AM Investment Strategies
AMS Spring 2023

Unseen Opportunity: What Is the Ideal In-Hospital 3D Printer

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Just a few years ago, 3D printers were rare inside hospitals. Now, over the past five years, we’ve seen a huge growth in 3D printing adoption inside hospitals. This includes teams collaborating with service bureaus to 3D print parts for their medical practices.

Additionally, there’s the emergence of a new breed of specialized firms that want to aid hospitals in transitioning to the use of additive manufacturing (AM). Take Axial3D, who wants to help doctors by segmenting files for 3D printing, file preparation, and even deploying print labs at hospitals. Korean firm Medical IP develops software to automatically aid doctors in segmenting files, while also offering anatomical models and new ways to visualize models.

However, paradoxically, we haven’t see any real development of specialized 3D printers for inside hospitals, which has been particularly confusing to me. Kumovis—recently acquired by 3D Systems to aid its pivot towards bioprinting and medical 3D printing—developed one of the only healthcare-specific 3D printers that I know of. Vshaper, which manufacturers high-temperature 3D printers, has two medical AM machines. Super-segmented Stratasys also has a PolyJet 3D printer for medical applications. Other than those, I’m struggling to think of other systems dedicated specifically to medical 3D printing.

What Similar Developments Are Happening in Other Markets?

This is a huge missed opportunity in the 3D printing industry. In ancillary markets, we can see real development toward intertwined solutions that are of great benefit for customers. In dental, for example Star3D has a complete material, vat polymerization, and software solution for dental. DWS has developed a line up of innovative systems each for different sized dental labs and practitioners. It also offers the DFAB, a printer specifically made for restorations. Formlabs develops specific material offerings and printers for dental. Prodways has dental 3D printers, as does SprintRay. Meanwhile Materialise and LuxCreo have dental specific software.

There are currently a great deal of vendors and resellers that I could ring up only to be offered a partially or fully integrated and easy-to-use solution for dentist offices and labs alike. Moreover, they would be able to 3D print a whole range of dental parts from restorations to orthodontics, bridges, and more. Dental is leading the charge in simple solutions that a practitioner who knows nothing about 3D printing could buy and get up and running in just a few days. Meanwhile, in medical, there is next to nothing.

Why Is 3D Printing for Hospitals So Important?

Right now, there may be over 200 3D print labs in hospitals worldwide. Every healthcare provider worth its salt will have a 3D printing lab eventually. Why?

First of all, these facilities save money. It’s far cheaper and faster to produce medical models in-house than to outsource them. For anatomical and pathology models, current desktop machines suffice. They’re easy to operate and work in offices prevalent at hospitals.

3D printing is an innovative technology to show off to patients, but it can also aid doctors in creating fixation solutions, post-operative braces, medical instruments. Additionally, AM can be used to prototype one-off innovative instruments or solutions. This could include devices that improve patient wellbeing, surrounding them patient in their hospital beds.

Surgical planning with the aid of models saves time and money, while in-house production of pathology models for a variety of diseases can educate staff and students. Patient-specific devices can be made for surgical procedures, but also for when the patient leaves the hospital. This includes braces as well as implants that could be made on site. Prosthetics are readily made with 3D printing, as well. In-hospital production of medical devices would be difficult and require meeting exact tolerances, but it is already being performed at the U.S Veterans Administration and the Hospital for Special Surgery.

The biggest benefit to hospitals is that they would have an ability to fabricate one-off items in house. A 3D print lab coupled with an engineer could work with other hospital staff to develop unique solutions for problems, in the same way that 3D printing’s greatest asset for businesses is the ability to solve unforeseen problems through part production.

Need a special attachment to put a gurney next to an MRI machine because a radiologist wants to MRI a giraffe? 3D print it. Have a patient who needs to protect a uniquely vulnerable ankle? Make a specialty brace cover to protect it. People are unique, as are a lot of their medical problems. 3D printing is very well suited to aiding those people.

I’m also sure that a number of benefits of 3D printing in hospitals have not yet been sufficiently developed. Think of Poka-Yoke tooling for hospitals, for example. A nurse on a medical round could obtain a part that organizes all of the needles and instruments for various procedures in a specific order to minimize errors. Surgeons could have these made for every procedure—some implant packaging is already specially made for each operation. Hospitals could use more jigs and fixtures on patients to reduce errors, as well.

