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The challenge

A cancer patient faces challenging surgery

Suffering from a tumour growing on his chest wall, a 54-year-old Spanish man needed his sternum and a portion of his rib cage replaced.

This part of the chest is notoriously trick to recreate with prosthetics, due to the complex geometry and intricate structures involved.

The patient's surgical team from Salamanca University Hospital determined that a fully customisable 3D printed sternum and rib cage was the best option.

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.

3D printed titanium sternum and ribs.
3D printed titanium sternum and ribs. ©

Our response

The world’s first 3D printed sternum and rib implant

The team of surgeons - Dr José Aranda, Dr Marcelo Jimene and Dr Gonzalo Varela - turned to Anatomics, a Melbourne-based medical device company, which designed and manufactured the implant using our 3D printing facility Lab 22.

Using high resolution CT data the Anatomics team created a 3D reconstruction of the patient's chest wall and tumour, allowing the surgeons to plan and accurately define resection margins.

Using our Arcam electron beam metal printer the team manufactured the implant out of a surgical grade titanium alloy. 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.

The results

A successful patient outcome

Once the sternum and rib prosthesis was complete it was couriered to Spain and implanted into the patient. Twelve days after the surgery the patient was discharged and has recovered well.

The surgical team praised the novel approach. "Thanks to 3D printing technology and a unique resection template, we were able to create a body part that was fully customised and fitted like a glove," Dr Aranda said.

[Music plays, CSIRO logo appears on bottom right hand corner of screen, and text appears on screen:  Cancer patient receives 3D printed ribs in world first surgery]

[Image changes to show various 3D printed objects]

[Image changes to show a building with a sign:  CSIRO Australia]

[Image changes to show Alex Kingsbury and text appears on screen:  Alex Kingsbury, Additive manufacturing research leader, CSIRO]

Alex Kingsbury:  CSIRO, in conjunction with Anatomics, has developed a sternum implant for a patient suffering from cancer.

[Image changes to show various images of the 3D printed implant]

It involved a very complex world first procedure.  Anatomics contacted CSIRO.

[Image changes back to Alex Kingsbury]

We have access to an electron beam metal printer, which means it’s a really high quality implant.

[Image changes to show a man operating the printer]

And we also have the experience of having done these types of jobs before.

[Image changes to show the door to the printer opening]

[Image changes back to Alex Kingsbury]

So 3D printing works by inputting a 3D digital CAD file into a computer, and then that computer talks to the machine.

[Image changes to show a man operating the printer]

[Image changes back to Alex Kingsbury]

The machine puts down layer upon layer of material, and each layer is fused.

[Image changes to show a computer generated simulation of the printer creating a 3D object]

So as each layer is fused you then start to build up a product as your layers increase.

[Image changes back to Alex Kingsbury]

And Anatomics and the surgeon worked together quite closely.

[Image changes to show a man at computer looking at the design and close up of design]

[Image changes back to Alex Kingsbury]

The way that they came up with a design was to have these pieces that went over the bone, and then you could screw through the bone.

[Image changes as the camera zooms to show the 3D printed implant held by Alex Kingsbury]

So it’s attached really securely.

[Image changes back to Alex Kingsbury]

The reason that 3D printing was desired for making this implant was because it needed to be customised exactly to suit the patient.

[Image changes to show the 3D printed implant]

[Image changes back to Alex Kingsbury]

No human body is the same, so therefore every implant is going to be different.  So this is the sternum here.

[Image changes as the camera zooms to show the 3D printed implant held by Alex Kingsbury]

[Image changes back to Alex Kingsbury as she points to the implant]

This here is mimicking the ribcage, and these pieces here are what attach on to the ends of the bone.

[Image changes back to Alex Kingsbury]

To get to this implant design Anatomics used the patient’s scan data.

[Image changes to show the 3D printed implant held in front of the design on the computer]

[Image changes back to Alex Kingsbury]

And that meant that they were able to make an implant design that exactly matched the patient’s anatomy.

[Image changes to show a person working with an object in the 3D printer]

It would be an incredibly complex piece to manufacture traditionally, and in fact, you know, almost impossible.

[Image changes to show various images of 3D objects]

Australia has a really fabulous skills base in biotech and biomedical manufacturing.

[Image changes back to Alex Kingsbury]

3D printing is set to really take advantage of that skills base.

[Image changes to show people working in a laboratory]

[Image changes back to Alex Kingsbury]

Internationally we’re now becoming very well known for our expertise in 3D printing for biomedical applications.

[CSIRO logo appears with text: Big ideas start here]

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