Editor’s highlights from 3DMedLIVE 2019: 3D printing in surgery
As we take time to reflect on our first, inaugural 3DMedLIVE, I spoke to members of the Future Science Group Editorial team about their top highlights from the 2 days.
As you should already be aware, 3DMedNet and the Journal of 3D Printing in Medicine hosted the first, inaugural 3DMedLIVE event, entitled 3DMedLIVE 2019: 3D printing in surgery (2–3 October; London, UK).
In our opinion, the event was a great success, facilitating conversation, encouraging collaboration and ultimately bringing the multifaceted, multidisciplinary surgical 3D printing community to life.
As I and the wider editorial team at Future Science Group reflect on the key areas covered at 3DMedLIVE, here are our top five takeaway messages from over the 2 days.
1. Personalization is the driving factor in future innovations for surgery
The conference started with a keynote talk surrounding the Royal College of Surgeons Commission on the Future of Surgery. The panel, hosted by Journal of 3D Printing in Medicine Editor-in-Chief, Dietmar Hutmacher (Queensland University of Technology, Australia), included Adrian Sugar (Centre for Applied Reconstructive Technologies in Surgery; Swansea, UK), Lorna Marson (British Transplant Society, UK) and Richard Kerr (Royal College of Surgeons; London, UK) as they discussed what the future holds for surgical practice, the NHS long term plan and the Getting It Right First Time (GRIFT) programme in relation to surgical techniques.
Complementing the key themes of the conference and recent discussion within medical 3D printing communities, the heavy focus on patient-centric and specific care highlighted why we were all there, recognizing the demand for the high level of personalization the next generation of technologies and treatments will need to be able to facilitate if they are to find themselves a role in the operating room of the future.
It was fascinating to hear about the RCS Commission on the Future of Surgery and how the uptake of exciting key technologies such as 3D printing, artificial intelligence and virtual reality could impact how the NHS delivers healthcare going forward. These remarkable advancements are pushing the boundaries of what is possible in surgery, making it a truly exciting time for the healthcare profession and a promising time for the patient.” – Adam Price-Evans, Managing Commissioning Editor, Future Science Group
Some important questions raised: “What added benefit can we gain for patients as we understand more about the #genomics of the recipient? Can we use machine learning to identify organ donors whose organs are likely to lead to better outcomes for patients?” #3DMedLIVE19
— 3DMedNet (@3DMedNet) October 2, 2019
2. Key regulatory and risk management questions remain to be addressed
A key highlight was the regulation panel, featuring Amie and Duncan. The audience had so many insightful questions and it was great to see the regulators really engage in the discussion.” – Freya Leask, Publisher, Future Science Group
As we continued on our journey from concept to patient experience, the ‘business case’ stream hosted various conversations surrounding regulatory challenges. In the main panel discussion focused on regulating 3D-printed medical devices, Duncan McPherson (MHRA; London, UK) and Amie Smirthwaite (BSI; London, UK) discussed key themes surrounding the 2020 European Act, responsibility, cost and quality management.
Talks in the business stream steered towards the practicality of setting up and running a successful (and ultimately, safe) 3D printing service, embedded or otherwise, as Amy Alexander (Mayo Clinic; MN, USA) led the conversation surrounding key risk management issues:
The big thing that I’m really passionate about is that we have the technology, but who is using it? Who is running it? How are we building the next generation of people to come in and do each of the steps revolving around 3D printing in medicine? It’s rare to find an individual who understands all the medical, pathological, radiological, software, segmentation and the printing aspects needed - the latter in itself is a whole different ball game! We need to train the next generation up so how do we do that as a community?” – Amy Alexander (Mayo Clinic; MN, USA) at 3DMedLIVE 2019: 3D printing in surgery
Amy is currently working on creating a textbook to be used at high school/undergraduate level as an optional module dedicated to helping the next generation of surgeons/bioengineers understand all of these aspects from a technician level to an engineering level, which I think is really inspiring. From what I have learnt from 3DMedLIVE this year, training the next generation to use next generation technologies is certainly a fundamental step in progressing this technology further into the medical field.” – Daniel Barrett, Commissioning Editor, Journal of 3D Printing in Medicine
3. Funding: in-house vs outsourced 3D printing service models
Funding was a common theme and there was a lively discussion about the best models of sourcing and paying for 3D-printed models.” – Freya Leask, Publisher, Future Science Group
It was very interesting to hear perspectives from different 3D printing service providers and surgeons working with two entirely different business models. On the one hand, embedded 3D printing services serve some UK hospitals incredibly well with fast turnarounds and immediate integration of the engineers into the surgical team, whereas other surgical teams may look to outsource their 3D printing to specialists away from the hospital, where they feel the process from digital data onwards may be more easily managed. Hearing from surgeons working with embedded and outsourced services as well as the service providers themselves helped us to glean insight into what is really required when addressing key questions associated with funding surgical 3D printing.
