From Academia: 3D Printing for Neurosurgery Training, Vat Photopolymerization, soft robotic microsystem

Category: Blog,From Academia
blank blank Oct 24, 2020

“From Academia” features recent, relevant, close to commercialization academic publications in the space of healthcare 3D printing, 3D bioprinting, and related emerging technologies. In this issue, we included a user suitability study focusing on neurosurgical training using 3D printed anatomical models, an article exploring the actuation of 3D printed soft robotic microsystem, and a review paper discussing the current status and future potential of vat photopolymerization 3D printing in medical device and drug delivery space.

Email: Rance Tino (tino.rance@gmail.com) if you want to pen an Expert Corner blog for us or want to share relevant academic publications with us.

Neurosurgical simulator for training aneurysm microsurgery—a user suitability study involving neurosurgeons and residents

Authored by Fredrick Johnson Joseph, Stefan Weber, Andreas Raabe & David Bervini. Neurosurgery Training, 11 August 2020 

Representation of the model during the training study: a Patient-specific 3D-printed trephined skull with brain model. b MCA aneurysm model located in the left Sylvian fissure. c Pulsating blood vessel and access to the pathology of the model. d Brain retractor during manipulation by resident. Copyright. Neurosurgery Training
Representation of the model during the training study: a Patient-specific 3D-printed trephined skull with brain model. b MCA aneurysm model located in the left Sylvian fissure. c Pulsating blood vessel and access to the pathology of the model. d Brain retractor during manipulation by resident. Copyright. Neurosurgery Training
Pictorial representation from the simulator and study participation: a Expert neurovascular surgeon manipulating the aneurysm model in the simulator and trying to clip. b Young resident neurosurgeon clipping. c Attempt to clipping. d Exploration after clipping. Copyright. Neurosurgery Training
Pictorial representation from the simulator and study participation: a Expert neurovascular surgeon manipulating the aneurysm model in the simulator and trying to clip. b Young resident neurosurgeon clipping. c Attempt to clipping. d Exploration after clipping. Copyright. Neurosurgery Training

Abstract: 

Due to its complexity and to existing treatment alternatives, exposure to intracranial aneurysm microsurgery at the time of neurosurgical residency is limited. The current state of the art includes training methods like assisting in surgeries, operating under supervision, and video training. These approaches are labor-intensive and difficult to fit into a timetable limited by the new work regulations. Existing virtual reality (VR)–based training modules lack patient-specific exercises and haptic properties and are thus inferior to hands-on training sessions and exposure to real surgical procedures. We developed a physical simulator able to reproduce the experience of clipping an intracranial aneurysm based on a patient-specific 3D-printed model of the skull, brain, and arteries. The simulator is made of materials that not only imitate tissue properties including arterial wall patency, thickness, and elasticity but also able to recreate a pulsatile blood flow. A sample group of 25 neurosurgeons and residents (n = 16: early residency with less than 4 years of neurosurgical exposure; n = 9: late residency and board-certified neurosurgeons, 4–15 years of neurosurgical exposure) took part to the study. Participants evaluated the simulator and were asked to answer questions about surgical simulation anatomy, realism, haptics, tactility, and general usage, scored on a 5-point Likert scale. In order to evaluate the feasibility of a future validation study on the role of the simulator in neurosurgical postgraduate training, an expert neurosurgeon assessed participants’ clipping performance and a comparison between groups was done. The proposed simulator is reliable and potentially useful for training neurosurgical residents and board-certified neurosurgeons. A large majority of participants (84%) found it a better alternative than conventional neurosurgical training methods. The integration of a new surgical simulator including blood circulation and pulsatility should be considered as part of the future armamentarium of postgraduate education aimed to ensure high training standards for current and future generations of neurosurgeons involved in intracranial aneurysm surgery.

