OCTOBER 11, 2014

Anastasia Rivas plans to learn to use her Robohand to ride a bike.
Anastasia Rivas plans to learn to use her Robohand to ride a bike.(Ben Baker for Parade)
By Jessica Winter

Like a lot of kids her age, 10-year-old Anastasia Rivas has energy to burn, playing softball and cheerleading and wrestling with her little brother at home in North Bergen, N.J. And unlike a lot of her peers, she also likes to help out around the house—carrying the groceries in after a supermarket trip, for instance. All those activities and much more have recently become a lot easier, because Anastasia now has a left hand—albeit one made out of plastic, elastic cords, and stainless-steel hardware.

Anastasia was born with amniotic band syndrome, in which strands of amniotic membrane get attached to and tangled up with the fetus; the condition leads to congenital abnormalities. In Anastasia’s case, her left arm ends in a tiny, partial palm and buttonlike buds of fingers. A standard prosthesis could run upward of $60,000, and a fast-growing kid like her could outgrow it every six to eight months, creating astronomical expenses.

Ben Baker for Parade
Anastasia with her brother, Giovanni; her mom (left), and her grandmother. (Ben Baker for Parade)
As a result, “traditional prostheses weren’t an avenue that we considered for Anastasia at this stage of her life,” says Wanda Oliveras, Anastasia’s grandmother. But then Oliveras saw a story on her Facebook news feed about a prosthesis that can be cheaply produced and repaired, called a Robohand. “We couldn’t contain our excitement,” says Oliveras. “We thought we could finally get a prosthetic device that could allow Anastasia to use fingers to pick up and grab things.” Anastasia’s new hand (she requested it in bright blue, in homage to her stepfather’s favorite football team, the New York Giants) ran just $2,000, and it can be replaced at a fraction of that cost.

How is this possible? Because Anastasia’s hand is created with a 3-D printer, which can build a three-dimensional object by laying down ultrathin layers of material, one at a time. Her hand is one of about 200 such prostheses that have been printed using a design perfected by Richard Van As, a South ­African carpenter who lost four fingers in a circular saw accident. Ty Esham, a hand therapist in Decatur, Ga., who studied under Van As, is the crafter of Anastasia’s ­Robohand, and she can ­cheaply produce most of its plastic components—the digits, the block of knuckles, the wrist hinge—with her desktop 3-D printer, the MakerBot Replicator 2.

Though the technology ­behind 3-D printing has been around since the 1980s, only in the past couple of years has it become possible to ­re-create more commonly found objects of everyday life. The first 3-D-printed book jacket (for Chang-rae Lee’s best seller On Such a Full Sea) could be found on bookshelves, and 3-D-printed ­custom toys, jewelry, or iPhone cases can be purchased online. There’s now even a DIY aspect of 3-D printing: Thousands of digital designs are available on ­Thingiverse.com, where ­anyone can download the blueprint to print out objects from chess pieces to napkin rings to World of Warcraft characters.

The technology has the ­potential to alter—even revolutionize—dozens of industries, from small-batch manufacturing to aerospace engineering, from prosthetics to reconstructive surgery and beyond. Within a decade, ­surgeons might even use 3-D printing to build organs for transplants and to harvest new nerve cells.

How It Works

A sweet aroma is always wafting around the MakerBot store in New York’s SoHo neighborhood. The scent emanates from the humming printers themselves, which use not ink but spools of polylactic acid (PLA) filament, a bioplastic derived from corn. “We’ll have ­classes here on a Saturday morning with machines running, and people will say, ‘It smells like waffles,’ ” says Jenifer Howard, MakerBot’s PR director.

