A patient at Queen Elizabeth Hospital in Birmingham, U.K. has recently received a 3D printed rib cage implant. The 52-year-old Linda Edwards had a collapsed breastbone due to issues from a previous operation and was initially told that her rib cage could not be repaired. With advanced 3D printing technology, however, this patient was able to receive a 3D printed titanium implant to remedy her condition.
This surgery was carried out by Ehab Bishay, a thoracic surgeon at University Hospitals Birmingham NHS Foundation Trust (UHB). In the operation, Bishay replaced a portion of the damaged rib cage with a 3D printed titanium device to add support. Edwards was only the sixth person in the world to have this type of surgery, which took place last month.
“I woke up from the operation feeling terrible and, at one point, I thought I had died, but I am feeling better every day!” she said to Blackpool Gazette. “I still feel numb because I am on a lot of drugs, but the main thing is my ribcage doesn’t keep shifting about.
Edwards began presenting symptoms of indigestion and heartburn in 2016, which her doctor diagnosed as angina (reduced blood flow to the cardiac muscles). Surgeons remedied this through bypass surgery, in which her sternum was cut open to access her heart. The sternum is repaired using wires in this operation, however, in Edwards’ case, these wires did not hold. This led to the collapse of her sternum, which can not only cause pain but can result in respiratory and circulatory issues as well.
She was operated on once more in 2017 to fix this, which resulted in yet another collapse of the sternum. At this point the need for another solution was imminent, but Edwards’ doctors were running out of options. After seeing a documentary highlighting Bishay’s work with 3D printed transplants, Edwards decided to contact the physician on Facebook.
“It was out of sheer desperation that I contacted Dr. Bishay because the situation with my rib cage was critical,” Edwards said. “It was getting steadily worse and I couldn’t see a way forward.” Bishay agreed to perform the surgery, and after receiving initial surgical permission in 2018, the operation was successfully carried out in July of 2019.
This surgical team at Queen Elizabeth was led by Stephen Rooney, with Bishay also assisting in the operation. He explained that titanium is used in this operation because it is resistant to infection, functional, strong, and lightweight.
“It’s fantastic to see that Mrs. Edwards is doing extraordinarily well given the complexity of the procedure she has undergone,” said Bishay. “That is due in part to the collaborative working of three highly-skilled surgical teams and their focus on improving long-term outcomes for patients by developing its capacity and experience to undertake these highly-complex procedures.”
“The plastic surgery team, led by Mr. Haitham Khalil, harvested several muscle flaps to cover all the extensive components of the prosthesis, a fundamental step in this operation,” he continued. “Fortunately, complications such as those experienced by Mrs. Edward’s following previous heart surgery are rare but are notoriously difficult to manage.”
Bishay conducted a similar surgery in 2017 on Edward Evans at Birmingham’s Heartlands Hospital. Evans received a 3D printed polymer and titanium implant and was the subject of the documentary that compelled Edwards to contact Bishay. This hybrid device was created by Anatomics, an Australian medical device company, and CSIRO, the national science agency in Australia.
“It feels incredible that I have had an operation as advanced as this. It’s priceless. I can hold my granddaughter and that’s the best feeling in the world.”
— 3D Printing Industry (@3dprintindustry) August 21, 2019
Image Credit: 3D Print