During the clinical talks, Tim Brown (Belfast City Hospital, UK) mentioned that the suitability of the 3D printing service for your practice depends entirely on the likely volume and complexity of the case. 3D printing services should be as personalized as the models they are producing!” – Laura Dormer, Editorial Director, Future Science Group
How do you pay for a #3Dprinted facility? Henry Pinchbeck (@henrypinchbeck @3DLifePrints) talks us through some options including capital spend vs opec spend, charity funding, academic support and NHS reimbursement #3DMedLIVE19 pic.twitter.com/uW1PMizStC
— 3DMedNet (@3DMedNet) October 2, 2019
4. Case studies: proving the concept is no longer a distant dream
David Dunaway (Great Ormond Street Hospital and University College London, UK) spoke about separating craniopagus conjoined twins (joined at the head), which was pretty amazing. We were shown various 3D images and models to including bone and vascular components, used to plan the surgery. David mentioned that one of the problems with this type of complex surgery is an overload of information, but 3D modeling helps to manage this.” – Laura Dormer, Editorial Director, Future Science Group
Since the story broke a few months ago, 3DMedNet and sister publication, BioTechniques, have followed this story closely. David Dunaway and his team used 3D printing to meticulously plan, rehearse and guide one of the most complex conjoined twin separations to date. Anatomically correct 3D-printed models with tissue-imitating materials were initially printed with cutting guides complete with vascular mapping, reducing bleeding, time in theatre and ultimately, risk.
The case studies stream did not only focus rare and exceptionally complex surgical procedures, but also considered pediatrics, joint replacement and transplant procedures. While I wouldn’t argue that either of these areas of surgical intervention are typically ‘routine’, it was refreshing to hear that challenges facing surgeons in many different fields of surgical specialism were also experiencing great advantages from the use of 3D-printed models, guides and other innovative designs.
Pankaj Chandak (Guy’s, St Thomas’ and Great Ormond Street Hospitals; London UK) highlighted the problem of implanting adult-sized donor organs into pediatric patients, explaining how 3D printing can help plan surgery more effectively than 2D imaging. Pankaj’s case study described how his team used 3D printing to prepare for a kidney transplant involving a 2-year-old girl – I found this particularly inspiring.” – Laura Dormer, Future Science Group
Joyce Lim (Alder Hey Children’s Hospital; Liverpool, UK) discussed the utilization of 3D-printed hearts in pre-operative planning, decision making, parental teaching and surgical training. It struck me that in pediatrics, the benefits of a singular 3D-printed model could be tremendously multidimensional. Particular examples would include the objective evaluation of a trainee’s skills to determine if they are ready for actual surgery and the inclusive, accessible method for describing a child’s condition to parents, using a physical model rather than complex language or images.” – Daniel Barrett, Commissioning Editor, Journal of 3D Printing in Medicine
5. Fundamentally, it all comes down to patient experience
Obviously the whole story of ProMake International (London, UK) from Jason Laing was amazing… Apart from the fact that he used 3D printing during the planning of his own surgery and implant development following a major accident, it was also interesting to hear about the implementation of 3D printing in South Africa, contrasted with the US and UK.” – Laura Dormer, Editorial Director, Future Science Group
As I mentioned right at the beginning, one of the key themes throughout 3DMedLIVE 2019, was the patient-centric focus. What does all this successful innovation really matter if the patient experience isn’t markedly improved? In previous editorials, I have explored the use of 3D-printed models reducing costs, procedure times and risk of post-operative complications, but one area that seemed to be supported time and time again is the use of 3D-printed models in guiding conversations around informed consent. Rather than navigating medical jargon and trying to make sense of a 2D digital image, 3D modelling, physical or otherwise, grants patients the opportunity to better understand their conditions and the surgeon’s strategy for treating it.
Tim Brown further explained how valuable 3D-printed models can be in explaining procedures to patients and how they can allow truly informed consent. The surgeon is assured that a patient properly understands their condition and treatment plan, and therefore has autonomy in deciding how to manage their disease.”– Laura Dormer, Editorial Director, Future Science Group
3DMedLIVE 2019: 3D printing in surgery was closed with a look towards the future, with a brief look at R&D projects including bioresorbable implants as well regenerative medicine and bioprinting technologies. It could be argued that while these areas of 3D printing are still a very long way from adoption into routine clinical care, there is a very real chance that these techniques could be instrumental in addressing the organ donor crisis, for example.
It was exciting to hear about the promise bioprinting has in the field; I look forward to being able to share real clinical case studies in the years to come, building on the great research which was presented this year.” – Freya Leask, Publisher, Future Science Group
We were also privileged to be able to hear about other innovative technologies including AR and VR, which are already showing promise as ‘tandem-technologies’ in supporting 3D-printed designs before, during and following surgery.
Finishing off the talks today we have Matt Ginn @ProximieAR who will be speaking about augmented reality and 3D technology in developing world #surgery #3DMedLIVE19 pic.twitter.com/U7wEOaFoBC
— 3DMedNet (@3DMedNet) October 3, 2019
Overall, the patient-focused, collaborative and community feel of 3DMedLIVE 2019: 3D printing in surgery is what I will be taking home and with me into the preparation of future events. I would like to take this opportunity to thank everyone involved, from the team at Future Science Group to the advisory board, sponsors, speakers and attendees who made all of this possible. It was truly a pleasure working with you and I am very excited to be starting work continuing the energy into next year’s event.
If you have any highlights from 3DMedLIVE 2019: 3D printing in surgery, please leave them below as we would love to hear them! Please also send your pictures and any feedback to the Editor at: firstname.lastname@example.org