WEBVTT - 3D Printing in Medicine 0:00:00.160 --> 0:00:07.160 Brought to you by Toyota. Let's go places. Welcome to 0:00:07.360 --> 0:00:14.880 Forward Thinking. Hey there, and welcome to Forward Thinking, the 0:00:15.080 --> 0:00:17.639 podcast that looks at the future and says, I'm not 0:00:17.680 --> 0:00:20.160 a real doctor, but I am a real worm. I'm 0:00:20.239 --> 0:00:23.040 Jonathan Strickland, and I'm Lauren Volke Bam and our other 0:00:23.120 --> 0:00:25.920 co host, Joe McCormick is out today, but he will 0:00:25.960 --> 0:00:29.480 be back very soon. And in the meanwhile, we're gonna 0:00:29.520 --> 0:00:35.000 talk three D printing because it's been like three days, yeah, 0:00:35.200 --> 0:00:38.160 or two and a half minutes, so you know, so 0:00:38.320 --> 0:00:40.440 three D printing. You may have heard us talk about 0:00:40.479 --> 0:00:43.200 this in such episodes as all the other ones we've done, 0:00:43.360 --> 0:00:47.120 but literally every episode they've ever done on Forward Thinking, 0:00:47.200 --> 0:00:50.879 But we wanted to specifically look at three D printing 0:00:51.120 --> 0:00:55.240 in emerging fields of medicine, not and not in the 0:00:55.280 --> 0:00:57.360 way that you might think, because we have talked about 0:00:57.600 --> 0:01:00.120 three D printers being used to print things like joints, 0:01:00.160 --> 0:01:02.440 like a new knee joint or hip joint, and we've 0:01:02.480 --> 0:01:05.240 talked about three D printers to print even things like 0:01:05.319 --> 0:01:09.520 prosthetic arms or even in the further off in the future, 0:01:09.520 --> 0:01:12.679 because this is not a mature technology yet, but living 0:01:12.840 --> 0:01:16.600 organs using three D printers to print actual organs for 0:01:16.680 --> 0:01:19.960 transplant patients. Maybe possibly if we work a whole lot 0:01:20.000 --> 0:01:23.399 of stuff out, But stuff that is working right now 0:01:23.640 --> 0:01:26.880 in the incredible future that is today is a bunch 0:01:26.920 --> 0:01:29.119 of stuff. Yeah, there's some more stuff that we wanted 0:01:29.120 --> 0:01:31.800 to talk about that that is outside of those uses. 0:01:32.080 --> 0:01:34.679 So one of them is the concept of three D 0:01:34.760 --> 0:01:37.560 printed drugs, which I think we may have mentioned on 0:01:37.560 --> 0:01:39.959 a previous episode, But the reason we're bringing it back 0:01:40.040 --> 0:01:43.000 up now is that in August two thousand fifteen, the 0:01:43.120 --> 0:01:46.160 US Food and Drug Administration also known as the f 0:01:46.319 --> 0:01:49.800 d A, approved a three D printed drug for the 0:01:49.880 --> 0:01:56.880 first time ever called spritum or sprite um or it 0:01:56.960 --> 0:02:00.360 could be spit tom. It's also known as a the 0:02:00.760 --> 0:02:06.240 Tierra se tam cool. Yeah, it's it's a pill specifically 0:02:06.360 --> 0:02:10.079 designed to help treat patients who are suffering from seizures 0:02:10.160 --> 0:02:13.520 like epilepsy or other types of seizures. And and it's 0:02:13.840 --> 0:02:16.799 really interesting. Yeah, they created it with a three D 0:02:16.919 --> 0:02:21.160 printer specifically because that technology lets them build a pill 0:02:21.240 --> 0:02:25.600 that's that's porous throughout that therefore can dissolve rapidly on 0:02:25.760 --> 0:02:30.000 contact and you know, get the medicine into the patient immediately. Yeah. 0:02:30.000 --> 0:02:32.000 In fact, one of the things I was reading about 0:02:32.000 --> 0:02:33.920 because I was curious, I was like, well, so it 0:02:33.960 --> 0:02:38.440 dissolves better. Okay, so what but two things. One, for 0:02:38.480 --> 0:02:40.400 people who have seizures, it means they can get that 0:02:40.480 --> 0:02:43.200 medication in their system much more rapidly and prevent the 0:02:43.240 --> 0:02:46.000 onset of the seizures, stop it before it really starts. 