3D Printing Better Surgery at the Mayo Clinic
3D printing is revolutionizing surgery and healthcare, and the Mayo Clinic is on the leading edge.
Surgeons at leading health centers around the world have been armed with new tools for groundbreaking care thanks to a new technology: 3D printing. In the case of London Secor, an 11-year-old patient at the Mayo Clinic, the benefits of 3D printing saved her from a painful and life-altering procedure. She suffered from a rare tumor near her hip socket that has traditionally been treated with leg amputation. The care team at Mayo, however, was able to produce a 3D model of the tumor and its surrounding environment, including her pelvis, blood vessels, and nearby organs. The surgeons used this model to chart a surgical path to remove the tumor without requiring amputation. [1] This article explores the impact of 3D printing, also known as additive manufacturing, on healthcare and specifically at the Mayo Clinic.
The use of additive manufacturing is growing in the healthcare space. 3D printing is playing a particular role in a surgical revolution at the Mayo Clinic. First, as described in the case of Ms. Secor, doctors now have the ability to create model organs that can be used to discuss, plan, and practice prior to surgeries. This practice is used for “particularly difficult oncology cases to help tailor the surgical approach and minimize complications, including getting to vessels, nerves, ureter, etc.” according to Dr. Brad Stevinson, M.D. [2] As a result, surgeons spend less time in the operating room. Patients experience a health benefit due to less time under anesthesia and fewer complications. Shorter surgeries also lead to lower unit cost for hospitals, as supporting functions – nurses, anesthesiologists, etc. – are not needed in the operating room as long. [3]
The other important application of 3D printing at the Mayo is the use of customized implants. Implants that match a patient’s body are less susceptible to wear and tear and require replacement less often. [4]
The Mayo Clinic, unsurprisingly, is on the forefront of this new technology. In the short term, the Mayo has invested in 3D printing technology for use in these applications. While amateur 3D printers cost less than a thousand dollars, industrial printers such as those used at Mayo can range from $10,000 to $400,000 depending on the materials, size, and tolerance requirements of the machine. Longer term, they are partnering with companies who make 3D printers to make on-site printing labs. They Mayo credits the on-site labs with eliminating middle men and reducing complexity in ordering of 3D models and implants. [5]
In the short term, the Mayo Clinic should focus on process improvement related to 3D printing technology. The model of Ms. Secor’s hip, for instance, took 60 hours to print. [6] Unknown is the amount of time that was required for engineers to convert MRIs, CT scans, and Ultrasound images into the file format required in order to print the pelvis bone and surrounding tissue on the 3D printer. Presumably, it is a labor-intensive process involving several high-salaried engineers. The Mayo Clinic should invest in technology that reduces the process time to convert this information to a usable file format – or automates it altogether.
Longer term, the file conversion and printing are processes that should be outsourced to a 3D printing center of excellence. By developing this ability in-house, the Mayo Clinic has created a service advantage it is able to provide patients. There will, however, inevitably be many hospitals who are fast followers that develop this ability. Eventually, this process – creating model mock-ups for surgeons – will be commoditized. When that happens, a business focused on serving a broader consumer base (i.e. other hospitals, in addition to the Mayo Clinic) would be able to achieve greater economies of scale. Cost savings and process improvement will inevitably follow. Indeed, this will add complexity to the supply chain and procurement for these hospitals. The advantages of a large-scale 3D printing business will nevertheless be worth the additional logistics.
There several areas on this topic worth further consideration. First, what other opportunities exist in which surgeons (or other medical professionals) could utilize 3D printing? Could surgeons use 3D printing to develop customized tools to match patient physiology? Specific to the critique presented in this article, does the outsourced 3D printing model make sense? Are the benefits of a remote yet large-scale 3D printing operation to support hospitals greater than the benefits of a localized printing lab?
[753 words]
[1] Aili McConnon, “How 3D Printing Is Changing Healthcare,” The Wall Street Journal, September 12, 2017, https://www.wsj.com/articles/how-3-d-printing-is-changing-health-care-1505268301, accessed November 2018.
[2] Richard D’Aveni, “The Pan Industrial Revolution: How New Manufacturing Titans Will Transform the World,” Houghton Mifflin Harcourt, October 2018.
[3] Dr. Brad Stevinson, M.D., interviewed by author on November 13, 2018.
[4] Aili McConnon, “How 3D Printing Is Changing Healthcare,” The Wall Street Journal, September 12, 2017, https://www.wsj.com/articles/how-3-d-printing-is-changing-health-care-1505268301, accessed November 2018.
[5] Aili McConnon, “How 3D Printing Is Changing Healthcare,” The Wall Street Journal, September 12, 2017, https://www.wsj.com/articles/how-3-d-printing-is-changing-health-care-1505268301, accessed November 2018.
[6] Aili McConnon, “How 3D Printing Is Changing Healthcare,” The Wall Street Journal, September 12, 2017, https://www.wsj.com/articles/how-3-d-printing-is-changing-health-care-1505268301, accessed November 2018.
