A revolution waiting to happen – in 3D - Veterinary Practice
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A revolution waiting to happen – in 3D

ROBIN FEARON reports that printing 3D objects is not simply the latest trend, it’s a powerful medical tool that is already being used in practices – including Croft Referrals in Northumberland

ADDITIVE manufacturing, or in its modern funky nomenclature 3D printing, is about to revolutionise the way we do veterinary medicine. From printing prosthetics to organs and even pharmaceuticals, the future has arrived in our enclave and the only limits are what we can imagine.

Hype enough for you? It should be, but there are several development cycles to go through before we can realise the promise of personal fabrication and the “desktop factory”. Right now, the real strength of the technology lies in its ability to quickly extrude a variety of plastics to produce prototypes.

Malcolm Ness, partner at Croft Referrals, uses 3D print to design surgical tools and plan operations. “We get plastic models of instruments and then create plans that we then use in cadaver surgery,” he explains.

“We have also been looking at using CT scans of dogs with angular limb deformities and getting plastic models made with a view to practising surgery and working out where we are going to cut before we perform the actual operation.”

Malcolm has investigated marketing the service and has moved on to other areas such as pre-fracture planning. “The difficulty we have is rapid development. A dog with a broken leg needs to be fixed quickly. If you have to sub-contract the CT scan and then get it sent somewhere else for the printing to be done – even at the minute when it is done with a two- or three-day turnaround – it is still a hassle.”

Printing a titanium implant is possible, but costly. “At the minute it is mind-numbingly expensive,” says Malcolm. “The vast majority of builds are in thermoplastics. As soon as you start doing that with implantable titanium then the costs start to escalate. Purity is another issue.”

The fact that we are discussing it at all is a sign of 3D print’s growing maturity. Several additive manufacturing technologies developed throughout the seventies and subsequent decades are now included in the 3D print category. Some work on a simple inkjet printer principle to build objects layer by layer, others use lasers to fuse powdered metals or light to solidify liquid resin.

Gary Fenton, director at Formative Design, has worked in 3D print since its early incarnations, first in automotive design and now increasingly in medicine. “As an evaluation tool it is really useful,” he says. “Prototypes of tools or implants are sent to the surgeon so they can have them in hand and play with them.

“They can put implants up against the bone and see how they fit, get a feel for what it is like in the joint space. Cost is an issue, depending on the materials you are printing, but the biggest absolute issue is size – an object with twice the volume costs twice the price. If you are manufacturing big parts, then the cost can be ridiculous.”

Still, he feels the stage is set for expansion in UK practices and for the industry to improve on advanced applications such as biomaterial printing. “There is no commercial pressure yet but it is an interesting market. 3D print is a revolution waiting to happen in veterinary medicine.”

Malcolm Ness echoes his sentiments. Having seen the technology’s manufacturing potential up close on visits to his 3D print bureau in Huddersfield, he would like to see improved desktop technology.

“It is mind-blowing what you can do now,” he says. “We are thinking in terms of surgical instruments and tools, these guys are printing out working cutaways of engines. Technology is getting smaller and cheaper all the time, but it depends on how quickly that continues.”

For potential in bioprinting and regenerative medicine look no further than videos from the Wake Forest Institute and its advanced partnerships with the US military. But not all cutting-edge research requires defence-style budgets. Take a look online at a University of Glasgow project using 3D technology to print drugs.

Researchers used a system that costs just £1,250 to create a range of organic and inorganic compounds, some of which can be used to treat cancer. By mixing together compounds in the 3D printer, the team has substituted glassware with what it terms “reactionware”.

A robotically controlled syringe builds an object out of a gel-based “ink”, into which chemicals and catalysts are mixed. Though still only at “proof of concept” stage, they boldly predict the technique’s use by pharmaceutical firms in the next five years and public adoption within 20.

Long term it is hoped this process could be used to make customised medicines. “We are showing that you can take chemical constituents, pass them through a printer and create what is effectively a chemical synthesiser in which the reaction occurs, allowing you to get out something different at the end,” chemist Mark Symes told the BBC.

Ramifications for drug dispensing in combination with DNA testing herald a brave new world of designer drugs for sure, but how about the dispensing vet with a unit in the back of his or her vehicle on remote farm visits. A heady brew of convergent technologies and one where 3D print is a catalyst.

Price tags on expensive laser sintering machines aside (£100K anyone?), the latest desktop systems start at around £1,000. Why not plug and play, then trawl through vast online depositories such as Thingyverse or Shapeways. What have you to lose but your chains?

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