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From personalized replacement body parts to safer surgeries, 3D printing is revolutionizing medicine. Dr. Frank Rybicki, an American expert in the field, tells Andrew Duffy what the future holds — and why he’s set up shop in Ottawa.
Five weeks after arriving as the new chief of medical imaging at The Ottawa Hospital, Dr. Frank Rybicki has not unpacked. His office walls are unadorned by pictures or diplomas; the floors and shelves are stacked with boxes.
But Rybicki, a star recruit from Boston, has unwrapped what he believes to be the future of personalized medicine: a series of 3D printed models.
There’s a skull, a child’s heart, a replacement part for a knee.
Rybicki, a leading expert in the application of 3D printing to medicine, says the technology holds the potential to revolutionize surgery and make it more precise, less expensive and safer. Already, the technology is widely used to create detailed anatomical models that allow doctors to plan and practice complicated heart, brain and reconstructive surgeries.
Dr. Frank Rybicki with a 3D-printed model skull at the Ottawa Hospital.
It’s not a question of what will be 3D printed, it’s a question of what will not be 3D printed.
But the universe of medical applications for 3D printing is expanding rapidly.
Customized body parts, surgical tools, pharmaceutical drugs — even living tissues — are being designed on computers, and produced with printers that can build, layer by thin layer, three-dimensional objects. A new generation of 3D printers is able to deploy materials such as silicone, titanium, sugar, rubber, ceramics, powders, even human cells.
The printers use the materials in place of ink to transform a computer-generated image into the real thing.
According to a recent article in the medical journal Pharmacy and Therapeutics, 3D printers have been used in recent years to produce bones, ears, exoskeletons, windpipes, jawbones, cell cultures, stem cells, blood vessels, vascular networks, and organ tissue.
More commonly, 3D printers are being used to produce custom-made skull plates, knee implants, hip joints, hearing aids and dentures.
“Ultimately, everyone will want everything 3D printed,” predicts Rybicki, who’s also chair of diagnostic radiology at the University of Ottawa. “It’s not a question of what will be 3D printed, it’s a question of what will not be 3D printed.”
With a PhD in nuclear engineering from the Massachusetts Institute of Technology (MIT) and a medical degree from Harvard University, Rybicki is in a unique position to assess the future of medical imaging. He was part of a Boston-based medical team that used 3D printing to plan and complete the first face transplant in North America.
Now a member of the senior management team at The Ottawa Hospital, Rybicki wants Ottawa to join what he’s convinced will be a medical revolution on par with the one ushered in by CT scans and MRIs, which gave doctors the power to look inside the body — at tissue and organs —without exploratory surgery.
There’s only one problem with that 3D dream: money.
****
Frank Rybicki’s medical career has traced the trajectory of computer technology.
Rybicki grew up in Philadelphia and Rhode Island where his father, a nuclear physicist, was a pioneering scientist with the Computer Sciences Corporation (CSC), a major player in the evolution of computer software. Rybicki decided early on that he would follow his father into physics.
“I got it: that’s what appealed to me about physics,” he says. “I was good at it, so it was fun.”
Rybicki studied mathematics at the University of Pennsylvania, then enrolled in an unusual doctoral program at MIT that allowed him to earn, concurrently, a PhD in nuclear physics and a medical degree from Harvard.
Rybicki’s doctoral work in the early 1990s focused on the use of high-speed MRIs to diagnose dangerous heart conditions.
The field of medical imaging was awash in innovation. Advances in computer technology had paved the way in the 1970s for the development of CT scans, which are essentially computer-processed X-ray images. A decade later, MRI scans combined magnets, radio waves and computing power to produce cross-sectional images of the body’s internal organs and tissues.
The technology gave radiologists a larger, critical role in patient diagnosis and disease management.
Rybicki was recruited to Brigham and Women’s Hospital in Boston, a renowned teaching hospital. There, he changed his research focus to concentrate on the use of advanced CT scans — fast enough to produce clear pictures of a beating heart — to diagnose coronary artery disease.
