As a surgeon, how can I not be excited by the promise 3D printing technology offers my patients?
3D printing uses computer control to add layers of a material to create a 3D object. Add to this the revolutionary technological changes occurring in bioprinting, where cell patterns can be printed while keeping the cells alive. This offers the promise of building individualised living tissue combined with precise anatomical control. 3D printing of biological materials from a bioprinter holds the promise of individualised, regenerative medicine.
One of the major limitations to date with 3D printing for medical use has been the need to print objects not only on a human scale, but also with the supporting framework necessary to allow the growth of blood vessels. This will provide the oxygenation and nutrition to support the new tissue. The 3D structure then needs to be surgically transplanted into the patient without damaging this delicate framework.
Currently, bio-printing is either scaffold-free, or scaffold-based. In scaffold-free bio-printing, tissues on a micro scale are precisely bio-printed to a given anatomical model. These tissues then grow and ‘self-assemble’ in the same manner as seen in embryonic development.
For my field of practice, I see the most promise in a scaffold-base method, which requires the use of bio-ink gel for cellular regeneration on the supporting scaffold. The cells contained in the bio-ink will then proliferate and mature in three dimensions across the scaffold. This technique will provide the framework not only for bone, but also for cartilage and muscle regeneration.
The ultimate goal is that, by using a tissue biopsy, a patient’s own stem cells would be isolated, or else other cells reprogrammed into stem cells. Once differentiated into the specific cells required, the a bio-ink can then be prepared. A 3D model is generated via MRI and CT scanning of the patient. A vascular network with supporting tissue then needs to be incorporated – or bio-printed – onto this model. Once the material has matured and is both functionally and mechanically stable, it would be transplanted into the patient.
In situ bio-printing – the direct printing of living tissue constructs into a deficit site in an operative setting – holds the promise of repairing a body part directly, using this technique. The technology may still in its infancy, but it holds a fascinating promise.
With the ongoing progress in 3D technology, I am sure the translation into clinical practise is not far away – and I hope that it will be into my clinical practice. The potential for indiviualised, regenerative medicine is enormous. As I said, how can I not be excited?