Many issues could be improved for patients in the hotel-like environments of the hospital, as well. Lights could be made easier to operate for people with Parkinson’s in a particular geriatric ward. Covers could be made in pediatric wards to prevent young patients from having access to lights and other equipment. Imagine a project to make the whole hospital Braille-friendly for the seeing-impaired? That would be enormous and costly. However, one person with a simple printer could get very far. Generally, a lot of items break in hospitals and printers could be used in maintenance extensively. Across the board, there is a high degree of interest in 3D printing inside hospital walls but I think there will be even more in the future.

What Would an Ideal 3D Printer for Hospitals Look Like?

There is also a special Vshaper Med version of the 270.

PBF or Another Technology?

What AM technology would be best suited for operating within the hospital environment? There’s powder bed fusion (PBF), favored by 3D printing bureaus for its ability to batch produce durable parts. However, PBF would give off a lot of dust and introduce an explosion and fire danger that I wouldn’t be too happy about, personally. Ultimately for medical campus setups that could include ancillary buildings with 3D printers, metal and polymer PBF systems would allow them to make PEEK polymer and titanium implants in-house. Such a development will happen one day, but is still further away in time. And, even then, these hospitals could use the same metal and polymer machines that orthopedic implant manufacturers use. So, in this case, there would not be a need for specialized in hospital printers.

At the moment material extrusion and vat photpolymerization printers in the Pro segment come closest to meeting the immediate needs of hospitals. For now, we’ve seen many hospitals turn to Ultimaker S5 or Formlabs systems for in-house use.

Safe for In-Hospital Use

What the ideal 3D printer would need would be the appropriate certifications and approvals for 3D printing the types of parts needed. In some countries, specific tests or certifications for ultra fine particles or material safety would have to be undertaken, as well. Obtaining these will be kind of a slog, but well worth it as hospitals are often obligated to rely on only certain devices with the correct approvals. So, the ideal in hospital printer would be easy to use (while wearing gloves) and conform to all of the relevant safety and medical approvals for parts made on it.

In a perfect world, the system would register prints and files, enabling accountability and traceability so that the hospital knows what was printed. It would also feature the proper privacy settings as to not expose patient data on the internet, for example.

The Kumovis R1 printer actually has many of these properties, including an integrated filter system, a build chamber that can be converted to a clean room to avoid contaminating the printed part. The company suggests that the printer is “clean room ready” for use in existing clean room environments and that it can be cleaned to medical standards. To me, these features are very compelling for an in-hospital 3D printer.

Medical Materials

It could run unattended for many hours without posing a fire or electrical danger, as well. It would minimize material handling and offer excellent material storage. In the case of a material extrusion technology, this machine would have to include great material conditioning, preheating, and annealing capabilities, as well. If the printer was sterile or produced sterile parts, that would be outstanding.

Generally, the ideal machine would have to have excellent setting profiles for materials, as well as safe, biocompatible, and certified materials. The software, too, would be easy to use and secure with patient data. Ideally, the software would be an integrated solution that would save a lot of time using automated workflows. Because a large number of parts would be for similar applications and certification levels, push-button workflows from CT scan to part would be perfect.

Larger build volumes would be required in some cases.  It would also be exciting to see a machine that can print high-temperature and autoclavable materials, such as PVDF, as well as specific materials that hospitals would want and care for. Components would have to be high grade and maintenance intervals would have to be spread apart. Service would have to be excellent, as well.

Do it

On the whole, developing the perfect printer for in-hospital use would not be an impossible challenge. It would require a lot of due diligence, precision, and care to do it right. This isn’t one of those move-fast-and-break-things kind of application.

It would have to be an excellent 3D printer made specifically for use in hospitals and the medical field. To a lot of people, this may seem niche. However, making an excellent, high-grade, high-spec, highly precise FDM or SLA machine would also mean that the machine could be used in any high-end manufacturing application. I urge someone to do this. This is an excellent opportunity that would be defensible, high-margin, and long-lasting.

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