October 29, 2015

When I attended Gigtank in Chattanooga last year, I was exposed to, not only a beautiful city and beautiful people, but exciting new 3D printing startups.  Among the most viable businesses was a company called 3D Operations, Inc., which was planning to use the city’s ultra-fast (just made even ultra-faster) 10 gigabit internet to convert medical scans into patient-specific 3D printable models for surgical preparation.  After carefully laying out their business model and taking on beta testers, 3D Ops has made a huge move, both for the firm itself and for the medical industry worldwide. The startup is partnering with the Erlanger Health System in Tennessee to conduct the world’s first hospital-wide study of how patient-specific, 3D printed models aid in surgical preparation.

Erlanger Health System 3D printed medical model study 3d ops

To my knowledge, there has so far been one other peer-reviewed study about how 3D printed models reduce surgery times and complications by preparing surgeons before they enter the operating theater. The 3D Ops study, however, will encompass every surgical department at Chattanooga’s Erlanger Health System, the seventh largest public hospital in the United States.  Over the course of the next six months, 3D Ops will work with Erlanger to 3D print models from MRI and CT scans ahead of surgical procedures to empirically determine just how much these patient-specific representations are in practicing and planning surgeries. Keith Campbell, President of 3D Ops, elaborates, “The results of this extensive study will clearly establish the value of 3D printing in improving patient outcomes. We believe these efforts will positively impact the lives of thousands of patients and their families.”

3D Ops 3D printed surgical models

Though there are other businesses out there working to provide 3D printed models for surgical preparation, 3D Ops has the benefit of using Chattanooga’s 10 gigabit internet, upgraded from 1 gigabit two weeks ago.  Now, for $299 per month, businesses and residents alike can obtain internet speeds ten times faster than Google Fiber, the much-anticipated fiber network to be soon rolled out in neighboring Nashville. This comes after years of legal battle between Chattanooga’s municipally-owned Electric Power Board, which was hoping to bring its high-speed internet to undeserved communities just outside of their jurisdiction, and traditional ISPs like Comcast, which didn’t see the economic incentive to serve those rural communities.

With the largest high speed internet network in the world, ahead of Vermont and North Carolina’s 10 gig internet in terms of size, Chattanooga is now able to provide startups like 3D Ops unparalleled service in the transmission of huge amounts of data, ideal for transferring massive CT and MRI scan data, as well as 3D models, according to the President of 3D Ops.  “Well, you may have heard that our Electric Power Board, EPB, announced two weeks ago that our Gig to every home has been upgraded,” Campbell says.“We now have the ability for 10Gig connectivity links. For our needs, each imaging file is very high resolution, which are very large files. Bandwidth availability is critical to our operation, especially when multiple files are being transmitted to 3D Ops simultaneously. Chattanooga’s powerful network makes any of the old bandwidth constraints vanish.”

3D Ops scan to 3D print process

In addition to high-speed data transfer, 3D Ops has been developing its business model for some time, seeking the right technology to fabricate its 3D models.  Campbell explains, “We currently use SLA and Multi/PolyJet. One of the advantages of our business model is that we are printer technology agnostic. Based on surgeon needs/preferences, we can use any printing technology to achieve the desired results. An example, recently, a surgeon wanted a model with two colors, one of which was clear. We used the Stratasys Connex technology to achieve that.”

But the 3D Ops President adds that they are further improving their business on the software and hardware side of things. “We have patents pending on our automated conversion software tools and are currently in the process of developing proprietary software to create the models automatically.” He continues. “Additionally, we will be testing two printers during the pilot that promise much faster printing while delivering some very interesting new materials that have great potential for pre-surgical planning.”

3D Ops 3D printed surgical brain models

Expanding on previous work achieved by such medically-focused 3D printing firms as Materialise and the peer-reviewed study mentioned above, which 3D printed kidney models in five different cases, the Erlanger study will lay the foundation for standards and protocols for converting medical data to 3D printed models.  As 3D printed medical models are relatively new to the field of medicine, creating such standards is essential for such a critical field.

“One of our main focus components of the pilot is to clearly identify the optimal imaging protocols and settings that deliver the best and most useful 3D printable files. Optimal quality of each model is required and it starts with the initial images,” says Campbell. “The imaging protocols have to be established by anatomy types, specific surgery types per anatomy, and by different imaging units. There are many types of imaging units, MRI by vendors, CT Scanning units by vendors, etc. The protocols for each, at least the most widely used units, are very important to ultimately deliver the best and most useful models to the surgeons.”

3D Ops 3D printed surgical heart models

He continues, “Our joint pilot with Erlanger will simultaneously study the needs of every surgical department and anatomy type. We will quantify many aspects of need and benefit for each type of surgery, with one of the main lessons expected being what types of surgeries are benefited the most and how. The focus of our whole study is to enhance patient outcomes and clearly add to the value of delivered surgical healthcare.” Elaborating on the distinction from the peer-reviewed study, Campbell says, “We will also be evaluating the benefits of 3D printing patient-specific models to patient and patient family communication in pre- and post-surgery. Additionally, our study will also include a larger sample set than the referenced study over a larger range of surgical specialties. If we get enough patient data in any specific area, we can possibly determine statistical significance of using models over not.”

While the study will certainly benefit 3D Ops, establishing the startup as a pioneer in the field of 3D printing for surgical preparation, it will also benefit the Erlanger Health System, placing the hospital at head of a cutting edge practice that will surely be implemented in hospitals worldwide.  Naturally, the hospital is excited about the ability to contribute to this groundbreaking study. Blaise Baxter, MD, of Tennessee Interventional and Imaging Associates, Erlanger’s imaging team, contributes in a press release, “We want to greatly reduce or eliminate exploratory surgery by using this amazing technology in pre-surgery planning.” Kevin M. Spiegel, FACHE, President and CEO of Erlanger Health System, adds, “We are thrilled to be working at the forefront of this revolutionary technology with 3D Ops. There is no question 3D printing will change the way surgeons plan for their procedures, improve patient satisfaction and outcomes, and enhance medical training at hospitals around the world.”

If doctors have had any doubt as to the efficacy of using 3D printed, patient-specific models for rehearsing and planning surgeries, or for medical education, this study is likely to change their minds six months from now. And, soon, hospitals will be the next big institutions to request in-house 3D printers in order to keep up with the rest of those in their field and, more importantly, improve the care of their patients.


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