0:02:46.120 --> 0:02:49.760 And another is that we're talking like seriously dissolving rapidly, 0:02:49.840 --> 0:02:53.280 so that people who have trouble swallowing pills, whether it's 0:02:53.320 --> 0:02:55.480 due to a medical issue or maybe it's a child 0:02:55.560 --> 0:02:59.639 who doesn't normally swallow pills, it's much easier to get 0:02:59.639 --> 0:03:02.720 the pill down than four people, you know, than are 0:03:02.720 --> 0:03:04.680 than a standard pill that would take a while to 0:03:04.720 --> 0:03:07.919 dissolve within the stomach itself. Oh sure. And furthermore, if 0:03:08.160 --> 0:03:12.040 if someone doesn't like swallowing pills, they're unlikely to take 0:03:12.080 --> 0:03:15.359 their medication as described, and this could help alleviate that. Yeah, 0:03:15.360 --> 0:03:20.720 it's called adherence, the concept of patients adhering to their medication, 0:03:20.800 --> 0:03:23.640 not sticking to it, but sticking with it. So in 0:03:23.680 --> 0:03:27.079 other words, they are more likely to continue taking their 0:03:27.120 --> 0:03:31.040 medication at the right time. Because it's not a completely 0:03:31.160 --> 0:03:34.080 unpleasant experience. Any of us who have had to take 0:03:34.120 --> 0:03:37.960 medications that are rough for one reason or another. Maybe 0:03:38.000 --> 0:03:40.840 it's the application itself, like it's an injection, or maybe 0:03:40.880 --> 0:03:43.640 it's the way it makes us feel afterward. You know, 0:03:44.320 --> 0:03:47.760 it takes an effort of will to continuously do that 0:03:47.880 --> 0:03:50.640 through the course of a medication, and it can get 0:03:51.160 --> 0:03:54.360 really hard on you psychologically. So anything that reduces that 0:03:54.440 --> 0:04:00.200 psychological burden on a patient is yeah. Yeah, And the 0:04:00.240 --> 0:04:02.440 technology came out of m I T. Right, Yeah. M 0:04:02.480 --> 0:04:05.760 I T developed the actual three D printing technology. The 0:04:05.880 --> 0:04:10.120 company that makes the drug is Appreciate A Pharmaceuticals, and 0:04:10.520 --> 0:04:14.640 they ended up calling the specific implementation of this technology 0:04:14.680 --> 0:04:18.800 originally developed by m I T zip dose, So zip 0:04:18.839 --> 0:04:21.120 dose is how they call it, and it's a neat process. 0:04:21.160 --> 0:04:24.360 It first involves laying down a layer of powdered medicine. 0:04:24.640 --> 0:04:27.159 Then it applies a drop of liquid that binds the 0:04:27.160 --> 0:04:30.320 particles together and creates that first porous layer. So that's 0:04:30.800 --> 0:04:33.760 layer one of your medication. And if you've ever used 0:04:33.760 --> 0:04:35.960 a three D printer, you will see that it lays 0:04:36.000 --> 0:04:39.120 down a thin layer of plastic or some other material. 0:04:39.240 --> 0:04:42.520 The plastic is generally what the consumer ones use, and 0:04:42.560 --> 0:04:45.120 then it will lay another layer on top of that, 0:04:45.279 --> 0:04:47.120 and another one on top of that and build it 0:04:47.320 --> 0:04:50.120 layer by layer until you get a final product. Well, 0:04:50.120 --> 0:04:52.080 in this case, it's doing that but with the powdered 0:04:52.120 --> 0:04:54.920 medication and then a drop of liquid to buying stuff together. 