AMS Spring 2023

Safer & Faster: German Researchers Invent 3D Printed Device for Endoscopic Submucosal Dissection

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uni-logo3D printing is currently providing substantial and highly beneficial transformation to a multitude of sectors covering everything from car parts to manufacturing jewelry and apparel. The medical sector has been transformed in countless ways as well, from medical implants and devices to numerous different ways of using 3D models during surgery, as well as for training and educating patients.

Now, change is coming to the way medical professionals are able to perform endoscopy procedures, via a new 3D printed tool created by Alexander Meining, MD, and a team from University of Ulm in Germany, who report that their motivation for the study was due to issues with endoscopic intervention and subsequent endoscopic submucosal dissection being so complicated, with such a high learning curve, and being associated with so many problems and risks.

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Traditional ESD

Patients generally are required to undergo these types of process through the esophagus, stomach, or colon to remove gastrointestinal tumors that are not yet in the patient’s muscle.  Currently they have to use a tube which must be inserted to reach tumors, while the patient is under anesthesia.

“When you do intervention endoscopy, you also do endoscopic submucosal dissection, which is a new and fascinating technology for therapy of early gastric cancer or neoplasms in the rectum,” said Dr. Meining. “The problem with that technique is that it’s rather complicated, it’s cumbersome, and it’s also risky. Even the ‘super experts’ have perforation rates of about eight percent.”

The team, a research consortium, has taken advantage of 3D printing technology in an effort to streamline the ESD process altogether, from ease in performing the process, to cutting the time doing the procedure exponentially.

“Now we have 3D printing and I don’t know if it will revolutionize our lives, but it’s certainly something we will become very familiar with in the next years, and I’m very certain that it will be more and more transferred into medical practice,” said Dr. Meining.

The research consortium was able to design a 3D printed overtube device with two arms for manipulating. They used a standard endoscope, but with arms at the tip. With the two arms, it’s a procedure not unlike eating with a knife and fork–while one arm can hold the tissue down, the other arm can cut.

“Because it’s a 3D printed system we can also easily adjust the system, so if we decide to make the arms  the tip of the overtube shorter, larger…it’s a big advantage of the new 3D printing technology that we can individualize our instruments,” said Dr. Meining.

The team has only performed the procedure on animals so far, but will begin human trials soon. They plan to have several different models of the 3D printed overtubes, depending on the procedure and based on various indications. With a whole selection of overtubes, the processes should be greatly refined.

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Dr. Alexander Meining explains, with fork and knife, how one arm of the 3D printed device is used to hold tissue in place, while the other cuts.

With the holding and cutting innovation, coupled with 3D printing, they are able to do the procedures two to three times as quickly, and the risk of perforation is little to none, which is certainly of major consideration in terms of benefit.

Compared to previous endoscopes, this should be a much better tool for offering the procedure to patients more safely and so much more quickly. They expect very few limitations for the new 3D printed device, except perhaps in the event that a patient has a very narrow throat.

Do you know anyone who has had to undergo a traditional endoscopic intervention or endoscopic submucosal dissection? What are your thoughts on the benefits of this new 3D printed device, which cuts down on time spent performing procedures as well as eliminating risk? Discuss in the 3D Printed Device for Endoscopic Intervention forum thread over at 3DPB.com.

 

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