidad Europea has a project for advanced clinical simulation through the Center for Robotic and Telemedicine Training (CERTEM) attached to the Hospital Universitario de Canarias (HUC). As Servando explains it, “we use digital fabrication, which includes 3D printing, to produce physical models that are faithful to reality and can be used to train residents in different specialties such as neurosurgery, anesthesiology, and maxillofacial or general surgery.”
Fabricio Santos, a founding member of the Spanish Network of Digital Creation and Fabrication (CREFAB), observes that there have been great advances in the “3D printing of complete corneas, in a question of minutes, in which the extruders are syringes and the materials are viscous.” To achieve this, the researchers use stem cells from the cornea of a healthy donor with a solution of alginate and collagen. Then the printer does the rest. And while it will still be several years before these artificial corneas can be implanted in patients, this discovery will make it possible to compensate for the scarcity of donors.
As explained by Carlos Serrano, assistant professor of Odontology at Universidad Europea, the field of dentistry has several years of advantage in 3D printing, which has been used as part of the production process in dental laboratories. Nevertheless, its democratization will be essential in the “fabrication of intermediary, temporary or definitive prosthetic structures that cut down on the number of visits to the dentist and allow procedures that are more comfortable for patients,” he says. Of course the process will also have an influence in “the manufacture of three-dimensional models that constitute a tool to help in diagnosis and transmission of information in the case of multidisciplinary treatments.”
The great challenge: the biomaterials
The idea is the create (almost) everything with a 3D printer. At the FabLab of Universidad Europea, “we are producing prototypes of a heart so as to carry out implants, a brain, vertebrae…”, says José Real, coordinator of the FabLab workshop. And many more things can be done, such as “designing a prosthesis for a child in Africa, and then sending the design to a nearby Maker Space to print up the piece,” he explains.
The main challenge for 3D printing in medicine involves research and finding “materials and biomaterials that are resistant, flexible and compatible,” says Sergio Alonso del Campo, professor of Architecture and Design at Universidad Europea de Valencia. There have been good results with bone tissues and stem cells, but this field is still developing. Indeed, Universidad Europea, in collaboration with different companies, is carrying out experiments in an effort to overcome these limitations. Professor Adolfo Nadal Serrano says that “in addition to reproducing organs, an effort is being made to use bacteria (such as kombucha or mycelium) to combine building structures and living materials that surpass the strict logic of construction.”
As José Real puts it, “the future of 3D printing is today,” and while there are still many obstacles to overcome, this technology is shaping current medicine. That is why research in this field is advancing so spectacularly and is allowing for great advances in health and in knowledge of the human body. And there’s still a great deal to come.