0:04:55.720 --> 0:04:58.719 The neat thing about this is using this process, you 0:04:58.760 --> 0:05:03.000 can actually determine you can you can tailor each pill 0:05:03.120 --> 0:05:07.680 to have a specific amount of the active pharmacological drug 0:05:08.279 --> 0:05:11.120 in that stuff, right, which again makes it easier on 0:05:11.200 --> 0:05:13.719 the patient because the patient doesn't have to like split 0:05:13.760 --> 0:05:16.400 a pill in half, or you know, maybe they've got 0:05:16.440 --> 0:05:17.840 a whole bunch of different stuff that they have to 0:05:17.880 --> 0:05:20.960 take together. And this could potentially let you print a 0:05:21.000 --> 0:05:24.200 single pill to take something like that. Yeah, so it 0:05:24.240 --> 0:05:27.120 means that like you might say, well, we want to 0:05:27.160 --> 0:05:30.640 give a certain number of milligrams of this as a dose. 0:05:30.960 --> 0:05:33.480 Normally we would get these one type of pills and 0:05:33.480 --> 0:05:35.640 cut them in half, like Lauren was saying, which is 0:05:35.720 --> 0:05:37.880 not always an exact science. If they give it to 0:05:37.960 --> 0:05:41.400 you to take to home, usually the pharmacologist will do it, 0:05:41.440 --> 0:05:43.560 you know, like the pharmacist will do it rather um 0:05:43.680 --> 0:05:45.960 they'll do it, do it for you. But but this 0:05:46.000 --> 0:05:48.640 way you print the pills specifically to the needs of 0:05:48.640 --> 0:05:51.560 the patient, meaning that down the road we could see 0:05:51.600 --> 0:05:57.080 personalized medicine where a very specific dosage is created for 0:05:57.120 --> 0:05:59.440 that person, and it may even be that that dosage 0:05:59.480 --> 0:06:03.720 needs to change over time, and that they could continuously 0:06:03.839 --> 0:06:07.159 print these pills so that they met the patient's needs 0:06:07.200 --> 0:06:11.440 throughout the course of the treatment. So it's a revolutionary 0:06:11.520 --> 0:06:14.320 step in that regard. Yeah, yeah, and it means you 0:06:14.360 --> 0:06:18.160 have incredible amount of control, So pretty neat. Yeah yeah. 0:06:18.400 --> 0:06:22.560 Now some people are theorizing that it could be even 0:06:22.640 --> 0:06:25.680 neater than that. Yeah, Lee Cronin of the University of 0:06:25.680 --> 0:06:28.960 Glasgow said at a TED talk once he talked about 0:06:29.000 --> 0:06:32.479 the possibility of this being used to the extent that 0:06:32.560 --> 0:06:35.400 people could have the printers in their own homes. So 0:06:35.440 --> 0:06:38.159 a patient might be able to have a drug printer 0:06:38.360 --> 0:06:41.680 at home and instead of going out and pursue, you know, 0:06:42.080 --> 0:06:44.600 having to fill a prescription, having to go down to 0:06:44.640 --> 0:06:46.920 the pharmacy or chemist or whatever you call it. Yeah, 0:06:46.960 --> 0:06:48.719 you instead of having to go down there, you would 0:06:48.720 --> 0:06:52.880 instead have a doctor's prescription for an algorithm, and the 0:06:52.920 --> 0:06:56.200 algorithm would be whatever your printer would need to do 0:06:56.320 --> 0:07:00.760 to create the chemically the drug. So I have a 0:07:00.800 --> 0:07:04.400 bunch of chemical inks to pull from, and the combining 0:07:04.560 --> 0:07:08.719 of those chemical inks and various temperatures, etcetera would allow 0:07:08.880 --> 0:07:11.640 for the creation of the drugs. Now, this is very 0:07:11.760 --> 0:07:16.360 much a future oriented idea. It's for many reasons. I 0:07:16.400 --> 0:07:23.280 think future oriented is a polite way of putting Yeah. Yeah, 0:07:23.360 --> 0:07:27.360 we Lauren and I