Staff Writer

Ottawa Hospital has become the first hospital in Canada to create a multi-department, medical 3-D printing program, producing prosthetic hands and setting the stage for even more complex planning and printing procedures. The program has been spearheaded by Ottawa Hospital's new Chief of Medical Imaging Frank Rybicki, recruited from Boston eighteen months ago and renowned for having used 3-D printing to plan and complete the first face transplant in North America.

"Dr. Rybicki is the father of modern day 3-D printing," Adnan Sheikh, Ottawa Hospital's Medical Director of 3-D Printing, told Medical Device Daily. "He knows this technology and is why we got into 3-D printing when he came to Ottawa Hospital. I consider him my mentor."

Central to the program, said Sheikh, is a 3-D printer that produces polymer prosthetics and just as importantly will allow surgeons to preplan for more highly complex surgical cases involving kidneys, livers and heart valves. Prior to this the hospital sent its computer assisted designs outside to third party vendors for 3-D printing. "Now we can do this much faster and much cheaper," said Sheikh. "The surgeons are very excited because they don't have to ask someone else to create these models. Everything is done in-house."

FEW LIMITS

For his part, Rybicki told Medical Device Daily other 3-D printing programs exist in clinical settings, but not all under one roof and integrated across departments. "In particular, we have medical stakeholders who are engaged and therefore we can have a large cross-section of patients who benefit from this technology," he said. "These include ENT applications, neurosurgery, interventional neuroradiology, interventional radiology just to name a few."

Of particular importance, said Rybicki, will be support for radiation oncology in the form of customized masks and devices to more accurately deliver radiation therapy. "We also have an oncology angle where we can print organs that are affected with tumors so that surgeons can plan better cancer treatments." The ultimate goal: to reduce the need for invasive surgery and lengthy anesthetics, improve patient outcomes and save money for the hospital and Canadian public health care.

The money question doesn't end there, Rybicki added. "Like any new technology, the true universal deployment comes with physician professional reimbursement." In addition to showing that 3-D printing saves money, lives and improves quality of life, "this is what will lead to Canadian [physician] reimbursement," he said.

"In short, 3-D printing enables personalized medicine, and lets our physicians care for our patients as they would a loved one," said Rybicki. "Would you want your loved one to have an `off-the-shelf' device or one that was 3-D printed to precisely and rapidly do the job, just for them?"

CENTRALIZATION KEY TO ADOPTION

In medical 3-D printing, success is based, in part, on build volume capacity, i.e. sufficient space to construct objects as small as ¾ inch for prosthetic hinges and as large as an entire adult pelvis. Depending upon their computer skills, physcians and medical students at Ottawa Hospital learn the system with relative ease, with students viewing it as a distinct plus over the use of cadavers in anatomy class.

In the meantime, plans are afoot, said Rybicki, to expand beyond polymer prosthetics and pre-surgical planning to printing titanium bone plates and organs. "We have a comprehensive program in the works for bio printing which includes the 3-D printing of tissues and organs. If fully executed, the grant we have applied for will be valued at C$26.4 million for the department of radiology and the University of Ottawa."

Sheikh put the printer's price tag at approximately $250,000, all if it covered by an anonymous donor. Other Canadian hospitals aren't likely to be as lucky, which is why he's discouraging construction of huge 3-D printing labs at every hospital site and absorbing the high operational costs this would entail.

"The best thing to do is to have these at three or four regional centers," said Sheikh. "That would be more cost effective. Pool resources, centralize them, and get these programs working."

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