In 2007, Rybicki was named director of the hospital’s applied imaging science laboratory, where he became involved in a case that would make U.S. medical history: the country’s first full face transplant. Surgeons wanted to restore the features of Dallas Wiens, a 28-year-old badly burned and left without lips, a nose or eyebrows after he touched a high voltage wire while painting a church in Fort Worth, Texas in 2008.
In charge of medical imaging for the operation, Rybicki decided to explore how 3D technology could help. He visited Capt. Gerald Grant at the 3D Medical Applications Center, at the Walter Reed National Military Medical Center in Maryland.
Dr. Grant had been using the technology for years to help rebuild the shattered faces of wounded U.S. soldiers. It was in Dr. Grant’s laboratory that Rybicki first saw a 3D printer in action, turning out a customized plate for a soldier’s jaw.
“That was my ‘aha’ moment,” he says. “It just hit me: we are going to someday be printing everything.”
Rybicki resolved to use the technology to assist Wiens’s surgical team plan his face transplant. Based on CT scans, Rybicki created a detailed three-dimensional computer image of Wiens’s head, then prepared the image for a 3D printer using specialized software.
He printed several life-sized models, which allowed surgeons to hold Wiens’s head in their hands and devise strategies for attaching a donor’s face to it.
Face transplant surgery is immensely complex since bone, blood vessels, nerves and muscle must be connected between the donor face and the recipient. The donor face usually includes part of the facial skeleton.
The operation took place in March 2011. Eight surgeons were involved in the procedure, which gave Wiens a new face that extended from the middle of his scalp to his neck. Subsequent tests showed that the transplanted tissue had sprouted new blood vessel networks and was thriving.
Two years after the transplant, Wiens was married in the same Texas church where he had been disfigured. “It’s amazing to be given a life that you weren’t sure for quite awhile that you were ever going to have again,’’ he told reporters.
Dr. Rybicki’s team created 3D models that enabled surgeons in the United States to perform the first full face transplant there on Dallas Wiens, shown here with his wife Jamie Nash in 2013.
Rybicki believes the transplant would not have been possible without 3D models: “The ability to work with the model gives you an unprecedented level of reassurance and confidence in the procedure.”
Detailed planning, he says, reduces the amount of time that a patient is under anesthetic and cuts down on surgical mistakes.
“For surgeons who have 3D printing, most won’t go into the operating room without it for a complicated procedure,” he says.
The best 3D models feature life-like flesh, bone and blood vessels that can be explored and dissected. It means that surgeons enter an operating room already familiar with a patient’s unique anatomical features, and with a rehearsed understanding of each step in a procedure.
Rybicki believes 3D printing is at tipping point: that the technology will soon become an irresistible force in medicine as cost barriers fall and applications multiply.
“It allows for incredible customization,” says Rybicki. “This is the ultimate form of personalized medicine.”
***
Dr. Frank Rybicki holds a 3D model of a child’s heart. Models help surgeons plan and perform intricate operations.
Rybicki says he decided to move to Ottawa because he covets the opportunity to design and shape this city’s first 3D medical imaging program.
“There’s great value in going to a place where you can direct a group and develop the technology the way you think it should be done,” says Rybicki, who arrived in June after months of red tape related to his work permit and visa.
His recruitment represents a coup for The Ottawa Hospital and a vote of confidence in its future, says hospital CEO Dr. Jack Kitts, who has devoted himself to bringing top medical talent to the institution. He markets the hospital as place where leading researchers can use state-of-the-art equipment and the latest technology in a supportive environment.
“Over the last several years, we’ve had a reverse brain drain where we’re attracting a lot more significant talent from the United States than is going there,” Kitts says.
“Having a world leader in 3D medical imaging is another piece of the puzzle for us because once your reach a critical mass of having the top talent, it attracts more.”
But Rybicki’s arrival also poses a challenge. The Ottawa Hospital does not yet own a 3D printer and must now send computer files to Toronto whenever surgeons require a custom model or surgical aid.