both think that this is probably 0:07:27.840 --> 0:07:30.080 if it does happen, it's going to have to overcome 0:07:30.200 --> 0:07:35.640 some significant hurdles, and not just technological hurdles, although there's 0:07:35.640 --> 0:07:38.920 certainly that right, well, certainly it's not like the three 0:07:39.000 --> 0:07:42.560 D printers that we have today. Even the most fabulous 0:07:42.640 --> 0:07:46.600 ones and the most fabulous labs are capable of molecularly 0:07:46.840 --> 0:07:51.240 combining stuff. That's a different issue. Yeah, So even if 0:07:51.280 --> 0:07:55.360 you had you know, forty different quote unquote inks, chemical inks, 0:07:55.440 --> 0:07:57.120 you know, you would have to design a printer that 0:07:57.160 --> 0:08:00.920 would be able to use all those properly to to 0:08:01.560 --> 0:08:05.400 build whichever drug you're specifically trying to make. Plus, then 0:08:05.640 --> 0:08:07.640 you also have to worry about well, let's say let's 0:08:07.640 --> 0:08:09.880 say that I do that. Let's say that I've built 0:08:09.920 --> 0:08:13.240 the printer. Okay, that's a really big step, because because 0:08:13.320 --> 0:08:15.120 right now what you're talking about is having like a 0:08:15.160 --> 0:08:18.360 tub of powdered drug that you give to a patient, 0:08:18.480 --> 0:08:21.680 which seems like a poor plan. Well, let's let's say 0:08:21.680 --> 0:08:23.840 that I've got let's say that we've worked this out. Yeah, 0:08:23.840 --> 0:08:26.520 I've got I've gotta I've gotta somehow, I've got like 0:08:26.720 --> 0:08:30.080 a cartridge that has all the different chemical components for 0:08:30.200 --> 0:08:33.600 various drugs, and that the printer can can access these 0:08:33.600 --> 0:08:37.000 in the appropriate amounts to make a drug. But then, 0:08:37.120 --> 0:08:39.880 even then, even saying I've somehow solved that problem, which 0:08:39.920 --> 0:08:44.280 is a huge if you still have other issues like cleanliness, 0:08:44.320 --> 0:08:48.240 I mean, if anything contaminates that, then you've got a 0:08:48.240 --> 0:08:51.640 possible toxicity problem. I mean, imagine that you have to 0:08:51.720 --> 0:08:54.280 print like let's say it's for a family, and you're 0:08:54.280 --> 0:08:58.360 printing out drugs to treat one person who is elderly 0:08:58.440 --> 0:09:01.079 and needs a certain type of medication. But then your 0:09:01.200 --> 0:09:03.480 child falls sick and you need to be able to 0:09:03.480 --> 0:09:05.800 treat your child too. Yeah, and so so all of 0:09:05.840 --> 0:09:08.400 a sudden, you've got you've got Nana's heart medicine and 0:09:08.480 --> 0:09:10.959 little Susie's tail and all all in the same printer. 0:09:11.120 --> 0:09:14.720 What if there's crossover contamination and not not good time, 0:09:14.920 --> 0:09:19.040 super scary. So so there's there's that basic technological hurdle 0:09:19.080 --> 0:09:22.560 which maybe is not insurmountable, but certainly is not something 0:09:22.640 --> 0:09:25.079 that we can achieve right now. And the home Yeah, 0:09:25.120 --> 0:09:28.520 I'm just just the number of potential problems that I'm 0:09:28.520 --> 0:09:30.920 thinking of with this and and you know this this 0:09:31.000 --> 0:09:33.520 is nay saying, but but man, like you know, if 0:09:33.520 --> 0:09:35.520 they think of all the problems that you're normal like 0:09:35.640 --> 0:09:39.280 p L a plaster printer, yea, yeah, I think about 0:09:39.280 --> 0:09:41.040 the ones that we've had, like we've we've had some 0:09:41.080 --> 0:09:45.240 deformed chess pieces come out of our Yeah, but you