[7] Aili McConnon, “How 3D Printing Is Changing Healthcare,” The Wall Street Journal, September 12, 2017, https://www.wsj.com/articles/how-3-d-printing-is-changing-health-care-1505268301, accessed November 2018.
Great article! It is interesting that you suggest outsourcing the development of the 3d printed model. My research into the area of bio-printing led to the same question.
Are doctors really expected to learn how to model and execute the drawings?
One other aspect is whether additive manufacturing for the purpose of surgery assessment is sustainable. Developments in the areas of Virtual Reality could potentially be a faster and eventually cheaper alternative.
This is very exciting to read. I have heard of research on the way as well that would make it possible to 3D print bones. This would mean that in the case of bone cancer, we could replace the bone and not need to amputate. We are probably about 10 more years away, but I think it gives hope to many people.
I strongly agree with the comment on creating a center of excellence for 3D printing. Most big hospitals already have them for imaging. Why not an adjacent department for 3D printing?
I think you make a great point that the economies of scale would potentially push hospitals towards outsourcing this work to third parties. It will be interesting to see how these companies will manage large manufacturing operations in the context of the sensitive nature of the products are that they are building. It will be very important to have strict and effective quality control to make sure that the surgical models are produced to specification, especially if they are being used to plan very complex and delicate surgeries. Also, the companies will need to manage inventory and information securely – the orders and physical models contain sensitive health data, and will need to be protected as such as they move through the supply chain. In the face of these uncertainties and the risk of malpractice suits that doctors in the US face, will the surgeons trust products that weren’t made under strict control in-house?
I think this is a fascinating and exciting concept for the future of the medical industry. Technology in the healthcare industry is always interesting to me; the anecdote at the beginning of this article is inspiring and uplifting. What would have happened if something had gone wrong because there was a mistake with the 3D model? In this industry, I think technological advancement is hugely important but will inevitably move more slowly than it should. Despite the huge benefits 3D printing can bring for improving health outcomes, a few mistakes have the potential to seriously jeopardize the progress being made.
Two things stick out to me here:
(1) 3-D printing will probably be better served by an outsourced or centralized center as described here due to time and cost factors. I think economics are currently challenging to make a 3-D printing machine operation effective, so focusing on maximizing utilization should help ease some of that burden, and
(2) because 3-D printing is at this point best suited for intricate parts that would otherwise need a lot extrusion or other work, one option might be to use additive manufacturing for complex joints like the knee.
Interesting read!! I completely agree with you on focusing on process improvement by converting a labor intensive model into a useable file format and automating it completely and outsourcing in the longer run. As an outsider to health care tech, one thing I would be interested in learning is safety to use and timeline, how far away are we from printing, for example, bones? To reach a large scale? To lower costs to a level that it is affordable to a vast majority? It really gives hope for patients who suffer from pain and save costs for hospitals, especially in developing countries, where health care resources are scarce. Great article!
Interesting read. There’s a public company called Conformis that offers custom/3D-printed surgical implants, so bet there’s some interesting market-related information in their 10-K. One additional point is that surgeons are creatures of habit: they are notorious for favoring/using the same devices from the same manufacturers over and over again. While 3D-printed implants may be superior I wonder how their adoption will play out from a cultural perspective.
The prospect of 3D printing becoming more integrated in healthcare is exciting. I do believe that outsourcing 3D printing may prove useful in the beginning, as it would help hospitals and health systems develop a more robust, supporting case for direct investment in technology. In time, I trust that there will be growing proof of additive manufacturing’s relevance in the context of medical procedures. I am eager to see how patient care standards may evolve as a result.
Really interesting article! One area where medical professionals should (and I believe are currently) innovate in 3D printing is organ creation. Patients can spend years on transplant lists for critical organs (hearts, kidneys, livers, etc.); if these organs could be printed-and effectively replicate the role of natural organs-this would allow patients to bypass waiting lists and more immediately receive life-saving transplant surgeries.
Interesting read! There have been recent advances in using 3D printing for organs and also preclinical research. I have a sense that 3D printing is still cost-prohibitive to most hospitals because of the limited near-term use case, which makes a centralized outsource model more viable. But as 3D-printing organs get approved and preclinical 3D models get validated in the future, it’s exciting to think that 3D printing should be more affordable and more widely implemented in clinical practice!
3D bioprinting is so exciting, and I loved seeing it being applied to make invasive surgery less harmful to the patient. I don’t think people are as aware of how poor surgery can leave a person cancer-free, but still feeling pretty debilitated. Sometimes entire organs and lymph nodes are removed. I think there should be another surgery using 3D bioprinting to reconstruct blood vessels, lymph nodes, organs.. Just because someone is no longer ill doesn’t mean all is well. There should be full restoration, and 3D printing as you describe it seems to present new options in the future.