Courtesy of Makerbot
he 3-D printer Makerbot Replicator 2 was used to print Anastasia’s Robohand. (Courtesy of Makerbot)
What exactly are those syrup-scented machines doing? Whether it’s happening at the industrial ­level, in a medical lab, or on a desktop, 3-D printing follows the same process. It starts with a blueprint created in a 3-D digital modeling program. Taking instructions from those digital files, the 3-D printer builds the object by laying down one superthin layer at a time of the material at hand, which could be anything from metal to plastic, ­ceramics to food purees to human cells. With MakerBot’s desktop 3-D printers, the PLA filament is spooled like cable in the back of the machine and fed into the machine’s extruder, which heats up the material to make it pliable and passes it through a tiny hole to “draw” the object, layer by layer, which can take anywhere from a few hours to a couple of days.

Three-dimensional printing originated in the mid-1980s with Charles Hull, inventor of a layer-by-layer manufacturing process he called stereolithography, which could be used for rapid prototyping and for small-batch production of specialized parts. Since then, the technology has been a mainstay of fields such as aerospace and automotive engineering, but it wasn’t until MakerBot arrived on the scene in 2009 that the notion of personal 3-D ­printing gained a foothold, along with the emergence of Thingiverse and, just this past summer, the opening of Amazon’s 3-D printing store.

In fact, MakerBot has become one of the most important players in the field, thanks to its relatively low-cost desktop printers (Ty ­Esham’s version costs under $2,000, compared to industrial models that can run $100,000 or more) and the passion of MakerBot’s CEO and cofounder, Bre Pettis. In February at the University of Louisville’s engineering school, an exact 3-D model of an ailing 14-month-old’s heart was created on a MakerBot printer. The ­baby’s medical team used the model to plan his life-saving surgery. And in August, images of a disabled Chihuahua named TurboRoo zipping around in his new 3-D-­printed wheeled cart went viral even before he was featured on the Today show.

A New Tool In the Classroom—And the Factory

A former K–8 teacher in ­Seattle, Pettis wants to put a printer in every K–12 school in the U.S. “When I was growing up,” he says, “there was an Apple IIe in the classroom, and if you were a nerd, you were taking it apart. That was probably the most important part of the education—it had nothing to do with what was on the test that day.”
Pettis thinks the MakerBot can be the Apple IIe of the 21st-century classroom, re-inserting an element of hands-on tinkering into a test-obsessed curriculum. “The students who get these printers start seeing the physical world differently, they start designing stuff, they’re activated as entrepreneurs, they start making and selling, say, iPhone cases with the school’s logo on them—and it all takes off from there,” says Pettis.

Three-dimensional printers are also becoming a mainstay on college ­campuses, such as Case Western Reserve University, home to an innovation center open to both students and members of the public called the think

. “It psyches the students up about things it’s hard to get them psyched about,” says James McGuffin-Cawley, Ph.D., chairman of materials science and engineering at Case Western. “Maybe they’re not excited about figuring out the glass transition temperature of a thermoplastic polymer. But if you’re having a difficult time trying to make something cool [with a 3-D printer], the faculty member who can explain it becomes someone you’d like to spend time with. It creates a motivated learner.”

Some even envision a future in which there’s a 3-D printer in every kitchen, printing our dinners and cabinet hinges, but most industry experts remain skeptical. “Industrial printing is where it’s at,” says Terry Wohlers, president of Wohlers Associates, a Fort Collins, Co.–based consulting firm that specializes in the 3-D printing industry. “The desktop printers are good for schools and education, for prototypes and models. But if you’re talking about a $1,500 machine as opposed to a $150,000 machine, the results are vastly different. I don’t see a future where we’re all just printing what we need at home and manufacturing goes away.”

Instead, 3-D printing will more likely enhance and advance traditional manufacturing. Mark Deadrick, who built TurboRoo’s cart and is president of the San Diego–based industrial design firm 3dyn, first encountered the technology 20 years ago as an auto ­engineer in Detroit, where Chrysler was 3-D-printing prototypes of engine blocks. Boeing has had tens of thousands of 3-D-printed parts in the air for years. And in what was seen as an industry bellwether, GE Aviation bought the additive-manufacturing company Morris Technologies in 2012 to make 3-D-printed parts for jet engines. “I strongly believe this technology will help create tens of thousands of new companies and jobs in the U.S. and abroad,” Wohlers says. “In fact, we’re seeing it happen.”