know, right, like, 0:09:45.280 --> 0:09:47.319 but if if that kind of thing messes up you, 0:09:47.320 --> 0:09:49.679 you've wasted a tiny bit of plastic, right as opposed 0:09:49.720 --> 0:09:51.880 to a human life and some of your time. Yeah, yeah, 0:09:52.000 --> 0:09:54.840 this this is it could be so dangerous and very 0:09:54.880 --> 0:09:59.040 expensive to make that kind of mistake. Right, So, even 0:09:59.160 --> 0:10:01.320 even if somehow we were to solve all that, we 0:10:01.360 --> 0:10:04.040 still have other issues. We've got ethical issues to consider. 0:10:04.160 --> 0:10:07.079 For example, what if someone gets hold of one of 0:10:07.120 --> 0:10:10.800 these and starts using it to make illicit drugs? Um Now, 0:10:10.840 --> 0:10:14.520 you could try and build protections in place to prevent 0:10:14.520 --> 0:10:17.360 that from happening. But here's the deal. When there is 0:10:17.440 --> 0:10:20.800 something technological out there that means it's hackable, that means 0:10:20.960 --> 0:10:25.120 people will find ways to manipulate that to some extent 0:10:25.200 --> 0:10:28.480 or another. They may not be able to completely revolutionize it, 0:10:28.559 --> 0:10:31.079 completely change it, but they might be able to nudge 0:10:31.120 --> 0:10:35.440 it enough to make a real problem happen. Certainly, so 0:10:35.520 --> 0:10:39.920 ethical and legal issues are here besides the technological ones. 0:10:40.920 --> 0:10:44.600 But either way, even even if this technology never sees 0:10:44.640 --> 0:10:48.040 that kind of application, uh, it's still it still has 0:10:48.080 --> 0:10:50.320 those those other upsides that we were talking about, you know, 0:10:50.360 --> 0:10:53.480 like certainly for doctors and pharmacies and uh and it 0:10:53.520 --> 0:10:58.280 could also potentially help with with with with development of drugs. Yes, 0:10:58.360 --> 0:11:00.960 it means that you could prototype us much more quickly. 0:11:01.000 --> 0:11:03.200 If you were developing a drug and you want to 0:11:03.240 --> 0:11:06.520 test the efficacy, You want to find out what the 0:11:06.559 --> 0:11:10.840 actual pharmacological dosage is, the the what is the effective 0:11:11.520 --> 0:11:15.600 uh dose for treating whatever ailment it might be. You know, 0:11:15.640 --> 0:11:17.840 that's a lot of trial and error. If you have 0:11:17.880 --> 0:11:20.240 a three D printing mechanism where you can say, all right, 0:11:20.240 --> 0:11:24.200 well let's print a pill that has you know, five 0:11:24.280 --> 0:11:27.160 milligrams of the effective drug in it, or one that 0:11:27.200 --> 0:11:30.040 has ten or fifteen, and then you can test each 0:11:30.080 --> 0:11:32.920 one to find out where those thresholds are both for 0:11:32.960 --> 0:11:35.800 the effectiveness of the drug and even the potential toxicity 0:11:35.840 --> 0:11:39.760 of the drug. Then that could make the medication uh 0:11:40.000 --> 0:11:44.240 much safer, much earlier than traditional methods and saving lab time. 0:11:44.440 --> 0:11:49.679 Is is a terrific way to get you know, cheaper drugs. Yeah. Yeah, 0:11:49.880 --> 0:11:53.400 and that's definitely in the news right now. I'm not 0:11:53.440 --> 0:11:56.280 going to go into it because BOYD made me mad, indeed, 0:11:56.360 --> 0:12:01.040 but let's talk about something that that person involved in 0:12:01.040 --> 0:12:04.160 that news story lax, which is hard. Yeah, that's very 0:12:04.160 --> 0:12:06.800 well put, Lauren. I like how civil we are being 0:12:06.800 --> 0:12:10.280 while we're both extremely angry about this. Um. Yes, if 