Kitts believes Rybicki’s reputation will attract the research grants and industry partnerships needed to launch a 3D printing program at the hospital. Clinical trials will then have to establish that the technology improves patient outcomes and reduces costs before it can become an embedded part of the health care system.
“We’re really in the early days of getting to understand the impact on quality and costs,” Kitts warns. “But I think we’re only seeing the tip of the iceberg in terms of the potential of this technology.”
For his part, Rybicki is untroubled by the hurdles that stand in the way of his quest to bring 3D technology to Ottawa. “Ultimately, you have to show it’s financially viable,” he says. “But really, I think the savings are going to be unbelievable.”
Rybicki says 3D printing will save time and money by facilitating better surgical planning and more precise interventions: Surgeons will need less time in operating rooms; patients will be under anesthetic for shorter periods; and outcomes will be better because there will be fewer mistakes. What’s more, 3D printing promises to one day deliver custom-made body parts manufactured on site, on demand.
“Just think: the cost of the stuff you need is ten times cheaper and it fits exactly,” he says.
A 3D printer capable of producing multi-coloured models and customized surgical instruments costs about $150,000, he says. Each model takes about $100 in materials to print and a 3D medical lab also requires computer hardware, software and staff. (A machine capable of making precise, titanium replacement joints is much more expensive and not yet viable for a hospital to own.)
But Rybicki is so convinced of the technology’s value that he plans to draw upon his network of U.S. contacts to bring a 3D printer here if he’s stymied by red tape.
“It will happen,” he says.
Related
Around the world, new medical applications for 3D printing are being pioneered every year. Among some of the recent developments:
查看原文...
Five weeks after arriving as the new chief of medical imaging at The Ottawa Hospital, Dr. Frank Rybicki has not unpacked. His office walls are unadorned by pictures or diplomas; the floors and shelves are stacked with boxes.
But Rybicki, a star recruit from Boston, has unwrapped what he believes to be the future of personalized medicine: a series of 3D printed models.
There’s a skull, a child’s heart, a replacement part for a knee.
Rybicki, a leading expert in the application of 3D printing to medicine, says the technology holds the potential to revolutionize surgery and make it more precise, less expensive and safer. Already, the technology is widely used to create detailed anatomical models that allow doctors to plan and practice complicated heart, brain and reconstructive surgeries.
Dr. Frank Rybicki with a 3D-printed model skull at the Ottawa Hospital.
It’s not a question of what will be 3D printed, it’s a question of what will not be 3D printed.
But the universe of medical applications for 3D printing is expanding rapidly.
Customized body parts, surgical tools, pharmaceutical drugs — even living tissues — are being designed on computers, and produced with printers that can build, layer by thin layer, three-dimensional objects. A new generation of 3D printers is able to deploy materials such as silicone, titanium, sugar, rubber, ceramics, powders, even human cells.
The printers use the materials in place of ink to transform a computer-generated image into the real thing.
According to a recent article in the medical journal Pharmacy and Therapeutics, 3D printers have been used in recent years to produce bones, ears, exoskeletons, windpipes, jawbones, cell cultures, stem cells, blood vessels, vascular networks, and organ tissue.
More commonly, 3D printers are being used to produce custom-made skull plates, knee implants, hip joints, hearing aids and dentures.
“Ultimately, everyone will want everything 3D printed,” predicts Rybicki, who’s also chair of diagnostic radiology at the University of Ottawa. “It’s not a question of what will be 3D printed, it’s a question of what will not be 3D printed.”
With a PhD in nuclear engineering from the Massachusetts Institute of Technology (MIT) and a medical degree from Harvard University, Rybicki is in a unique position to assess the future of medical imaging. He was part of a Boston-based medical team that used 3D printing to plan and complete the first face transplant in North America.
Now a member of the senior management team at The Ottawa Hospital, Rybicki wants Ottawa to join what he’s convinced will be a medical revolution on par with the one ushered in by CT scans and MRIs, which gave doctors the power to look inside the body — at tissue and organs —without exploratory surgery.
