Medical 3D Printing – An Indian Perspective on Point of Care Micro Labs

India has a vast segment of highly qualified doctors who deal with some of the most complex surgeries known across the world. Yet, with a population of over 1.3 Billion and over 1 Million people undergoing surgeries every year, they are highly short-staffed, with a ratio of 1:1600 as opposed to WHO norm of 1:1000 with 80% in urban areas. This gives rise to the need for innovation in processes and technology that can make surgeries faster, easier, and more precise for the medical team. This allows medical personnel to cater to more patients in the same amount of time, with fewer chances of failure, thereby avoiding a recurrence of the condition. One of the most effective ways to cater to this problem is to obtain dependable pre-operative information and customized tools to ensure the treatment is smooth and effective in the first attempt. Such a complex problem can have a simple solution, utilizing additive manufacturing, commonly known as 3D Printing.

Anatomiz3D’s foundation was formed on a case of an infant suffering from a complex cyanotic congenital heart defect called DORV (Double Outlet Right Ventricle) with a large remote VSD (Ventricular Septal Defect) and 2 adequate sized ventricles. Many surgeons were doubtful to perform this complex surgery on a 6-month-old baby. To find a solution, the surgeon opted for a 3D printed heart model. This model played a crucial role for the surgeons to plan the surgery and perform it smoothly. It was the first surgery performed across the whole of the soft tissue vertical using the 3D printing technology in India. With this, 5 years ago, our journey began.

Role of 3D Printing in Medical Field

Each year, 3D printing offers more and more applications in the healthcare field, supporting to save and improve lives in ways never imagined until now. 3D printing has been practiced in a wide range of healthcare settings including, but not limited to cardiology, neurosurgery, oral and maxillofacial surgery, ophthalmology, orthopedic surgery, and transplant surgery.

Thanks to the several benefits that this technology could influence in the area, the principal direct applications of 3D printing in the medical fields are as follows:

1. Pre-operative devising: This will lead to a multistep method that, blending clinical and imaging data, will determine the most suitable remedial choice. Several studies have confirmed that patient-specific presurgical preparation may lessen the time consumed in the operating procedures and result in fewer complexities. Moreover, this may lead to reduced postoperative stays and lower healthcare expenses. 

2. Customized surgical instruments: 3D printing can be used to produce custom surgical guides and instruments. Surgical Guides, pre-designed onto the patient native anatomy and 3D printed for surgery, help surgeons considerably cut precisely and drill the bone at pre-defined locations and angles. Therefore, the customization of surgical instruments means a decrease in the time required to perform surgery and of the overall cost enabled by 3D printing techniques.

Drilling Jigs for Scoliosis (Photo Credit: Anatomiz3D)
Cutting jig for pelvic tumour (photo credit: Anatomiz3D)

3. Customized Implants: It is possible to design and print customized implants in Medical Grade Titanium, as per patient’s anatomical needs and surpass the limitations of pre-fabricated implants in terms of design, form, and fit. One can also provide with the mold of the designed implant, having variable thickness matching the contours of the anatomy, for the casting of Bone Cement/PMMA. Our ISO 13485 facility enables us to practice these procedures with caution and traceability.

Customized bone implants (photo credit: Anatomiz3D)

4. Enhancing medical literacy: 3D-printed patient-specific models have illustrated that they can increase performance and foster rapid learning, while significantly improving the knowledge, authority, and confidence of the trainees despite the area of expertise. The benefits of 3D printing in education are the reproducibility and safety of the 3D-printed model concerning the cadaver study, the possibility to model diverse physiologic and pathologic anatomy from a large dataset of images, and the possibility to share 3D models among different establishments, especially with ones that have fewer means. 3D printers that can print with different thicknesses and shades can be used to emphasize the anatomical details. Our Portfolio consists of innumerable surgeries across varied specializations. We have curated a vast database of case studies and have made them available to the world to be used to learn, teach, and train on normal anatomy and rare deformities.

5. Custom Aids: Innovation is always at the heart of the application. Hence, we always urge the surgeons or medical teams to step forward for collaboration to develop custom aids that help in enhancing the accuracy and effectiveness of the method reasonably. These custom aids accommodate patient-specific templates/molds developed from the scan data or custom instruments designed by our team with inputs from surgeons.

