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London there’s an artist who creates “designer” artificial limbs. Three-dimensional printing of biological materials is advancing, too. San Diego-based Organovo can print human cells and tissue. Currently this work is aimed at testing drug therapies. Someday it could create tissue for use in people. Meanwhile, 3D printing is allowing surgeons to perform sophisticated advance game-planning for delicate procedures. “It really is transforming how surgeons approach surgery,” said Katie Weimer, vice president of medical devices at 3D Systems, which has a dedicated healthcare unit providing services to hospitals and surgeons. The company calls it “virtual surgical planning.” Using standard medical scans such as MRIs and CTs, 3D Systems can create three-dimensional digital models of internal anatomy. Doctors can view organs and systems from any angle, and manipulate and cut things on the screen. Those digitized anatomical parts then can be “printed” with plastics and other materials that provide accurate textures and tissue resistance. One service 3D Systems offers is a physical replica of a patient’s heart. “It feels like a heart, looks like a heart, reacts like a heart,” Weimer said. “Doctors can practice cutting and suturing, or potentially running fluid through it.” The digitization process also allows surgeons to create tools and cutting guides for use during surgery, specific to the patient and the procedure. All of these aids were employed to help surgeons prepare for the challenging operation on conjoined twins Anias and Jadon McDonald. The boys were joined at the tops of their heads, creating a situation where neither could sit up or even be held

ing bone they shared. Preliminary surgeries inserted tissue expanders to increase skin available for stretching after separation. Then the team was able to use 3D-printed cutting guides that transferred the virtual plan to the operating room. The procedure took more than 20 hours and involved more than 30 members of the medical staff at Montefiore. Doctors knew KATIE WEIMER that despite the computerized Vice President of Medical Devices at 3D Systems planning, they might get surprises—and they did. The twins had grown while in the hospital, and The surgeons’ high-tech planning their brains had fused more, creatbegan with CT and MRI scans that ing a challenge that called upon the became 3D digital models. 3D Systems team’s experience and skill. High-tech provided these digital models along planning helped make the procedure with real-size physical models to the possible, but there’s no substitute for Montefiore medical team, led by neurosurgeon Dr. James Goodrich and plastic human expertise. The McDonald twins have a long surgeon Dr. Oren Tepper. recovery ahead of them. Doctors The doctors did a virtual separation recently called it “right on target.” And of the twins via computer, “much like a week after the surgery, mom Nicole pilots do with a flight-simulation plan,” McDonald was able to hold Jadon said Dr. Tepper. They cut vessels in her arms for the first time (Anias and bone, moving the boys apart as remained too fragile). “I’ve dreamed of they would do in the operating room. this moment,” she wrote on Facebook. They looked at the requirements of reconstruction, which would involve KPMGVoice: Read more of The Great Rewrite series rebuilding each boy’s skull from existat forbes.com/TheGreatRewrite by their parents in a conventional way. Most twins joined at the head die by age two, and separation was deemed to be the best option.

“It really is transforming how surgeons approach surgery.”

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