There’s only one problem with that 3D dream: money.
****
Frank Rybicki’s medical career has traced the trajectory of computer technology.
Rybicki grew up in Philadelphia and Rhode Island where his father, a nuclear physicist, was a pioneering scientist with the Computer Sciences Corporation (CSC), a major player in the evolution of computer software. Rybicki decided early on that he would follow his father into physics.
“I got it: that’s what appealed to me about physics,” he says. “I was good at it, so it was fun.”
Rybicki studied mathematics at the University of Pennsylvania, then enrolled in an unusual doctoral program at MIT that allowed him to earn, concurrently, a PhD in nuclear physics and a medical degree from Harvard.
Rybicki’s doctoral work in the early 1990s focused on the use of high-speed MRIs to diagnose dangerous heart conditions.
The field of medical imaging was awash in innovation. Advances in computer technology had paved the way in the 1970s for the development of CT scans, which are essentially computer-processed X-ray images. A decade later, MRI scans combined magnets, radio waves and computing power to produce cross-sectional images of the body’s internal organs and tissues.
The technology gave radiologists a larger, critical role in patient diagnosis and disease management.
Rybicki was recruited to Brigham and Women’s Hospital in Boston, a renowned teaching hospital. There, he changed his research focus to concentrate on the use of advanced CT scans — fast enough to produce clear pictures of a beating heart — to diagnose coronary artery disease.
In 2007, Rybicki was named director of the hospital’s applied imaging science laboratory, where he became involved in a case that would make U.S. medical history: the country’s first full face transplant. Surgeons wanted to restore the features of Dallas Wiens, a 28-year-old badly burned and left without lips, a nose or eyebrows after he touched a high voltage wire while painting a church in Fort Worth, Texas in 2008.
In charge of medical imaging for the operation, Rybicki decided to explore how 3D technology could help. He visited Capt. Gerald Grant at the 3D Medical Applications Center, at the Walter Reed National Military Medical Center in Maryland.
Dr. Grant had been using the technology for years to help rebuild the shattered faces of wounded U.S. soldiers. It was in Dr. Grant’s laboratory that Rybicki first saw a 3D printer in action, turning out a customized plate for a soldier’s jaw.
“That was my ‘aha’ moment,” he says. “It just hit me: we are going to someday be printing everything.”
Rybicki resolved to use the technology to assist Wiens’s surgical team plan his face transplant. Based on CT scans, Rybicki created a detailed three-dimensional computer image of Wiens’s head, then prepared the image for a 3D printer using specialized software.
He printed several life-sized models, which allowed surgeons to hold Wiens’s head in their hands and devise strategies for attaching a donor’s face to it.
Face transplant surgery is immensely complex since bone, blood vessels, nerves and muscle must be connected between the donor face and the recipient. The donor face usually includes part of the facial skeleton.
The operation took place in March 2011. Eight surgeons were involved in the procedure, which gave Wiens a new face that extended from the middle of his scalp to his neck. Subsequent tests showed that the transplanted tissue had sprouted new blood vessel networks and was thriving.
Two years after the transplant, Wiens was married in the same Texas church where he had been disfigured. “It’s amazing to be given a life that you weren’t sure for quite awhile that you were ever going to have again,’’ he told reporters.
Dr. Rybicki’s team created 3D models that enabled surgeons in the United States to perform the first full face transplant there on Dallas Wiens, shown here with his wife Jamie Nash in 2013.
Rybicki believes the transplant would not have been possible without 3D models: “The ability to work with the model gives you an unprecedented level of reassurance and confidence in the procedure.”
Detailed planning, he says, reduces the amount of time that a patient is under anesthetic and cuts down on surgical mistakes.
“For surgeons who have 3D printing, most won’t go into the operating room without it for a complicated procedure,” he says.
The best 3D models feature life-like flesh, bone and blood vessels that can be explored and dissected. It means that surgeons enter an operating room already familiar with a patient’s unique anatomical features, and with a rehearsed understanding of each step in a procedure.
