The soft glow of Amy Alexander's alarm clock in the darkness toyed with her attempt to fall back to sleep. Her thoughts wandered to the job she left on the printer the night before. Knowing she wouldn't rest until she knew it was running smoothly, Amy headed into work early.
As part of the Anatomic Modeling Lab at Mayo Clinic, Amy, a biomedical engineer, pressed print the day before on a life-sized 3-D model of a 35-year-old man's face for a surgeon preparing to repair a misaligned jaw.
The model, which took about 12 hours to complete, ran through the night to be ready in time. It held the key to the surgeon's preparation to restore the man's ability to perform seemingly simple tasks such as eating solid foods.
For this particular craniofacial surgery, the surgeon planned to take three pieces of the patient's leg bone and attach it to the jaw — a procedure he had done many times before. But, because he had a model of the patient's exact facial anatomy, he was able to rehearse the surgery and knew in advance precisely where to make the cuts and what to expect during the operation, making the procedure quicker and less invasive. This surgical simulation supports better outcomes and faster recovery times.
"Medicine is very visual, and 3-D models represent another way to look inside a patient, look at the disease," says Jonathan M. Morris, M.D., a neuroradiologist and co-director of Mayo Clinic's 3-D modeling lab. "Surgeons can hold, manipulate and see a specific patient's anatomy with a clarity that cannot be replicated in two dimensions on a computer."
Mayo Clinic's journey into 3-D anatomical modeling began in 2006 when planning for the complex and critical separation of conjoined twins who shared a liver. The success of the surgery and the usefulness of the anatomical models spurred additional requests for 3-D printing. As a result, Mayo Clinic has become a leader in anatomical modeling and 3-D printing.
"It's an educational tool we can offer to provide next-level visualization to contribute to precision surgery," says Jane Matsumoto, M.D., radiologist and co-director of Mayo Clinic's 3-D Anatomic Modeling Lab.
Mayo Clinic uses 3-D models for planning and practicing procedures in all medical specialties. Many surgeons also use the models as educational tools for current and future physicians, and as a visual to explain diagnoses to patients and families and talk through treatment options.
Powering Patient Care
Originally misdiagnosed with tendinitis from bike riding, Isaac Garcia later learned he had a cancerous tumor on his left hip joint and would need a replacement for the removed hip bone. Christopher P. Beauchamp, M.D., created a 3-D model and then printed it as an implant in titanium.
Isaac Garcia wakes up each morning looking forward to jumping dirt hills on his mountain bike with his son.
But it wasn't that long ago that the energetic 38-year-old father of three sought out a local physician in New Mexico for the dull pain in his groin area. Originally misdiagnosed as tendinitis from his dirt bike riding, Isaac later learned he had a cancerous tumor on his left hip joint requiring care from a specialist.
"My wife and I were floored," Isaac says. "We drove around all day trying to see an orthopedic oncologist. The wait times were six weeks or more."
Left without a plan for next steps, Isaac's wife, Sarah, searched online for "best bone cancer doctors." It led the Garcias to Mayo Clinic where Isaac was seen within days of calling.
"Isaac's tumor was quite rare in a very troublesome location where the only treatment is surgery to remove all of his hip joint and some of his pelvis," says orthopedic surgeon Christopher P. Beauchamp, M.D.
Until now, the options for treatment after removal of the tumor were far from perfect. Options included removing the hip joint and not replacing it or using a cadaver bone shaped to fit.
With the technology available today and recent developments in 3-D modeling, implant printing and manufacturing, Dr. Beauchamp had a new option — one he'd been tweaking and perfecting for nearly a decade.
Dr. Beauchamp created a model of the cancerous bone out of modeling clay to fit Isaac's exact anatomical shape. The clay copy was then converted to a 3-D model and printed in titanium. This replica of his entire left hip socket and part of his pelvis was inserted during the tumor removal surgery.
"Because of Mayo Clinic, I'm back to living a normal good life," Isaac says. "I have a whole new appreciation for all the little things you usually take for granted. They all mean a lot now."
Printing the Future of Medicine
Physician-scientists are also building off of this foundation in regenerative medicine to recreate living tissue in a process called bioprinting. This experimental technology uses a scaffold seeded with cells to mimic tissues such as skin, bone, muscles and valves so patients might someday have a nonmechanical replacement for their damaged tissue. For example, cardiologist Amir Lerman, M.D., Barbara Woodward Lips Professor, is researching bioprinting heart valves to free patients from the need for multiple surgeries or the fear of blood clots.
From tumor resections to facial reconstructions and heart surgeries, 3-D models take away guesswork and facilitate communication among physicians and scientists.
"It's a tool we can use to offer individualized care," Dr. Matsumoto says. "The demand for 3-D printing at Mayo Clinic is really a reflection of the high level of surgery our surgeons do here."
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