Ohio State's M4 Lab is defining the future of 3D printing in medicine

Otolaryngologist Kyle VanKoevering, MD, always had a passion for combining his engineering expertise with his love of medicine. About eight years ago, the engineer-turned-physician stumbled upon a relatively new technology — three-dimensional (3D) printing. Immediately, he knew that the emerging tech had enormous potential to change the future of medicine.

“Manufacturing of medical devices involves a highly regulated process that was only possible in a handful of big facilities across the country,” says VanKoevering, a head and neck surgeon in the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University Wexner Medical Center and director of the Medical, Modeling, Materials and Manufacturing (M4) Lab at The Ohio State University.

With the launch of his new M4 Lab, that was all about to change.

As personalized medicine evolves and changes the way we deliver care, large-scale manufacturing of such devices will become less relevant. The M4 Lab's interdisciplinary team of researchers is discovering new diagnostics, developing a better understanding of how diseases function at the molecular and genetic levels and finding new solutions to complex medical problems. With these breakthroughs, doctors and engineers can customize their treatments to fit their patients’ anatomy or biological needs.

VanKoevering started his M4 Lab with dreams of finding resolutions to surgical roadblocks that he encountered in his head and neck surgeries. By making models of a patient's anatomy, surgeons can now use a replica to guide and expedite reconstruction after complicated tumor surgery.

“Once we’ve removed a tumor, we try to rebuild the facial structure in a way that the patient can still chew, talk and function in daily life,” VanKoevering says. “We used to have to eyeball it, but the M4 Lab has changed that.”

A roadmap to the future of medicine

3D printing is already revolutionizing the practice of medicine. At Ohio State's M4 Lab, researchers can digitally build a replica of a patient's organ or tumor using imaging such as a CT scan or magnetic resonance imaging. Lab engineers can collaborate with physicians to design a device or perform a procedure tailored perfectly to their patients. And, because the lab sits on the university's West Campus, technicians can manufacture solutions faster and cheaper at the point of care.

As a collaborative initiative that aims to accelerate and improve patient care, the M4 Lab:

• Teaches future generations of ear, nose and throat (ENT) providers
  With access to 3D printing, ENT surgeons can hand students a replica of patient anatomy to hold and examine before heading into the operating room. The ability to study these models has revolutionized the way trainees learn. They can better understand the geometry of procedures, the complexity of tumor biology and the surgical approaches used in the operating room.
• Enhances patient communication
  Calming a patient's fears is never easy, especially in complex cases. 3D-printed models are invaluable communication tools that help doctors contextualize a procedure for a patient and their loved ones before surgery.
• Improves surgical outcomes
  Surgeons use 3D printing to customize cutting guides they can use in the operating room during complicated procedures. This groundbreaking tool is leading to reductions in complications, side effects and morbidity. For example, viewing tumors from different angles provides new perspectives that can give surgeons a better grasp of the location of major nerves and arteries.
• Pushes the medical frontier
  3D printing is ushering in a new era of customization. The M4 Lab allows physicians to personalize devices in days rather than months or years. “We can individualize on the device side like we already do on the treatment side with chemotherapies and other medications,” VanKoevering says. “And I love that I can come up with an idea today, design it tomorrow and use it in a patient the next day.”

The M4 Lab’s director of Additive Manufacturing Ed Herderick, PhD, has his sights set on scaling the lab’s work in the near future. “It would be a big task, but I envision that we will make 3D printing the standard of care for any surgeon or patient that could benefit,” he says. Also, for a teaching hospital that trains scores of medical students and residents, the ability to print 3D models for an entire class of students is a game changer.

Real-world applications of digital design and 3D printing

Recently, VanKoevering and his team designed airway stents for laryngectomy patients experiencing life-threatening airway obstruction. The ENT specialists developed a customized silicone tracheal stent that could keep the airways open. “It’s important that we can manufacture solutions on an urgent basis at the hospital for these critically ill patients,” VanKoevering says. “These people couldn't breathe. We have helped them return to a relatively normal life. It's super gratifying.”

The M4 Lab is conducting medical devices research trials that will pioneer airway management even further. With digital design and 3D printing, the lab is investigating custom prosthetics and molds for medical-grade silicone. “We've discovered ways to use well-tolerated materials to build biological scaffolds shaped to the right size, dimensions and geometry for a patient,” VanKoevering says. “The end goal is to print with living cells so what we print and put into the body will evolve, grow and develop into a fully functional replacement organ.”

The ENT specialists have also turned to the M4 Lab for complex jaw reconstructions for cancer patients. They used 3D-printed models to strategize how to take a patient's leg bone, reshape it and transplant it into the exact location in the jaw. The team has performed this procedure for more than 40 cancer patients.

The sky's the limit

Ohio State's M4 Lab sees the applications for otolaryngology as endless. As the technology advances, the team hopes to make organ replacement, instead of transplants, the standard of care. “I don't think we can overstate the ambition of printing organs to match a patient's physiology, so they don't have to take anti-rejection drugs,” Herderick says.

While the notion of printing an ear, heart valve or aorta seems like science fiction, it's a goal Ohio State’s medical printing experts are striving toward. According to VanKoevering, bioprinting cells and tissue from a digital file is years, not decades away.

“We have the opportunity to do this work at a level we haven't seen before,” VanKoevering says. “Using engineering tools and 3D printing, we will change lives in ways we can only imagine.”

This story was originally published by The Ohio State University's Wexner Medical Center