Rybicki believes 3D printing is at tipping point: that the technology will soon become an irresistible force in medicine as cost barriers fall and applications multiply.
“It allows for incredible customization,” says Rybicki. “This is the ultimate form of personalized medicine.”
***
Dr. Frank Rybicki holds a 3D model of a child’s heart. Models help surgeons plan and perform intricate operations.
Rybicki says he decided to move to Ottawa because he covets the opportunity to design and shape this city’s first 3D medical imaging program.
“There’s great value in going to a place where you can direct a group and develop the technology the way you think it should be done,” says Rybicki, who arrived in June after months of red tape related to his work permit and visa.
His recruitment represents a coup for The Ottawa Hospital and a vote of confidence in its future, says hospital CEO Dr. Jack Kitts, who has devoted himself to bringing top medical talent to the institution. He markets the hospital as place where leading researchers can use state-of-the-art equipment and the latest technology in a supportive environment.
“Over the last several years, we’ve had a reverse brain drain where we’re attracting a lot more significant talent from the United States than is going there,” Kitts says.
“Having a world leader in 3D medical imaging is another piece of the puzzle for us because once your reach a critical mass of having the top talent, it attracts more.”
But Rybicki’s arrival also poses a challenge. The Ottawa Hospital does not yet own a 3D printer and must now send computer files to Toronto whenever surgeons require a custom model or surgical aid.
Kitts believes Rybicki’s reputation will attract the research grants and industry partnerships needed to launch a 3D printing program at the hospital. Clinical trials will then have to establish that the technology improves patient outcomes and reduces costs before it can become an embedded part of the health care system.
“We’re really in the early days of getting to understand the impact on quality and costs,” Kitts warns. “But I think we’re only seeing the tip of the iceberg in terms of the potential of this technology.”
For his part, Rybicki is untroubled by the hurdles that stand in the way of his quest to bring 3D technology to Ottawa. “Ultimately, you have to show it’s financially viable,” he says. “But really, I think the savings are going to be unbelievable.”
Rybicki says 3D printing will save time and money by facilitating better surgical planning and more precise interventions: Surgeons will need less time in operating rooms; patients will be under anesthetic for shorter periods; and outcomes will be better because there will be fewer mistakes. What’s more, 3D printing promises to one day deliver custom-made body parts manufactured on site, on demand.
“Just think: the cost of the stuff you need is ten times cheaper and it fits exactly,” he says.
A 3D printer capable of producing multi-coloured models and customized surgical instruments costs about $150,000, he says. Each model takes about $100 in materials to print and a 3D medical lab also requires computer hardware, software and staff. (A machine capable of making precise, titanium replacement joints is much more expensive and not yet viable for a hospital to own.)
But Rybicki is so convinced of the technology’s value that he plans to draw upon his network of U.S. contacts to bring a 3D printer here if he’s stymied by red tape.
“It will happen,” he says.
Related
Around the world, new medical applications for 3D printing are being pioneered every year. Among some of the recent developments:
- In Japan, surgeons used an exact 3D printed model of an adult’s liver to figure out how best to trim the organ and transplant it into the donor’s child.
- In Britain, doctors used 3D-printed models, surgical templates and titanium implants to repair devastating facial injuries suffered by a 29-year-old man in a motorcycle accident.
- In France, a 3D printed titanium plate solved a problem that plagued Maxime Turpin for 30 years: his eye drooped into the hole created by cancer surgery that removed a diseased part of the orbital bone in his face. The customized plate was modelled on the healthy side of Turpin’s skull.
- In Beijing, surgeons last year implanted the first 3D printed vertebrae in a 12-year-old boy who had a malignant tumour in his spinal cord. The titanium implant, custom made to fit with the other bones in his spine, was designed with tiny pores so that his healthy bones could grow into it, eliminating the need for cement and screws to hold it in place.
- In Ann Arbor, Mich., a critically ill child, Garrett Peterson, was saved when surgeons designed and implanted a 3D-printed splint to hold open his collapsing windpipe.
查看原文...
