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Cancer patient receives 3D-printed titanium ribs

11 September 2015

A 54-year-old Spanish man suffering a chest wall sarcoma has had his sternum and a portion of his rib cage removed and replaced with a 3D-printed implant.

The front of 3D printed titanium sternum and ribs (photo: CSIRO)

The implant was designed and manufactured by medical device company, Anatomics, who utilised the Australian Commonwealth Scientific and Industrial Research Organisation's (CSIRO's) 3D printing facility, Lab 22, in Melbourne.

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," says Dr Aranda. "We wanted to provide a safer option for our patient, and improve their recovery post-surgery."

That's when the surgeons turned to Anatomics. After assessing the complexity of the requirements, Anatomics CEO Andrew Batty says the solution lay in metallic 3D printing.

"We wanted to 3D print the implant from titanium because of its complex geometry and design," says Mr Batty. "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 re-operation."

Through high resolution CT data, the Anatomics team was able to create a 3D reconstruction of the patient's 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," Mr Batty adds.

Working with experts at CSIRO's 3D printing facility Lab 22, the team then manufactured the implant out of surgical grade titanium alloy.

"We built the implant using our $1.3 million Arcam printer," says CSIRO's Alex Kingsbury. "The printer works by directing an electron beam at a bed of titanium powder in order to melt it. This process is then repeated, building the product up layer-by-layer until you have a complete implant.

"3D printing has significant advantages over traditional manufacturing methods, particularly for biomedical applications. As well as being customisable, it also allows for rapid prototyping - which can make a big difference if a patient is waiting for surgery."

Once the prosthesis was complete it was despatched to Spain and implanted into the patient. The procedure was described as "very successful".

The procedure is described in The European Journal of Cardio-Thoracic Surgery.


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