0:12:10.280 --> 0:12:13.840 you wanted to ever give your heart to your sweetie, 0:12:14.080 --> 0:12:17.120 you could possibly do that by undergoing an m R 0:12:17.160 --> 0:12:20.320 I and then having that information mapped out and then 0:12:20.480 --> 0:12:22.880 printed in a three D model where you actually have 0:12:22.960 --> 0:12:25.280 a three D model of your heart. This would be 0:12:25.320 --> 0:12:28.520 the uh sort of the the Indiana Jones and the 0:12:28.520 --> 0:12:33.080 Temple of Doom method of giving your sweetheart. Yeah, it's 0:12:33.120 --> 0:12:36.320 not it's not like a little actually, I could if 0:12:36.360 --> 0:12:39.080 if this, if this technology ever ever grows to a 0:12:39.080 --> 0:12:42.360 consumer market, like I I know twenty people off the 0:12:42.400 --> 0:12:43.719 top of my head who would do it. Like, we 0:12:44.559 --> 0:12:47.800 know the same twenty people because lots of names. I 0:12:47.800 --> 0:12:52.760 mean a certain puppeteer we both know. Uh yeah, there's 0:12:52.800 --> 0:12:57.280 tons of many of them are artists. Yeah weird. But 0:12:57.280 --> 0:13:00.120 but but more more critically and to the point to 0:13:00.200 --> 0:13:04.240 this episode, this could be terrific for heart surgeons. Yeah, 0:13:04.320 --> 0:13:06.960 so this is actually not the The idea of making 0:13:06.960 --> 0:13:09.600 a model of a heart for a surgeon to get 0:13:09.600 --> 0:13:13.079 a look at before performing surgery on a specific patient 0:13:13.559 --> 0:13:16.520 is not entirely new. Uh, that's something that's been done 0:13:16.559 --> 0:13:19.040 for a while. But the three D printing and the 0:13:19.080 --> 0:13:23.440 development of a new algorithm are making this a faster 0:13:23.679 --> 0:13:26.719 process that could save a lot of time. And for 0:13:26.800 --> 0:13:31.000 some patients, time is the difference between a lifesaving operation 0:13:31.160 --> 0:13:34.280 and sadly passing away. So so this could have a 0:13:34.360 --> 0:13:37.920 real difference. And uh, this all comes down to a 0:13:37.920 --> 0:13:42.480 partnership between M I T and Boston Children's Hospital and 0:13:42.520 --> 0:13:45.480 they started looking at a way to create three D 0:13:45.600 --> 0:13:49.800 printed hearts using a computer algorithm to build out as 0:13:49.920 --> 0:13:52.760 much of the heart as possible into a kind of 0:13:52.800 --> 0:13:55.319 a three D model so that could then be printed 0:13:55.760 --> 0:13:59.240 um and taking out the element as much as you 0:13:59.280 --> 0:14:02.720 could of having a human have to go by like 0:14:02.840 --> 0:14:05.640 frame by frame and check and make sure that everything 0:14:05.640 --> 0:14:09.360 matches up to probable reality based on these m r 0:14:09.400 --> 0:14:12.200 I scans. Yes, so m r I s when they 0:14:12.200 --> 0:14:14.120 when they do an m r I scan, you get 0:14:14.120 --> 0:14:16.640 a bunch of cross sections of a three dimensional object, 0:14:17.320 --> 0:14:20.600 and m r I s have light sections and dark 0:14:20.680 --> 0:14:25.000 sections that tell you about different tissues and different uh 0:14:25.040 --> 0:14:29.200 anatomical features. And generally speaking, the boundaries between the two 0:14:29.240 --> 0:14:34.480 tend to show a actual edge of an anatomical structure 0:14:34.520 --> 0:14:38.520 like an ajorda for example, but they don't always. Sometimes 0:14:38.560 --> 0:14:42.960 that border is deceptive, it's not actually an anatomical feature. 