3D printing is a new technology that surgeons in veterinary and human medicine are using in conjunction with computed tomography (CT scans) for operational planning.
Dan Lewis DVM and Adam Biedrzycki discuss how the use of 3D printing for surgical planning, to develop surgical procedures and as a teaching tool in veterinary medicine, is enhancing patient outcomes in large and small animals.
Selected Podcast
The Next Dimension of Care: How 3D Printing is Advancing Veterinary Surgery in Large and Small Animals
Featuring:
Learn more about Dr. Lewis
Adam Biedrzycki, D.V.M., Ph.D. is an Assistant professor of large animal surgery, UF College of Veterinary Medicine.
Learn more about Adam Biedrzycki, D.V.M., Ph.D.
Dan Lewis, DVM | Adam Biedrzycki, D.V.M., Ph.D.
Dr. Lewis is the chief of the small animal orthopedic surgery service and has been a professor at our college for many years – a renowned leader in the area of orthopedic surgery for small animals. He has been the driver on many aspects of the 3D printing for operative planning in fracture repair and angular limb deformity corrections in small animals. A key component of this podcast will be the ways our large and small animal surgeons are collaborating and learning from each other as they aim to improve patient outcomes through surgery. Although Dr. Stan Kim, another faculty member involved in our initial story about 3D printing work, has also been very involved in this work, Dr. Lewis as leader of the small animal surgery service was recommended to speak to this topic.Learn more about Dr. Lewis
Adam Biedrzycki, D.V.M., Ph.D. is an Assistant professor of large animal surgery, UF College of Veterinary Medicine.
Learn more about Adam Biedrzycki, D.V.M., Ph.D.
Transcription:
Melanie Cole (Host): Welcome to UF Vet Med Voice with the University of Florida College of Veterinary Medicine. I'm Melanie Cole, and I invite you to listen as we explore the next dimension of care, how 3D printing is advancing veterinary surgery in large and small animals. Joining me in this physician round table panel is Dr. Adam Biedrzycki, he's an Assistant Professor of Large Animal surgery at the University of Florida College of Veterinary Medicine; and Dr. Dan Lewis, he's an eminent scholar and a Professor of Small Animal Surgery. He's also the Orthopedic Surgery Service Chief at the University of Florida College of Veterinary Medicine.
Gentlemen, I'm so glad to have you with us. This is an absolutely fascinating topic. Dr. Biedrzycki, I'd like to start with you. Can you tell us a little bit about the evolution of 3D printing and how it's being evolved for use in veterinary medicine?
Dr Adam Biedrzycki: Sure. Well, if you think about 3D printing, that's essentially seeing an object on a computer and sending it to a printer that can print something in three dimensions, as opposed to two dimensions like you see on paper. So in the past, a lot of 3D printers have been expensive and a lot of companies have held onto that technology. It's not really been available at a cost price for veterinary medicine. Certainly, the humans have been using it more than we have. But as time's gone on and those costs have come down and the advantages of 3D printing are becoming more evident, it becomes more accessible for animal patients, both large and small. But even so, it's not just like you can use any material, it's got to be biocompatible and there's various other things that we can do with the printer and the software that we have. So a lot of the evolutions come with enhanced cost benefits over time. And now, it's at a point where it's accessible for people to 3D print stuff for veterinary patients.
Melanie Cole (Host): Dr. Biedrzycki, sticking with you for just a second. You mentioned the benefits and the cost benefit ratio. What are some of the top benefits that you've seen of 3D printing for veterinary medicine ?
Dr Adam Biedrzycki: There's two things that it uses to save costs. So one of those is time. If you can plan something and execute the surgery more rapidly, you have quicker OR times, OR time's expensive. You have quickest surgery times. The patient's under anesthesia for a shorter period of time. So it accelerates a lot of those things so that it saves costs for the expense of things. Now, obviously there is a cost for doing a CT scan to get 3D images and for planning the surgery, which can all be done beforehand, but there is a cost with that.
The other advantage of it is, is that previously some surgeries were really kind of eyeballed, surgeons experience, best guess, kind of judgment for some thing. With the 3D planning, you can be very precise and accurate for whatever you want to achieve. And it gives you the advantage of rehearsing or practicing the surgery before you actually get into the patient. So, yes, there's a cost with 3D printing, but a lot of that cost is offset by patient outcomes and shorter OR surgery and recovery times.
