A Spanish cancer patient has received an Additive Manufactured titanium sternum and rib cage, in what is stated to be a world-first operation. The design and manufacture of the implant was the result of international collaboration between the patient’s surgical team based at Salamanca University Hospital, Spain, and Anatomics, a medical device company based in Melbourne, Australia, along with CSIRO’s 3D printing facility, Lab 22, in Clayton, Australia.
The 54 year old patient, suffering from a chest wall sarcoma, required his sternum and a portion of his rib cage to be replaced. This part of the chest is stated to be difficult to recreate with prosthetics due to the complex geometry and individual design required for each patient. The surgical team identified Additive Manufacturing as the best option for a fully customisable sternum and rib cage.
The surgical team, Dr José Aranda, Dr Marcelo Jimene and Dr Gonzalo Varela from Salamanca University Hospital, knew the surgery would be difficult due to the complicated geometries involved in the chest cavity. “We thought, maybe we could create a new type of implant that we could fully customise to replicate the intricate structures of the sternum and ribs,” stated Dr Aranda. “We wanted to provide a safer option for our patient, and improve their recovery post-surgery.”
The implant was designed and manufactured by medical device company Anatomics, who utilised the CSIRO’s 3D printing facility, Lab 22. After assessing the complexity of the requirements, Anatomics CEO Andrew Batty said the solution lay in metallic 3D printing.
“We wanted to 3D print the implant from titanium because of its complex geometry and design,” Batty stated. “While titanium implants have previously been used in chest surgery, designs have not considered the issues surrounding long term fixation. Flat and plate implants rely on screws for rigid fixation that may come loose over time. This can increase the risk of complications and the possibility of reoperation.”
Through high resolution CT data, the Anatomics team were able to create a 3D reconstruction of the chest wall and tumour, allowing the surgeons to plan and accurately define resection margins. “From this, we were able to design an implant with a rigid sternal core and semi-flexible titanium rods to act as prosthetic ribs attached to the sternum,” Batty added.
Working with experts at CSIRO’s 3D printing facility Lab 22, the team then manufactured the implant out of surgical grade titanium alloy using an Arcam EBM system. Once the prosthesis was complete it was couriered to Spain and implanted into the patient.
“The operation was very successful,” Dr Aranda stated. “Thanks to 3D printing technology and a unique resection template, we were able to create a body part that was fully customised and fitted like a glove.”
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