0:14:43.400 --> 0:14:48.080 So usually what would happen is experts would pour over 0:14:48.160 --> 0:14:51.600 these images and kind of manually tweak what they believed 0:14:51.640 --> 0:14:55.600 to be the actual boundaries of any anatomical feature of 0:14:55.640 --> 0:14:58.080 the heart so they could tell the three D printer 0:14:58.400 --> 0:15:01.920 what to do. Yeah, so this would take ten hours 0:15:01.920 --> 0:15:04.880 on average for experts to go over all the information. 0:15:04.960 --> 0:15:08.040 That's before you even sent it to be built. Right, 0:15:08.480 --> 0:15:12.680 So the m i T and Boston Children's Hospital partnership 0:15:12.760 --> 0:15:17.080 is all about creating this algorithm that can take a 0:15:17.120 --> 0:15:20.440 little bit of information from an expert and then extrapolate 0:15:20.520 --> 0:15:24.040 based on that information what the rest of the m 0:15:24.160 --> 0:15:26.200 r I actually means. And what they did was they 0:15:26.240 --> 0:15:29.680 divided the heart up into nine sections, and they had 0:15:30.200 --> 0:15:32.880 uh the expert give a little bit of information about 0:15:32.920 --> 0:15:35.920 each section, and then the algorithm took over from the 0:15:36.120 --> 0:15:39.560 From there, so while the algorithm knew a little bit 0:15:39.640 --> 0:15:41.800 about nine different sections of the heart, it had to 0:15:41.840 --> 0:15:46.040 extrapolate the rest and they found that it agreed uh 0:15:46.080 --> 0:15:51.440 at at nine of the experts belief of what was 0:15:51.520 --> 0:15:54.160 actually represented in the m r I, right, right, and 0:15:54.160 --> 0:15:56.440 and yeah, so it cut down this this eight to 0:15:56.480 --> 0:15:59.960 ten hour process, this full extra day that you're atting 0:16:00.240 --> 0:16:04.200 to the prep for surgery, down to to nothing that 0:16:04.320 --> 0:16:06.480 humans really had to do. Yeah, it's it's down to 0:16:06.640 --> 0:16:09.360 like an hour total just to build out the model 0:16:09.400 --> 0:16:11.960 and then another couple of hours to physically build the 0:16:12.000 --> 0:16:14.520 heart with the three D printer. So something that took 0:16:14.560 --> 0:16:18.560 ten hours just for the analysis now took three three 0:16:18.600 --> 0:16:21.840 to four hours total to have a finished model heart 0:16:21.920 --> 0:16:25.720 that the surgeon could then use to plan out uh 0:16:25.800 --> 0:16:29.840 surgical procedures right because you know, usually if someone is 0:16:29.880 --> 0:16:32.640 having heart surgery, it means that there's something irregular about 0:16:32.640 --> 0:16:36.520 the structure of their heart. So it's extra it's really 0:16:36.560 --> 0:16:39.560 really cool to to be able to have the surgeon 0:16:39.560 --> 0:16:41.680 who's going to be working with it. You know that 0:16:41.760 --> 0:16:44.360 the imaging alone is terrific, but being able to actually 0:16:44.360 --> 0:16:48.880 hold that image uh and hold that model and and 0:16:49.320 --> 0:16:52.720 poke into it with stuff, it has to be just incredible. Yeah. 0:16:52.840 --> 0:16:55.480 And in fact, one of the quotes that we saw 0:16:55.880 --> 0:17:00.640 around this was from Paulina Galand of m I T, 0:17:01.240 --> 0:17:03.520 a computer scientist with m I T, who said that 0:17:03.640 --> 0:17:07.840 the phrase I heard is that surgeons see with their hands. 