Melanie Cole (Host): Dr. Lewis, I'd like you to expand for us about that operative planning for fracture repair and angular limb deformity corrections in small animals specifically. Tell us about the many aspects of 3D printing for this planning that's so interesting.
Dr Dan Lewis: Yeah. Well, initially when we started using 3D printing, what we did is basically print a deformed bone and then you could hold it in your hands and look at it. And actually, you know, say it's much different than looking at an x-ray that is a two-dimensional representation of a very complex deformity. But now, it's graduated to the point that what we can do is with the software that we use is very powerful and that we can actually perform a virtual surgical procedure on the computer and go ahead and correct the deformity in 3D and space. And then we can work backwards from our solution, our corrected bone, and we can create a series of guides that will help us perform our cuts in the bone and align the bone as we apply plates to go ahead and stabilize the bone definitively that allow it to heal.
So it's really just phenomenal technology that honestly like even 10 years ago, we couldn't really imagine that we could have this at our fingertips.
Melanie Cole (Host): It really is very cool. So I'd like to ask both of you, but Dr. Lewis, I'll kind of start with you. One of the key points of this podcast, I think, for other professionals is the way that you're large and small animal surgeons. Obviously, you and Dr. Biedrzycki are working together and collaborating and learning from each other as you aim to improve patient outcomes through surgery in this multidisciplinary way. Dr. Lewis, how did this come about? Tell us about this collaboration.
Dr Dan Lewis: Well, it's kind of funny because I'm Adam's mentor and, as he's coming up through the ranks, he was kind of bouncing ideas off of me. And I said, "You need to find something unique that you can hang on to, that you can build your research program around." And we work with people in the College of Engineering and it kind of gravitated to the point that this would be a great area to get into.
So Adam was actually the one that got the software, got the 3D printers and got the ball rolling. And then he serves on some of our resident's graduate committees and one of our residents started doing a project with Adam's guidance to look at the utility of using that software in 3D printing to perform complex hip replacements. And from there, it just grew and the collaboration grew. And now, we plan multiple cases each month where we utilize the computers and the printers in his labs to do small animal surgeries.
Melanie Cole (Host): Well, then Dr. Biedrzycki, can you expand on that a little bit about the collaboration and how you are using it as a teaching?
Dr Adam Biedrzycki: What I would add to what Dr. Lewis said, that at the UF College of Veterinary Medicine, we have really good collaborations with the Engineering Department, with the human hospital as well. We've utilized a lot of other departments here and we have a very good relationship with collaborations we do. In fact, after this podcast, Dr. Lewis and I have to go and operate together on a goat patient.
So the collaborations we have, it's a very good relationship and that benefits a lot of our patients. In regard to the teaching aspect with 3D printing, we have actually been offering here a medical 3D printing course to graduate students, which is usually attended by veterinary residents and interns who are going through graduate student programs.
But also we've had undergrads from animal science and from the engineering department who want to get more involved in not just 3D printing, but specifically the medical aspect of it. So they come over here and there's a course we do in the full semester where they go through CT scans, virtual surgeries, planning things, sending it to the printer, going through different iterations of design and what effects different surgeries have. So it's a really unique course in that regard. And it was very, very popular when we did offer it last time.
Melanie Cole (Host): And Dr. Lewis, as we've talked a little bit, we touched on the materials a little bit. Tell us anything interesting that you find absolutely fascinating about this, whether it's on the technique or the materials or developing these surgical planning and procedures, what would you like other providers to find as fascinating as you do about this technology?
Dr Dan Lewis: Well, I think that it's just a game changer, things that we just couldn't even conceive that we could do. We're currently involved with a project that we're doing with one of our residents where we will CT dogs with tibial fractures that come in and we'll take that CT and we'll feed it into the computer. We'll develop guides that can be applied to the tibias in surgery. And then we virtually can just slide a plate in through two incisions at the proximal and distal end of the bone and stabilize the fracture and the guides that we build will result in very acceptable alignment of the fractured limb and it's just amazing.
And right now, it's pretty time-consuming to construct the guides virtually and then print them and all that. But these are early days and, 10 years from now, there'll probably be an app on a phone that'll actually just scan the tibias and send them to the printer and you'll have your guides within, you know, an hour or two and you can go ahead and just align the fracture up. So it's just incredible how this is all evolving.