Pre-surgical custom aid model of Mandible Tumour with visible nerve (photo credit: Anatomiz3D)

6. Bioprinting: the 3D printing allows the modeling of implantable tissue. A few examples to the state are 3D printing of synthetic skin for transplanting to patients, who sustained burn wounds. It may also be used for testing of chemical, pharmaceutical, cosmetic products. Another example is the replication of heart valves using a combination of cells and biomaterials to manage the valve’s stiffness or the replication of human ears using molds loaded with a gel comprising bovine cartilage cells suspended in collagen.

Therefore, these examples express that 3D printing is one of the most disruptive technologies that have the potential to change the clinical field, improving medicine and healthcare, making care affordable, convenient, and personalized.

Point-Of-Care: Healthcare solution

We had commenced with a goal in mind: to provide personalized medical solutions. Since the company’s formation, we have aimed at spreading the benefits of this technology to every nook and corner of India.

To date, we are advocating on how to exploit 3D printing technology and make the most out of the situation by implementing it into the healthcare workflow process for rapid and efficient treatment. But a recent tie-up with MAX-Healthcare to set up 3D labs at the hospital has opened up many new avenues for the healthcare sector, in India, to explore and set up at point-of-care.

Point-of-care has several advantages that can transform the face of the medical segment. They provide an expeditious solution with non-parallel results. They are time-saving and respond to patients in an emergency without any delays. It may account for a lower mortality rate during emergencies in the hospital with proper treatment.

For example, if there is a case that requires urgent action, the design can be made at the point of care with ideation and confirmation from the surgeon, 3D Printed using appropriate technology, and expecting a turn-around time of fewer than 24 hours. This helps provide access to the benefit of the technology to more number of patients, who otherwise could not have been eligible for it due to time constraints seen in outsourcing the design.

At this point, it is important to mention that the facility should be empowered with highly skilled engineers and technicians to ensure the accurate design and print output. This is crucial to the success of any surgery, and eventually, of the industry as a whole. At Anatomiz3D, we ensure all our processes at the point of care are regulated and monitored, to avoid providing inaccurate products which disable the benefits of the technology.

Simulation model of Lung and neck tumour (photo credit: Anatomiz3D)

About Anatomiz3D:

700 plus successful cases in their repertoire with a recent drive to aid the healthcare workers and the police personnel by providing face shields and other COVID19 related products for protection against coronavirus, Anatomiz3D, is to support healthcare institutions increase their capabilities and create hyper-personalized care that stimulates the higher patient-care process in India.

Anatomiz3D is proud of being an influencer, with many research papers published, and act as a linchpin, to many of the future cases for reference purpose. To name a few cases in which Anatomiz3D pioneered and provided imminent support to the medical fraternity are First partial amputee prosthetic hand and first kidney tumor case, and the model for tongue cancer was the first in the world, along with a provisional patent on Pedicle Screw Guides. These cases helped to stem the importance of 3D printing technology in India and also solve hurdles to overcome some of the wrong beliefs regarding the technology.

Craniosynostosis Helmet (photo credit: Anatomiz3D)

About the Author:

Firoza Kothari, Co-Founder & CTO – Anatomiz3D Medtech Pvt. Ltd. – A B.Tech in Biotechnology Engineering, Firoza Kothari started her journey to provide patient-specific medical solutions and one day end the organ donation problem by creating live organs out of patients’ stem cells. With that aspiration, she gave birth to Anatomiz3D. She, along with her team, was the first to execute soft tissue models in India through Paediatric Cardiology, partial amputee prosthetic hand, first kidney tumor case in India, and the model for tongue cancer was the first in the world. Being a Co-founder and CTO of Anatomiz3D, she, along with her team, has successfully added 700 plus case studies. Her multi-disciplinary expertise prevails in converting 2D DICOM CT/MRI/Echo Scans to 3D Printed anatomical replicas, medical devices, and allied products, using various combinations of Hardware and Software, across multiple medical specializations. Anatomiz3D has played a vital role in creating the market for 3D Printing in the Medical industry in India and are pioneers for the same. Firoza will be speaking on her experience of Point of Care at 3DHEALS2020.

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