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TABLE OF CONTENTS
| S.No | Pg. No | |
| 1 | Introduction | |
| 2 | Methodology | |
| 3 | Result | |
| 4 | Discussion | |
| 5 | References |
Introduction:
Three-dimensional printing a process in which a physical model is constructed by laying down layers that being transferred from the Computer aided design to the 3d printer, also known as additive manufacturing and rapid prototyping. (Cohen, Laviv et al. 2009, Rengier, Mehndiratta et al. 2010, Hoy 2013).
This concept was first introduced in 1984 when Chuck Hull invented a process called stereo lithography, in which the layers are added on top of each other’s by a curing photopolymers along with UV lasers (Hull, 1986).
Since then it went through major advancement worldwide, and hold importance in different fields including the medical field.
The growing market for 3D desktop printers gives rise to extensive research in that field; medical application may include: surgical planning, prosthesis, implanted structure, medical education and other applications (Holy, 2013).3d printing application in surgery
The most attractive feature of 3D printing is that they can produce custom made items which can be valuable for the patients as well as the surgeons. For instance, surgeons will be able to use 3D printing instead of organ transplantation.
Organ transplant is a very expensive procedure and it is difficult to find a donor match and even then many a times it results in organ rejection. In cases of emergency it also becomes very difficult to arrange for an organ which will be compatible with the recipient’s body system.
In the year of 2009, more than 150, 000 patients alone in the U.S. were on the waiting list of receiving an organ for transplant. However, only 27, 996 3d printing application in surgery patients received a transplant which comprises of only 18% of the patients of the original donor list, many others who did not receive a transplant died due to organ failure.
The numbers in the previous year (2014) have increased but only a small percentage of those patients receive organs which they require. Hence 3D printing will be used by using cells of the patients and build an organ which can replacement the old, diseased one.
Moreover, 3D printing also has a vital role in 3d printing application in surgery neurosurgery where cranial implants are required. Patients to receive a head injury require the fitting of a cranial plate later. 3D printing is being used to produce the accurate design and fitting of the cranial plates (Ventola, 2014).
In this review paper we aim to discuss the current application of 3D printing in the surgical field, along with future perspective of this tool and how it affects the surgery practice.
3d printing is indeed making its way in the surgical departments of hospitals and many surgeons are using this technology but at a small scale.
3d printing has shown high prospects of becoming a technology which can eradicate the use of transplanting organs from one person to another as well as reduce the common issues such as sterilization which occur during surgical procedures.
Since first introduced, 3d printers went into a huge developments in the past three decades, different types of 3d printers were manufactured, depending on the uses, materials and accuracy.
Recently, range of developers and company urges to market the concept of the desktop 3d printers branding it as the new personal computers revolution, since then a huge development in that field was addressed to attract the consumers with a highly competitive atmosphere between all developers; medium sized companies and huge ones (Protosys, 2005).
While desktop printers ranging from home assembled parts or 200 dollars to 3000 dollars the professional 3d printer unit can be expensive and could cost more than 500.000.000 dollars in price. In the table below we aim to introduce a quick comparison between the most prominent.
3d printer’s types, how it works, advantages, disadvantages, materials of each printers for better understanding of the 3d printing process (Horvath, 2014).
| Type | Mechanism | Advantages | Disadvantages | Material | Other |
| SLA | UV light is used to create the object by curing and solidifying a liquid resin. | · High resolution prototypes
· Good finishing at the surface |
· Support structure is needed.
· Require post curing |
Resin; a curable laser photopolymer
Or other plastic like products. |
Layer thickness:
0.05~0.2mm |
| SLS | laser fuses the layers of a powder material | · Ability to produce complex/functional parts.
· Doesn’t require support structure
· High productivity |
· Surface finish is rough | Plastic, nylon, polystyrene, metals; steel, titanium,
And composites.
|
Layer thickness: 0.06 – 0.10 – 0.12 – 0.15 – 0.18 mm |
| FDM | Extruding small breads of the melted plastic material which harden after. | · No post curing
· Easy material changeover
· Low cost machines compared to other |
· Slow processing especially on large parts.
· Low detailing accuracy
· Low surface finish integrity |
Filament of thermoplastic polymer; ABS, PLA. | Layer thickness:
0.15-0.25mm (adjustable)
|
| DLP | DLP projector project the light into in a repetitive process | · Good resolution
· Fast processing time |
· Support structure is needed.
|
Liquid resin | Accuracy: 139µ |
| INKJET | Spraying liquid or photopolymer depending on the type of the jetting; binder or material | · Variety of material choice
· High precision · Colored parts |
· Require post curing | Plastic, metal And ceramics. | Layer thickness:
Material: 0.013 mm (min) Binder: 0.09 mm (min) |
Methodology
Literature was searched through PubMed and other reliable sources using keyword “3d printing” “surgery” “implantation” “education” “planning” “plastic and reconstructive” 146 papers were found, exclusion criteria was;
papers not in English, papers in animals, papers before 10 years, and not full text papers, inclusion criteria was; original paper, 80 paper were excluded, 66 remaining papers were evaluated. Papers included resemble the most relevant study data to our review.
Result
- Surgical planning:
As a part of any surgical intervention planning is a very important step in which the surgeon and the whole treating team collaborate to plan a successful surgery, it’s the key for understanding the disease and apply the knowledge in the right manner.
Surgical planning gain a lot of advancement with the on-going development of the imaging techniques which gave the surgeon better visualization and better understanding for the anatomy and pathology (Chae et al., 2014).
While the current practice might be adequate for surgical planning in some cases, other complex cases required better understanding which will lead to better results, lower complications, and less time of surgery, 3d printing with its capability to produce exact similar structure models of body organs give rise to research interest in the field of planning among different surgical specialties
. Different centres around the worlds present cases in which a fabricated models was created from the imaging modalities through the computer aided design which was the printed in a 3d printer and planning procedure took place then by the treating team (Schmauss, Gerber and Sodian, 2013)…
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