Melanie Cole (Host): I'd like to give you each a chance for a final thought. And Dr. Biedrzycki, starting with you, as this 3D printing is new technology and the veterinary surgeons are using this, as you've said in this podcast, absolutely so fascinating, tell us how you're using it in conjunction with CT scans and where you see this going in the future. Dr. Lewis just mentioned even possibly an app in the next 10 years. Where do you see this going in the future? What would you like to see happen?
Dr Adam Biedrzycki: I think one of the things that's kind of limiting us right now is probably some of the material costs. So the next kind of area, I think that will be accessible would be printing plates and various things in metal. Now, obviously that's a very specialized area, but it's something that is probably going to be coming down the road. And other things that we're looking at is using an AI or artificial intelligence platform.
Right now, you know, people come and design and kind of sit at the computer for hours, working on things. And it's something they're looking at in humans for things like knee replacement, is having an AI design the optimum guides and outcomes based on all the data it has.
So I think the AI part's going to be the big evolution for a lot of surgical planning. But I mean, the printers just print, they print, whatever you tell them, and they will be more accessible. But the next leap will be like Dr. Lewis is mentioning on an app, the automation of, "Hey, here's a fracture," five minutes later, the computers worked out this is what you need without the input from surgeon, which is still important at the end of the day, making sure the surgeon is comfortable with the plan, but automating a lot of these things will be a big part in increasing the throughput of the system. And again, making it more accessible to a lot more people. Anyone with a CT scanner, if you don't have a 3D printer, you could scan something, send it and the next day you get the guides or whatever you need to perform the surgery.
Melanie Cole (Host): Thank you so much. And Dr. Lewis, last word to you. What are some other exciting applications for this incredible technology that you see? And what would you like other providers to take away from this fascinating podcast and the exciting work that you're doing at the University of Florida College of Veterinary Medicine?
Dr Dan Lewis: This technology is only limited by people's imagination and what they can conceive that they can do with it. And I think there's numerous applications that it could be potentially used for in surgery. And I think that what needs to be done is to continue to work with engineers and other professionals that can accelerate the process. And that's I think where it's going to go.
Things that we're doing now, we're not even on the radar, even as recent as a decade ago. So there's unlimited applications for this and not just in orthopedics, IN soft tissue, neurosurgery, potentially in other aspects of medicine. It's just going to be a part of the culture now. And we can start to tack into what we have as far as the resources and just improve the delivery of the application.
Melanie Cole (Host): So interesting. Gentlemen, thank you so much for joining us and I hope you'll join us again and update us as you see some of these exciting things evolve in veterinary medicine. And to listen to more podcasts from the experts at the University of Florida College of Veterinary Medicine, you can always visit vetmed.ufl.edu.
That concludes today's episode of UF Vet Med Voice, brought to you by the University of Florida College of Veterinary Medicine, advancing animal, human and environmental health. I'm Melanie Cole.
Melanie Cole (Host): Welcome to UF Vet Med Voice with the University of Florida College of Veterinary Medicine. I'm Melanie Cole, and I invite you to listen as we explore the next dimension of care, how 3D printing is advancing veterinary surgery in large and small animals. Joining me in this physician round table panel is Dr. Adam Biedrzycki, he's an Assistant Professor of Large Animal surgery at the University of Florida College of Veterinary Medicine; and Dr. Dan Lewis, he's an eminent scholar and a Professor of Small Animal Surgery. He's also the Orthopedic Surgery Service Chief at the University of Florida College of Veterinary Medicine.
Gentlemen, I'm so glad to have you with us. This is an absolutely fascinating topic. Dr. Biedrzycki, I'd like to start with you. Can you tell us a little bit about the evolution of 3D printing and how it's being evolved for use in veterinary medicine?
Dr Adam Biedrzycki: Sure. Well, if you think about 3D printing, that's essentially seeing an object on a computer and sending it to a printer that can print something in three dimensions, as opposed to two dimensions like you see on paper. So in the past, a lot of 3D printers have been expensive and a lot of companies have held onto that technology. It's not really been available at a cost price for veterinary medicine. Certainly, the humans have been using it more than we have. But as time's gone on and those costs have come down and the advantages of 3D printing are becoming more evident, it becomes more accessible for animal patients, both large and small. But even so, it's not just like you can use any material, it's got to be biocompatible and there's various other things that we can do with the printer and the software that we have. So a lot of the evolutions come with enhanced cost benefits over time. And now, it's at a point where it's accessible for people to 3D print stuff for veterinary patients.