Addressable Acoustic Actuation of 3D Printed Soft Robotic Microsystems

Authored by Murat Kaynak, Pietro Dirix, Mahmut, Selman Sakar. Advanced Science. 21 September 2020

The fabrication and operation of acoustically excited ”jet engines. a) Schematic representation of the working principle of the ”jet engine. The red arrows show the direction of pumping generated by acoustic streaming inside the device. b) Electron microscopy images showing fully (left) and partially (right) printed ”jet engines. c) Illustration of the microfluidic test platform. The holder was printed along with the ”jet engine to stabilize the motion. d) Representative bright‐field image of a 3D‐printed ”jet engine that is anchored to pillars. e,f) Streamlines inside and around the ”jet engine are visualized experimentally using fluorescent microparticles (e) and numerically using CFD simulations (f), respectively. The localized microstreaming around the tip of the conical wedge results in jet in the middle of the device. g) Electron microscopy image of the bidirectional ”jet engine. The arrows show the outlets of the pump. h) Numerical simulations show addressable acoustic excitation of the ”jet engine within the same device at different frequencies. Figure S5 in the Supporting Information shows corresponding images with exaggerated deformation. i) Streamlines showing the flow generated at the resonance frequency of each ”jet engine. Scale bars: 75 ”m in (b), (e), and (i) and 150 ”m in (d).. Copyright. Advanced Science
The fabrication and operation of acoustically excited ”jet engines. a) Schematic representation of the working principle of the ”jet engine. The red arrows show the direction of pumping generated by acoustic streaming inside the device. b) Electron microscopy images showing fully (left) and partially (right) printed ”jet engines. c) Illustration of the microfluidic test platform. The holder was printed along with the ”jet engine to stabilize the motion. d) Representative bright‐field image of a 3D‐printed ”jet engine that is anchored to pillars. e,f) Streamlines inside and around the ”jet engine are visualized experimentally using fluorescent microparticles (e) and numerically using CFD simulations (f), respectively. The localized microstreaming around the tip of the conical wedge results in jet in the middle of the device. g) Electron microscopy image of the bidirectional ”jet engine. The arrows show the outlets of the pump. h) Numerical simulations show addressable acoustic excitation of the ”jet engine within the same device at different frequencies. Figure S5 in the Supporting Information shows corresponding images with exaggerated deformation. i) Streamlines showing the flow generated at the resonance frequency of each ”jet engine. Scale bars: 75 ”m in (b), (e), and (i) and 150 ”m in (d)..Copyright. Advanced Science

Abstract: 

A design, manufacturing, and control methodology is presented for the transduction of ultrasound into the frequency‐selective actuation of multibody hydrogel mechanical systems. The modular design of compliant mechanisms is compatible with direct laser writing and the multiple degrees of freedom actuation scheme does not require incorporation of any specific material such as air bubbles. These features pave the way for the development of active scaffolds and soft robotic microsystems from biomaterials with tailored performance and functionality. Finite element analysis and computational fluid dynamics are used to quantitatively predict the performance of acoustically powered hydrogels immersed in the fluid and guide the design process. The outcome is the remotely controlled operation of a repertoire of untethered biomanipulation tools including monolithic compound micromachinery with multiple pumps connected to various functional devices. The potential of the presented technology for minimally invasive diagnosis and targeted therapy is demonstrated by a soft microrobot that can on‐demand collect, encapsulate, and process microscopic samples.

Vat photopolymerization 3D printing for advanced drug delivery and medical device applications

Authored by Xiaoyan Xu, Atheer Awad, Pamela Robles Martinez, Simon Gaisford, Alvaro Goyanes, Abdul W. Basit. Journal of Controlled Release. 5 October 2020

Vat photopolymerization 3D printing for fabrication of drug delivery systems. Copyright. Journal of Controlled Release
Vat photopolymerization 3D printing for fabrication of drug delivery systems. Copyright. Journal of Controlled Release

Abstract: 

Three-dimensional (3D) printing is transforming manufacturing paradigms within healthcare. Vat photopolymerization 3D printing technology combines the benefits of high resolution and favourable printing speed, offering a sophisticated approach to fabricate bespoke medical devices and drug delivery systems. Herein, an overview of the vat polymerization techniques, their unique applications in the fields of drug delivery and medical device fabrication, material examples and the advantages they provide within healthcare, is provided. The outstanding challenges and drawbacks presented by this technology are also discussed. It is forecast that the adoption of 3D printing could pave the way for a personalised health system, advancing from traditional treatments pathways towards digital healthcare and streamlining a new cyber era.

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