When a patient with a gunshot wound to the face came through the Level 1 trauma center at Tampa General Hospital a few months ago, it was up to Dr. Joshua Elston to try to reconstruct what had been shattered.
But putting the pieces back together after a traumatic injury can sometimes feel like trying to build a house without blueprints, said Elston, a plastic surgeon.
"When the boney landmarks are destroyed by an injury, it can be like guessing," he said. "You're really trying to build from nothing."
In this case, though, Elston was able to call on the expertise of Summer Decker, who directs the 3D Anatomical Modeling and Printing Division within the department of radiology at the University of South Florida's USF Health.
"Within 36 to 48 hours after I call Decker and her team, I'll have a 3-D print in my hands," Elston said. "I can use it to physically show a patient what I will do during surgery, and I use it as a template for reconstruction, including all the hardware with plates and screws."
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The use of 3-D printers in medicine is not new, but it's becoming more mainstream. The American Medical Association approved new 3-D printing billing codes that take effect this month, which means the cost of the service soon could be covered by more insurance reimbursements. And thanks to recent advancements in the technology, Decker and her team can print 3-D replicas in record time, making it much more useful in settings like the Tampa General operating room.
"Years ago, it was difficult to find doctors who would take the time to use the technology. It was mostly for research," Decker said. "But now the conversation has flipped. What we hear is, 'I won't touch this case until I've got the 3-D print.'"
Decker and a biomedical engineer, Jonathan Ford, make up the two-person team at USF. Together they man a unit inside the USF Health building across from Tampa General Hospital that is equipped with six 3-D printers, which are able to print body parts with precision.
These aren't the 3-D printers some hobby enthusiasts have their garage. They are sophisticated machines, Decker said. Scans using ultrasound, MRI and computerized tomography technology give physicians a good idea of what's going inside their patients, but the images are often grainy and not overly specific. Decker and Ford are able to plot the exact measurements of a heart, lung or skull, including any injuries or defects, into a computer to create a 3-D animation, and then print it out.
"We're training radiologists and lab techs on what kind of scans we need to make an accurate print, which makes all the difference," Decker said. "Once they know what kind of information we need, we can make an accurate model."
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Some of the printers use multiple materials, which means Decker can print a replica of a spine and use sponge-like, bendable material in between each vertebrae or for each heart valve. That makes it much more lifelike to work with, said Dr. Fadi Matar, a Tampa General cardiologist.
Matar is often working on patients with valve problems or holes in their hearts. Using a 3-D printed replica of the organ allows him to practice where he'll fit a valve replacement or go in with catheters or stents, before he goes into surgery to do the real thing.
"We're using the replicas for procedures that are so complex," Matar said. "It help us identify dangers or possible problems ahead of time. I can see how a valve may interact with the patient's anatomy before it happens. And if there's a problem, we can modify it."
Physicans are also using 3-D prints to show patients before and after success stories, using prints that show the stages of their recovery. And the cost is pretty cheap. Decker said she printed a replica of her skull, which cost about $9. This doesn't include the initial cost of the printers, which can run into the hundreds of thousands, if not millions, of dollars.
While Decker is a leader in 3-D printing research internationally, she also worked as an anthropologist and used the technology in forensics cases as well, including cold cases for the FBI, before receiving her doctorate in medicine at USF.
As the program has grown, Decker and Ford have worked on unique cases over the years with doctors at Moffitt Cancer Center, Johns Hopkins All Children's Hospital, St. Joseph's Hospital and even with veterinarians at Busch Gardens and the Florida Aquarium. They've even 3-D printed the skull of a baby sloth and the leg of a penguin.
"Sometimes I get a couple of weird looks when I'm walking across the street to the hospital with a 3-D printed heart in my hand," Decker said.
USF's program is unique, in that is located on the campus of a major hospital. But it's location makes it available to doctors when in need.
"I've used 3-D prints with patients that had severe facial injuries. If it wasn't available, I could guarantee bad outcomes for these patients," Elston, the plastic surgeon, said. "Having the technology is like having a blueprint that wasn't there before."
Contact Justine Griffin at firstname.lastname@example.org or (727) 893-8467. Follow @SunBizGriffin.