Melanie Cole (Host): Dr. Biedrzycki, sticking with you for just a second. You mentioned the benefits and the cost benefit ratio. What are some of the top benefits that you've seen of 3D printing for veterinary medicine ?
Dr Adam Biedrzycki: There's two things that it uses to save costs. So one of those is time. If you can plan something and execute the surgery more rapidly, you have quicker OR times, OR time's expensive. You have quickest surgery times. The patient's under anesthesia for a shorter period of time. So it accelerates a lot of those things so that it saves costs for the expense of things. Now, obviously there is a cost for doing a CT scan to get 3D images and for planning the surgery, which can all be done beforehand, but there is a cost with that.
The other advantage of it is, is that previously some surgeries were really kind of eyeballed, surgeons experience, best guess, kind of judgment for some thing. With the 3D planning, you can be very precise and accurate for whatever you want to achieve. And it gives you the advantage of rehearsing or practicing the surgery before you actually get into the patient. So, yes, there's a cost with 3D printing, but a lot of that cost is offset by patient outcomes and shorter OR surgery and recovery times.
Melanie Cole (Host): Dr. Lewis, I'd like you to expand for us about that operative planning for fracture repair and angular limb deformity corrections in small animals specifically. Tell us about the many aspects of 3D printing for this planning that's so interesting.
Dr Dan Lewis: Yeah. Well, initially when we started using 3D printing, what we did is basically print a deformed bone and then you could hold it in your hands and look at it. And actually, you know, say it's much different than looking at an x-ray that is a two-dimensional representation of a very complex deformity. But now, it's graduated to the point that what we can do is with the software that we use is very powerful and that we can actually perform a virtual surgical procedure on the computer and go ahead and correct the deformity in 3D and space. And then we can work backwards from our solution, our corrected bone, and we can create a series of guides that will help us perform our cuts in the bone and align the bone as we apply plates to go ahead and stabilize the bone definitively that allow it to heal.
So it's really just phenomenal technology that honestly like even 10 years ago, we couldn't really imagine that we could have this at our fingertips.
Melanie Cole (Host): It really is very cool. So I'd like to ask both of you, but Dr. Lewis, I'll kind of start with you. One of the key points of this podcast, I think, for other professionals is the way that you're large and small animal surgeons. Obviously, you and Dr. Biedrzycki are working together and collaborating and learning from each other as you aim to improve patient outcomes through surgery in this multidisciplinary way. Dr. Lewis, how did this come about? Tell us about this collaboration.
Dr Dan Lewis: Well, it's kind of funny because I'm Adam's mentor and, as he's coming up through the ranks, he was kind of bouncing ideas off of me. And I said, "You need to find something unique that you can hang on to, that you can build your research program around." And we work with people in the College of Engineering and it kind of gravitated to the point that this would be a great area to get into.
So Adam was actually the one that got the software, got the 3D printers and got the ball rolling. And then he serves on some of our resident's graduate committees and one of our residents started doing a project with Adam's guidance to look at the utility of using that software in 3D printing to perform complex hip replacements. And from there, it just grew and the collaboration grew. And now, we plan multiple cases each month where we utilize the computers and the printers in his labs to do small animal surgeries.
Melanie Cole (Host): Well, then Dr. Biedrzycki, can you expand on that a little bit about the collaboration and how you are using it as a teaching?
Dr Adam Biedrzycki: What I would add to what Dr. Lewis said, that at the UF College of Veterinary Medicine, we have really good collaborations with the Engineering Department, with the human hospital as well. We've utilized a lot of other departments here and we have a very good relationship with collaborations we do. In fact, after this podcast, Dr. Lewis and I have to go and operate together on a goat patient.
So the collaborations we have, it's a very good relationship and that benefits a lot of our patients. In regard to the teaching aspect with 3D printing, we have actually been offering here a medical 3D printing course to graduate students, which is usually attended by veterinary residents and interns who are going through graduate student programs.
