Posts made in August, 2014


Additive manufacturing, or 3D printing, as it is more commonly known, is being used to produce everything from food to guns to jewelry and clothing. If that isn’t incredible enough, the medical community has been using 3D technology to manufacture human body parts, including skulls, spinal inserts, and other bones, as well as facial prostheses and breast implants for cancer patients. Human organs are even on the horizon, and that could mean the end of organ donor waiting lists. Welcome to the future of medicine.

 

Printing Bones

The obvious advantage to using 3D technology to print human bone replacements is that the procedure itself allows for the bone’s internal structure to be mimicked in a way that makes the replacement part as resilient and light as the original. The bone can can also be printed to perfectly match the break. Additionally, since 3D body parts that are made from titanium or the patient’s own cell tissue will not cause adverse allergic reactions, they will not be rejected by the body. This technology is being used in hospitals and research centers around the world, from Italy to the Netherlands, and the Walter Reed National Military Medical Center in Bethesda, Maryland even has its own 3-D Medical Applications Center devoted to everything from orthopedics to dentistry and craniofacial reconstruction.

As recently as 2012, spinal implants were in the clinical trial stage at Peking University in Beijing where surgeons implanted 3D-printed titanium spinal implants into 50 patients. One year later, team leader, Dr. Liu Zhongjun, reported that all of their trial patients had recovered well with no “undesirable side effects or adverse reactions”, according to an article posted at www.engineering.com. Fast forward to August 2014 and Dr. Zhongjun and his team have successfully implanted the first 3D-printed spine vertebrae into a 12-yr old boy suffering from Ewing’s sarcoma, a type of rare bone cancer. Medical advancements have sure come a long way, but researchers aren’t finished yet.

 

Human Organs

In April 2013, Organovo, a company that designs “functional human tissue”, produced 3D human liver tissue that retained its function for more than five days. Just six months later, in October 2013, Organovo issued a press release indicating that they were able to extend that timeframe to 40 days. In a period of only six months, Organovo increased the functional longevity of their 3D-printed liver tissue by an astonishing 800%.

Researchers from Harvard University and Sydney, Australia have collaborated on a medical breakthrough that just may lead the way toward the printing of fully functional 3D organs. They have developed nutrient and oxygen-delivering capillaries using the 3D printing process. These tiny vessels allow 3D organs to excrete waste, which, along with the nutrients and oxygen, will allow the organ cells to grow and thrive. Researchers believe that full-sized, fully functioning human organs may be years away from being a reality, however, given the accelerated pace of the research done by Organovo, Harvard and Sydney, among others, the timetable may be overly cautious.

Organ donor lists may one day be a thing of the past, which is lifesaving news for the more than 100,000 people who are on the list at any given time in the United States alone. What researchers have been able to accomplish already, though, is astonishing. 3D printed body parts is a futuristic concept that may leave some people feeling a bit uneasy. However, for those whose health and lives have and will be positively impacted, the future of medicine couldn’t have come soon enough.

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When an airplane crashes, the rush is on to find the black box. This is a recording device that can help investigators piece together what happened to cause the accident. A similar device recently was developed for use in the operating room. The researchers behind the device hope it prevents medical malpractice and improves patient outcomes much in the same way it aids in airline safety and accident investigations.

Reducing the rate of surgical errors is an important cause. A 2012 study from Johns Hopkins University found that such mistakes, known as “never events”, happen at least 4,000 times each year. These mistakes include wrong site surgeries, performing the wrong procedure and leaving foreign objects behind in a patient. By helping medical professionals to understand why these seemingly simple mistakes happen, a black box could help surgeons reduce their occurrence.

Black Box Prototype Tested at Three Hospitals

HealthCanal.com reports that Dr. Teodor Grancharov, who specializes in minimally invasive surgical procedures, developed the box where he works at St. Michael’s Hospital in Toronto. Up to this point, the device has been tested at the facility and two additional hospitals in Denmark.

It is about the size of a cable box. The device records everything that goes on in the operating room much like a black box on an airplane records everything that goes on in the cockpit.

The device captures any video from scopes inserted into the body. It also captures the room temperature, patient vitals, decibel levels and conversations among different healthcare workers in the operating room.

For now, the device works only for minimally invasive procedures such as those using small laparoscopic incisions. However, the hope is that its use will be expanded to a wider range of surgical procedures.

The goal is to have a documented account of everything that takes place during a surgery. Understanding where errors happen can help doctors and hospitals prevent additional mistakes and develop training and education.

Dr. Grantcharov says that developers of the black box are looking for performance issues. For example, did a surgeon apply an incorrect technique during an operation? They are also looking at “less tangible” factors that can contribute to surgical errors such as miscommunication between members of the operating team.

In addition to providing surgeons and hospital officials with information on how to improve patient safety, such devices could give medical malpractice victims important evidence of negligence if a mistake results in serious personal harm.

Your Role in Preventing Surgical Errors

While the development of a black box for surgical procedures is a promising advance in patient safety, it may be a long time before such a device is widely used and its benefits are realized in terms of preventing surgical errors.

For now, if you are undergoing surgery, you can take steps to help protect yourself. The Joint Commission (pdf), an organization that accredits healthcare agencies and promotes patient safety, offers the following tips for patients:

  • Ask your doctor detailed questions about the surgery before it occurs.
  • Ask for detailed pre-op instructions regarding meals, water, medications, make-up, nail trimming and other preparations you should make before the day of surgery.
  • Write down any questions you may have as you prepare for surgery.
  • Bring someone you trust with you on your operation day and tell them your concerns as they will be your advocate if you are unable to speak or communicate.
  • Make sure all information on consent forms is correct before signing them. Ask questions if you have any before you sign the forms.
  • Make sure markings put on your body for the surgery are in the right place.
  • Ask your surgeon if the team will take a “time out” before your operation.

The outcome of a surgery may not be your responsibility but rather that of the surgeon and team attending to you. Still, speak up if you have questions and hold your healthcare providers accountable for any errors or problems you may experience.

Submitted by Powers & Santola, LLP

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