Three-dimensional printing surgical instruments: Are we there yet?

Timothy M. Rankin, Nicholas A. Giovinco, Daniel J. Cucher, George S Watts, Bonnie L Hurwitz, David G Armstrong

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Background The applications for rapid prototyping have expanded dramatically over the last 20 y. In recent years, additive manufacturing has been intensely investigated for surgical implants, tissue scaffolds, and organs. There is, however, scant literature to date that has investigated the viability of three-dimensional (3D) printing of surgical instruments. Materials and methods Using a fused deposition modeling printer, an Army/Navy surgical retractor was replicated from polylactic acid (PLA) filament. The retractor was sterilized using standard Food and Drug Administration approved glutaraldehyde protocols, tested for bacteria by polymerase chain reaction, and stressed until fracture to determine if the printed instrument could tolerate force beyond the demands of an operating room (OR). Results Printing required roughly 90 min. The instrument tolerated 13.6 kg of tangential force before failure, both before and after exposure to the sterilant. Freshly extruded PLA from the printer was sterile and produced no polymerase chain reaction product. Each instrument weighed 16 g and required only $0.46 of PLA. Conclusions Our estimates place the cost per unit of a 3D-printed retractor to be roughly 1/10th the cost of a stainless steel instrument. The PLA Army/Navy retractor is strong enough for the demands of the OR. Freshly extruded PLA in a clean environment, such as an OR, would produce a sterile ready-to-use instrument. Because of the unprecedented accessibility of 3D printing technology world wide and the cost efficiency of these instruments, there are far reaching implications for surgery in some underserved and less developed parts of the world.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalJournal of Surgical Research
Volume189
Issue number2
DOIs
StatePublished - Jun 15 2014

Fingerprint

Surgical Instruments
Operating Rooms
Costs and Cost Analysis
Tissue Scaffolds
Polymerase Chain Reaction
Printing
Stainless Steel
Glutaral
United States Food and Drug Administration
poly(lactic acid)
Three Dimensional Printing
Technology
Bacteria
Efficiency

Keywords

  • 3D printing
  • Additive manufacturing
  • Instruments
  • Polylactic acid (PLA)
  • Printing surgical instruments
  • Surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Three-dimensional printing surgical instruments : Are we there yet? / Rankin, Timothy M.; Giovinco, Nicholas A.; Cucher, Daniel J.; Watts, George S; Hurwitz, Bonnie L; Armstrong, David G.

In: Journal of Surgical Research, Vol. 189, No. 2, 15.06.2014, p. 193-197.

Research output: Contribution to journalArticle

Rankin, Timothy M. ; Giovinco, Nicholas A. ; Cucher, Daniel J. ; Watts, George S ; Hurwitz, Bonnie L ; Armstrong, David G. / Three-dimensional printing surgical instruments : Are we there yet?. In: Journal of Surgical Research. 2014 ; Vol. 189, No. 2. pp. 193-197.
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abstract = "Background The applications for rapid prototyping have expanded dramatically over the last 20 y. In recent years, additive manufacturing has been intensely investigated for surgical implants, tissue scaffolds, and organs. There is, however, scant literature to date that has investigated the viability of three-dimensional (3D) printing of surgical instruments. Materials and methods Using a fused deposition modeling printer, an Army/Navy surgical retractor was replicated from polylactic acid (PLA) filament. The retractor was sterilized using standard Food and Drug Administration approved glutaraldehyde protocols, tested for bacteria by polymerase chain reaction, and stressed until fracture to determine if the printed instrument could tolerate force beyond the demands of an operating room (OR). Results Printing required roughly 90 min. The instrument tolerated 13.6 kg of tangential force before failure, both before and after exposure to the sterilant. Freshly extruded PLA from the printer was sterile and produced no polymerase chain reaction product. Each instrument weighed 16 g and required only $0.46 of PLA. Conclusions Our estimates place the cost per unit of a 3D-printed retractor to be roughly 1/10th the cost of a stainless steel instrument. The PLA Army/Navy retractor is strong enough for the demands of the OR. Freshly extruded PLA in a clean environment, such as an OR, would produce a sterile ready-to-use instrument. Because of the unprecedented accessibility of 3D printing technology world wide and the cost efficiency of these instruments, there are far reaching implications for surgery in some underserved and less developed parts of the world.",
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