But also we've had undergrads from animal science and from the engineering department who want to get more involved in not just 3D printing, but specifically the medical aspect of it. So they come over here and there's a course we do in the full semester where they go through CT scans, virtual surgeries, planning things, sending it to the printer, going through different iterations of design and what effects different surgeries have. So it's a really unique course in that regard. And it was very, very popular when we did offer it last time.
Melanie Cole (Host): And Dr. Lewis, as we've talked a little bit, we touched on the materials a little bit. Tell us anything interesting that you find absolutely fascinating about this, whether it's on the technique or the materials or developing these surgical planning and procedures, what would you like other providers to find as fascinating as you do about this technology?
Dr Dan Lewis: Well, I think that it's just a game changer, things that we just couldn't even conceive that we could do. We're currently involved with a project that we're doing with one of our residents where we will CT dogs with tibial fractures that come in and we'll take that CT and we'll feed it into the computer. We'll develop guides that can be applied to the tibias in surgery. And then we virtually can just slide a plate in through two incisions at the proximal and distal end of the bone and stabilize the fracture and the guides that we build will result in very acceptable alignment of the fractured limb and it's just amazing.
And right now, it's pretty time-consuming to construct the guides virtually and then print them and all that. But these are early days and, 10 years from now, there'll probably be an app on a phone that'll actually just scan the tibias and send them to the printer and you'll have your guides within, you know, an hour or two and you can go ahead and just align the fracture up. So it's just incredible how this is all evolving.
Melanie Cole (Host): I'd like to give you each a chance for a final thought. And Dr. Biedrzycki, starting with you, as this 3D printing is new technology and the veterinary surgeons are using this, as you've said in this podcast, absolutely so fascinating, tell us how you're using it in conjunction with CT scans and where you see this going in the future. Dr. Lewis just mentioned even possibly an app in the next 10 years. Where do you see this going in the future? What would you like to see happen?
Dr Adam Biedrzycki: I think one of the things that's kind of limiting us right now is probably some of the material costs. So the next kind of area, I think that will be accessible would be printing plates and various things in metal. Now, obviously that's a very specialized area, but it's something that is probably going to be coming down the road. And other things that we're looking at is using an AI or artificial intelligence platform.
Right now, you know, people come and design and kind of sit at the computer for hours, working on things. And it's something they're looking at in humans for things like knee replacement, is having an AI design the optimum guides and outcomes based on all the data it has.
So I think the AI part's going to be the big evolution for a lot of surgical planning. But I mean, the printers just print, they print, whatever you tell them, and they will be more accessible. But the next leap will be like Dr. Lewis is mentioning on an app, the automation of, "Hey, here's a fracture," five minutes later, the computers worked out this is what you need without the input from surgeon, which is still important at the end of the day, making sure the surgeon is comfortable with the plan, but automating a lot of these things will be a big part in increasing the throughput of the system. And again, making it more accessible to a lot more people. Anyone with a CT scanner, if you don't have a 3D printer, you could scan something, send it and the next day you get the guides or whatever you need to perform the surgery.
Melanie Cole (Host): Thank you so much. And Dr. Lewis, last word to you. What are some other exciting applications for this incredible technology that you see? And what would you like other providers to take away from this fascinating podcast and the exciting work that you're doing at the University of Florida College of Veterinary Medicine?
Dr Dan Lewis: This technology is only limited by people's imagination and what they can conceive that they can do with it. And I think there's numerous applications that it could be potentially used for in surgery. And I think that what needs to be done is to continue to work with engineers and other professionals that can accelerate the process. And that's I think where it's going to go.
Things that we're doing now, we're not even on the radar, even as recent as a decade ago. So there's unlimited applications for this and not just in orthopedics, IN soft tissue, neurosurgery, potentially in other aspects of medicine. It's just going to be a part of the culture now. And we can start to tack into what we have as far as the resources and just improve the delivery of the application.
Melanie Cole (Host): So interesting. Gentlemen, thank you so much for joining us and I hope you'll join us again and update us as you see some of these exciting things evolve in veterinary medicine. And to listen to more podcasts from the experts at the University of Florida College of Veterinary Medicine, you can always visit vetmed.ufl.edu.
That concludes today's episode of UF Vet Med Voice, brought to you by the University of Florida College of Veterinary Medicine, advancing animal, human and environmental health. I'm Melanie Cole.