A life-saving surgery has made use of a 3D printed titanium implant to reconstruct a cancer patient’s entire chest bone and ribs.
Carried out by Manipal Hospitals in India, the complex surgery managed to remove the cancer from the patient and reconstruct his sternum and ribs, meaning he would not be dependent on medical ventilation for the rest of his life.
“Advanced technology can be used nowadays to offer treatment in complicated cancer cases, which otherwise is thought to be incurable by many,” said Dr. Somashekhar, Chairman and HOD – Surgical Oncology at Manipal Hospitals.
“The credit for this case goes to excellent coordination between Manipal Comprehensive Cancer Centre and Department of Plastic and Reconstructive Surgery which boasts modern technology coupled with experts in the field of medicine which offer hope to millions of cancer patients across the globe.”
A particularly complex surgery
The 50-year-old patient from Bangladesh was suffering from a rare and complex form of cancer that affected his sternum and the first eight ribs on both his left and right side. Even if the cancer could be removed through surgery, there was no feasible solution to fix his sternum and ribs, which would be essential for breathing normally.
The patient approached Manipal Hospitals, and his MRI showed a tumor mass measuring 15×12.7 centimeters sitting on his lung and heart that had destroyed the length of the patient’s sternum and inside his ribcage. Prior to surgery, the surgeons took CT scans of the affected area to create a personalized 3D model of the required implant, which was then 3D printed in titanium.
“The entire chest bone and the costosternal junction was printed with titanium powder and liquid titanium and a new titanium chest bone was formed, custom-made for this patient according to his size, height, weight, and the portion of the skeleton to be removed,” explained Someshekhar. “Multiple meetings were held with the company technologists, engineers and Manipal onco surgery and plastic surgery team for the same.”
The patient underwent the tumor removal surgery, which saw his entire sternum and ribs removed without much blood loss. This area was then replaced with the customized titanium implant which was fixed in place leveraging a new drilling technique and titanium wire. The implant was then overlaid with muscle flaps taken from the front of the patient’s chest before closing the skin, to restore normal breathing function.
“Such implants are usually very heavy, up to five kilograms,” continued Someshekhar. “In this case, this would be too heavy for the patient to carry such weight on the chest. To rectify this, a modified honeycomb technology was used to make the chest bone and sternum weighing less than 250 grams.”
Making a full recovery
Once the surgery was completed, the patient recovered smoothly and after chest physiotherapy was gradually mobilized. During his discharge from hospital, he was reportedly feeding, breathing and walking normally without any complications.
According to Dr Ashok, Consultant – Plastic, Reconstructive and Cosmetic Surgery at Manipal Hospitals, the 3D printed implant provided many vital benefits to the patient’s recovery.
“Such implants are strong, durable and at the same time light in weight,” he said. “Moreover, they are well-accepted by the body and less prone to immune reactions and implant rejection. Such implants reduce the risk of osteoporosis and fractures around the implant that may arise due to uneven stress transfer between the implant and surrounding bone tissue.”
The successful implantation of the 3D printed titanium implant meant that the patient would not be permanently dependent on mechanical ventilation to breathe once the tumor and the affected skeletal parts had been removed.
“New age technology and materials are helping patients with complex problems to be solved and recover fast,” Ashok added.
“This patient is a perfect example with the combination of excellent medical care and technology coming together.”
3D printing-enabled treatments in the real world
Additive manufacturing is increasingly finding new real-world applications in healthcare, for instance in the form of anatomical models to aid surgeons during complex operations.
Aside from 3D printed models, the technology has also been deployed in the form of a biocompatible splint within corrective nasal surgery, as implants used in hip surgery, and as a customizable mandibular plate for use in facial reconstruction surgery.
Additionally, in November last year a London man became the first in the world to be fitted with a 3D printed prosthetic eye, potentially paving the way for a significant reduction in protheses waiting lists.
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Featured image shows entire sternum ribs reconstruction using a 3D printed custom-made titanium implant. Image via Manipal Hospitals.