A Medical Revolution

By far the most exciting ways in which 3-D printing is being used are in the medical field. Across the U.S., research teams have been making rapid progress in 3-D-printing a bewildering array of human body parts: ear cartilage and muscle tissue; skin, skulls, and bones; organs large and small.

“It’s nuts!” says Faiz Bhora, M.D., chief of thoracic surgery at Mount Sinai Roosevelt and St. Luke’s Hospitals, whose team is working toward a breakthrough: the first 3-D-printed tracheas to be successfully implanted in humans. “I think within five years, we are going to see parts of 3-D-printed organs being implanted, as well as things like jawbones, tibia bones—things that are not very complicated and where failure is not usually catastrophic. The next step up perhaps is tubes and ­cylinders—the airway, perhaps, the ureters, arteries, veins. The third tier will be whole organs, heart valves, maybe parts of the kidneys, nerve cells.

“We’re going to get to a point,” Bhora says, “where if you have a defect in an organ, you’ll just get a new one. Imagine: You’re 40 years old, and you can print the same organ you had when you were 21. It’s like a car: You fix it a couple times, and then you realize it’s cost-effective to replace the part.”

“The process is the same no matter what we’re making,” says Anthony Atala, M.D., of the Wake Forest Baptist Medical Center’s Institute for Regenerative Medicine. “We take a very small piece of tissue from the ­patient’s organ—less than half the size of a postage stamp—then tease that tissue apart to its individual cell components.” ­After a month or so spent growing those cells in a lab, they’re combined with a gel and fed into the printing cartridge. “We can then print the tissue layer by ­layer—imagine an ink-jet ­printer, but instead of ink, it’s printing cells. You lay down a layer of scaffold, then a layer of cells so that the 3-D shape is formed, like baking a layer cake.”

Because the cells are har­vested from the patient’s own body, 3-D-printed implants would present far fewer risks in terms of transplant rejection. They also open up a host of ­research and treatment possibilities beyond transplants. “We can create tissues and organs to test drugs for toxicity, for ­example,” Atala says. “Or we can think about what we can do for burn victims—we’d be able to scan the wound so that the cells could be placed where they need to be.”

Jonathan Phillips, capturelifethroughtime.com
In her office in Decatur, Ga., Ty Esham makes adjustments to Anastasia’s Robohand. (Jonathan Phillips, capturelifethroughtime.com)
Customization is also key. “It’s particularly important in the pediatric age group. In most pediatric operations that require implants, we’re just using the smallest possible adult sizes and trying to make that work,” Bhora says. “One of the biggest advantages of 3-D printing is the ability to customize an organ for the patient.”

And Anastasia Rivas is benefitting from that customization. Her new hand is not as sophisticated as many tradi­tional prostheses—she can close only all fingers at once, not a digit at a time. But the Robohand has other benefits. “If she outgrows it, we can print another,” Esham says. “If she breaks it, it’s easy to fix. There are no batteries to recharge. She can get her hand wet and dirty; you can’t do that with the expensive prosthetic hands, even though getting wet and dirty is what hands do! 3-D printing gives you something lightweight, cheap, and functional.”

“The kids at school think my Robohand is really cool,” says Anastasia, who recently started fifth grade. “Now I can pick up my eyeglass case, and I can pick up a pencil, although that is still hard to do—I keep practicing.” Anastasia also wants to practice using the hand to play baseball and basketball and to ride her bike. As far as Anastasia’s grandmother, Wanda Oliveras, is concerned, the sky is the limit, and she’s as bullish as anyone on the future of the technology.

“I will be counting on Ty as Anastasia grows, so that someday she will feel like she has two hands like anyone else,” Oliveras says. “Our relationship with these machines is going to be a lifelong relationship.”


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