3D printing is now at the heart of lifesaving surgery

For the first time in Kenya, doctors at Kenyatta National Hospital managed to separate conjoined twins. 

This was one of the first such operations successfully done at a hospital in sub-Saharan Africa (see another one here), and it was possible in part because of 3D printing.

Dr Fred Kambuni, the lead surgeon, said that a 3D printed model helped his team of medics conduct the delicate spinal surgical interventions without experiencing any complications. The model was developed from the patients’ CT scan data, giving the doctors a valuable understanding of the problem.

With the model providing graphic and tangible input on the patients’ actual situation, doctors rehearsed the procedure in advance and completely eliminated the risk of unanticipated variables on the operating table.

Whilst Dr Kambuni and team were celebrating their 26-hour success, doctors in New York’s Children's Hospital at Montefiore Medical Center in the Bronx were starting an even more complex operation to separate conjoined twins, this time joined at the head. 

Again, using 3D printing, they managed to separate the twins and to rebuild their skulls in a successful procedure lasting 27 hours.

The use of 3D printing as a disruptive technology and alternative to traditional manufacturing processes has grown rapidly over the past five years. The International Data Corporation (IDC) estimates that worldwide, spending on 3D printing is expected to surpass $35 billion in 2020, and has a year-on-year growth rate of  25 per cent.

The origins of 3D printing were in industrial prototyping, allowing many inventors to create many versions of a product faster and arrive at the desired product more efficiently. The applications for 3D printing are wide-ranging, and are most prevalent in the medical, aerospace, automotive, jewellery, art, architecture, fashion and food sectors.

STERILE MODELS

3D printing in the medical sector has seen some of the largest growth. It is changing the landscape of how medical institutions provide patient care and helping to reduce operational costs. 

Implants for the body are now 3D custom-printed in a wide variety of materials, including titanium, and 3D printed medical devices are improving patient care and being used for pre-surgical assessment and planning.

The future is now moving heavily towards 3D bio-printing of human organs and limbs.

3D LifePrints is a local company that realised the potential benefits of 3D printing. It was formed three years ago by a Nairobi-based team of social entrepreneurs, engineers and clinicians. Their initial focus was to develop a low-cost, durable and patient-specific prosthetics for amputees.

Their services have helped patients across Kenya and neighbouring countries who would otherwise have had no access or finances to obtain a prosthetic, impeding their ability to lead a more normal life again.

They continue to evolve their designs and create sustainable operational frameworks utilising local medical institutions and resources.

Additionally, 3D LifePrints is looking to set up telemedicine ecosystems in the region, where patients who have difficulties accessing medical facilities can access medical knowledge repositories and have voice and video calls with doctors to assess their conditions.

This will be in conjunction with mobile money operators and incumbent telecommunication providers.

3D LifePrints has subsequently branched out to work with the UK's National Health Service, one of the world's largest medical institutions with over one million employees and a budget in excess of $150 billion. 

With the NHS, they have developed a countrywide eco-system that uses MRI and CT scans to create patient-specific 3D-printed anatomical medical models.

Through the provision of these models to assist surgeons in assessment and planning of patient cases, operational costs have been lowered while ultimately improving patient care and lowering rehabilitation times.

It costs around $2,000 per hour to run an operating theatre and the use of a model can reduce these costs by over 10 per cent, as less time is spent in the theatre.

3D-printed models, in a variety of hard and soft materials, are also used to train doctors and surgeons on surgical procedures in a highly realistic manner.

JUNIOR DOCTORS

In a recent example, the UK’s 3D LifePrints created a life-sized 3D-printed replica model of a spine from the CT scan of an eight-year-old child.

This model was sterilised and used by specialised children's orthopaedic surgeons in the operating theatre to guide the team during a procedure to correct a complex congenital spinal problem called kyphoscoliosis. See pictures below.

Senior surgeon Jai Trivedi said: “There is no doubt the model made this complex procedure operation much safer as it allowed for accurate pre-operative planning and implementation at surgery. Sterile models that can be held during an operation should prove helpful for other surgeons.”

Kenya has fast become one of the most innovative countries in Sub-Saharan Africa, with the world's largest market for mobile money systems.  

It has the opportunity to be one of the first nations on the continent to truly harness the power of 3D printing and continue to be a technology leader. 

3D LifePrints is looking to replicate their UK-based model of providing 3D-printed medical models and medical devices in medical institutions across the country, providing cost-saving benefits to hospitals and improving patient care for every Kenyan who needs treatment.

The benefits for hospitals using 3D models before surgery are many, including practical pre-operation simulation of complex cases, training of junior doctors without putting patients at risk and lowered costs for surgical planning. 

For the country to fully utilise this transformative technology, capacity building around it is essential, ranging from radiologists who will develop computer images of the patient to doctors utilising them. 

Either way, 3D printing must become a regular tool in our hospitals in order to minimise the mistakes that often creep up in complex operations.

3D printing has been proven to be effective in dealing with congenital heart diseases (CHD) that are more prevalent in Africa. 

A recent study titled “Congenital heart disease and rheumatic heart disease in Africa: recent advances and current priorities”concluded that Africa continues to carry the heavy burden of Rheumatic Heart Diseases (RHD) in children and young adults while access to appropriate management of CHD, including simple defects, remains to be addressed.

New data confirms a high prevalence of subclinical RHD in studies from Uganda, Senegal and Mozambique. These problems are opportunities that Kenya must seize to create an African hub for advanced technology in healthcare. 

It is a shame that after more than 50 years of independence, we continue to look to India for all manner of interventions in healthcare. There is a compelling reason to develop local capacity to handle African health problems.

Kenyans continue to demonstrate the capacity to leverage technology and solve big problems but we need to support such initiatives, build massive capacity in our abundant youth and scale the solutions. 

New technologies like 3D printing present a great opportunity to build the much-needed confidence to take Africa to the next level.

The writer is an associate professor at University of Nairobi’s School of Business. Twitter @bantigito