With the advance of medical technology, physicians need to communicate not only with patients but also with engineers. The definition of “professional" now includes being able to apply new technologies and keep up with technological progress.
The high-speed 3D printer makes a roaring sound as anatomic models of artificial teeth, shin bones and vertebrae take shape inside.
We are not witnessing the making of these custom-printed body parts at a medical device manufacturing plant but at the 3D Printing Medical Research Center of China Medical University Hospital, the first 3D printing center inside a hospital in Taiwan.
The 200-square-meter space used to be a respiratory care ward but was refurbished in 2014 to house the new center. Hospital beds and IV drip stands made way for 3D printers and dozens of computers. Where patients with acute respiratory conditions were once treated, now around 20 engineers with diverse backgrounds in mechanics, information engineering, design, material sciences and chemistry are working as a team.
“We built a customized factory inside the hospital. We let physicians and engineers collaborate directly to create a new mindset and improve the quality of medical care for our patients,” notes surgeon Fang Hsin-yuan, director of the hospital’s 3D Printing Medical Research Center. Fang, who doubles as director of the Department of Thoracic Surgery, looks back on a medical career of more than 20 years, witnessing first-hand how much the emergence of 3D printing is revolutionizing clinical medicine.
For instance, thanks to 3D printing technology, a life-size 1:1 model of a bone can be produced within a week’s time. This allows the medical team to see and touch a bone before surgery is performed. When planning a surgical approach and procedure in the past, physicians had to rely on X-ray imaging and other 2D technologies to discuss and visualize it. With the help of 3D printing, they can now create printed custom guides for surgeries that involve cutting and drilling into bones.
Over the past two years, more than 50 China Medical University Hospital physicians across medical disciplines such as dentistry, orthopedics and thoracic surgery have used 3D printing technology in procedures involving some 200 patients. The new technology helped them shorten time spent in surgery by a third.
As the hospital introduces new technologies, its physicians also learn new skills. They no longer only diagnose patients and operate on them; they also need to gain expertise in new fields such as understanding the terminology used in 3D printing and collaborating with engineers. “It is impossible for us to have the same expertise as engineers, but communication becomes easier if there is a certain overlap in how our brains work,” remarks Chang Hao-wei, an orthopedic surgery resident at the hospital.
For young physicians who will face massive technological changes in their careers, thinking outside of the medical school box is even more important. At the hospital Chang, who was born in 1988 and graduated from medical school three years ago, belongs to the younger generation of digital natives. This year, he participated in a training program at the 3D Printing Medical Research Center. On top of that, he went to the Mayo Clinic and the Georgia Institute of Technology in the United States for a month-long expert exchange on the medical applications of 3D printing. Chang is among the first batch of physicians to receive such training.
“We make our tools ourselves. 3D printing technology gives us an opportunity to create devices,” Chang points out. “We are not only using the machines provided by our suppliers; we also know there is a new field that we can discuss with engineers, which increases the treatment options.”
When the aspiring orthopedic surgeon talks about the new magic tool of 3D printing, his bespectacled eyes sparkle with enthusiasm. He grasps a surgical guide with five holes to demonstrate an example. This tool was designed by the medical team in preparation for surgery of a patient with knock knees. The five holes in the printed guide, created based on data about the patient’s individual bone structure, help the attending surgeon insert nails in the skeletal structure in exactly the right position.
This concept is the result of lengthy discussions between physicians and engineers as well as actual operations. It involved diagnosing the patient’s condition, converting medical images, making graphic designs, selecting model materials, printing and cutting the model to ultimately performing the surgery in the operating room. Every step in the process integrates medical know-how with software and hardware engineering expertise. Speaking animatedly, Chang points out, “If you are not familiar with the design principles and process of 3D printing, you will easily reach the limits of your imagination. But after studying [3D printing], you know what this technology can achieve and under what conditions it can be achieved, which will give you many more ideas.”
Learning from Scratch
Crossing over from the world of white doctor’s coats to engineering does not necessarily come easily. During his seven years in medical school, Chang's studies focused on physiology and pathology. While he had heard of 3D printing, he had no idea at all how this technology could be applied in clinical medicine research; it felt like starting out with a blank page.
As the young physician worked through massive amounts of information and countless videos, and different engineers guided him through practical work, the blank page gradually filled up and gained color. What are the principles of 3D printing? How can diagnostic imaging be converted into digital drawing files? How do you work with the software, write programs and create 3D models? How can the softness and hardness of different materials be put to use? These are only a handful of the questions he encountered in the process.
“You can only understand new stuff and be able to get in on it if you study it from the very beginning,” states Chang in a tone that reveals his sense of mission when it comes to saving patients’ lives. And now that the digital revolution is sweeping through our hospitals, this sense of mission makes him search ceaselessly for better tools to create a new lease on life for his patients.