For the past year and a half, Skåne University Hospital has been researching 3D printing technology, which includes personalizing patient-specific tools for surgery. In an ongoing study, the hospital is exploring whether it can independently perform the entire process of cranial implants, including design, printing and surgery.
"We have developed software that reads CT images and designs cranial implants based on them. This is done by mirroring the healthy side to the diseased side so that the symmetry of the skull can be reshaped. In addition, when designing the implant, holes for titanium screws are added and the surgeon can advise on the exact location of the screws. Once these steps are completed, the implant is ready to be printed."
——Einar Heiberg Brandt
Skåne University Hospital
Medical and Nuclear Medicine Engineer, Clinical Physiology
The implant was printed on an Apium M220 3D printer, a model designed for high-performance polymers and capable of high-precision printing at high temperatures. The material used for printing was Evonik's PEEK thermoplastic filament, which has been extensively proven in medical device applications and offers excellent biocompatibility and mechanical stability.
"The implant is 3D printed at high temperatures, around 450 °C for the nozzle and 250 °C for the print chamber.After printing, the support structure needs to be removed and some simple post-processing may be required, such as sanding off sharp edges. Before the procedure, the implant is sterilized. "
——Einar Heiberg Brandt
Skåne University Hospital
Medical Technical Engineer, Clinical Physiology Medicine and Nuclear Medicine
This method has been in development for several years and was part of a large study that has continued to this day. Recently, the hospital performed the first surgery using a 3D printed skull implant. The patient was a woman in her 40s who had suffered a skull injury in an accident. Researchers describe the procedure as a success. Currently, 40 patients have been approved to undergo surgery with 3D printed implants.
It is hoped that this approach will lead to faster surgery and a lower risk of infection due to a better fit of the 3D printed implant.
In the long term, we would also like to develop this approach further, especially with regard to materials.
"What we wanted to explore in our study was whether it was possible to reduce the time from opening the implant package to implantation and skin closure. The shorter the time, the lower the risk of infection. Currently we use high-performance materials, but in the future we would like to print with other materials that are more biocompatible and closer to human tissue."
——Peter Siesjö
Skåne University Hospital
Chief of Neurosurgery and Pain Rehabilitation at Skåne University Hospital
Skåne University Hospital successfully performed the first in-hospital printed implant surgery using an Apium M220 3D printer, marking an important breakthrough in medical 3D printing. This innovative approach to 3D printing implants by customizing them to better fit the patient's needs and could shorten surgery time and reduce the risk of infection. The research also plans further improvements with more biocompatible materials. The potential for development of this technology is enormous and promises to significantly improve patient care and surgical efficiency.
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