0:17:07.880 --> 0:17:10.520 So a surgeon getting his or her hands on a 0:17:10.600 --> 0:17:13.760 model heart has a much better feel for what they 0:17:13.800 --> 0:17:16.880 need to do when the surgery is is when it's 0:17:16.880 --> 0:17:20.040 time to actually perform the surgery. So this is not 0:17:20.240 --> 0:17:22.800 something that's just being rushed into practice. In fact, it's 0:17:22.840 --> 0:17:28.119 being put into a very controlled test system. Yes, seven 0:17:28.240 --> 0:17:32.440 cardiac surgeons at Boston Children's Hospital are going to be 0:17:32.560 --> 0:17:36.120 working with this new technology right exactly, so no patients 0:17:36.200 --> 0:17:38.280 lives will be at risk. What they're doing is they're 0:17:38.280 --> 0:17:41.919 actually going to use ten cases that have already gone 0:17:41.960 --> 0:17:44.520 through treatment. So these are people who have already had 0:17:44.520 --> 0:17:47.960 surgical procedures done on them, and they're just using the 0:17:48.040 --> 0:17:51.719 data from those ten cases. So the patients are gone there, 0:17:51.440 --> 0:17:55.440 they've left the hospital, but their information remains. And so 0:17:55.520 --> 0:17:59.720 these seven cardiac surgeons are going to get these ten cases, 0:18:00.040 --> 0:18:02.680 which includes all the mri I data that was gathered 0:18:02.760 --> 0:18:08.040 about the different patients and will include either a physical 0:18:08.080 --> 0:18:10.920 model or a three D model that will be randomly 0:18:11.040 --> 0:18:16.320 determined on each case basis for each surgeon, and the 0:18:16.359 --> 0:18:19.640 source of the information for that physical model or three 0:18:19.720 --> 0:18:23.120 D model will either be from the traditional ten hours 0:18:23.200 --> 0:18:27.639 of expert analysis or through this computer algorithm. All of 0:18:27.680 --> 0:18:30.280 that's going to be randomly determined. I imagine they're going 0:18:30.320 --> 0:18:33.280 to do this in a double blind approach, so that 0:18:33.400 --> 0:18:35.760 none of the cardiac surgeons will be aware if the 0:18:35.840 --> 0:18:39.480 model they have came from the traditional method or through 0:18:39.520 --> 0:18:43.560 the algorithm. Then all the cardiac surgeons will describe what 0:18:43.840 --> 0:18:46.679 their process would be, what their plan would be for 0:18:46.760 --> 0:18:50.800 surgery for that particular case out of all the ten cases, 0:18:51.400 --> 0:18:53.199 and then what will happen is at the very end 0:18:53.240 --> 0:18:56.879 of it, they will start to compare what was actually 0:18:56.960 --> 0:19:00.639 done in the in the in cases, yeah, that the 0:19:00.680 --> 0:19:05.720 plan that the actual surgeons made with the traditional stuff. Yeah, 0:19:05.800 --> 0:19:09.000 and also what the outcome was, like did the model 0:19:09.400 --> 0:19:13.400 accurately represent what was really in that patient? And then 0:19:13.520 --> 0:19:16.360 after all of that, they're going to see if the 0:19:16.440 --> 0:19:20.280 algorithm three D approach is uh, is something that would 0:19:20.320 --> 0:19:23.639 be of value to the surgeons, right, something that that 0:19:23.880 --> 0:19:27.400 hypothetically would have created a better plan. Uh. It could 0:19:27.440 --> 0:19:31.760 also help reduce problems after surgery because sometimes prosthetic patches 0:19:31.880 --> 0:19:34.919 need to be be applied to the heart and of course, 0:19:34.960 --> 0:19:37.639 having you know, the wrong shape or the wrong size 0:19:37.640 --> 0:19:41.399 of patch, even even slightly off, can wind up causing 0:19:41.480 --> 0:19:43.920 damage like lesions and stuff like that from the line. 0:19:44.280 --> 0:19:47.439 And so this technology could let surgeons tailor three D 0:19:47.480 --> 0:19:50.200 printed patches to the patients a lot more easily. Yeah, 0:19:50.240 --> 0:19:53.919 it's pretty pretty cool stuff and uh so we really 0:19:54.240 --> 0:19:56.160 pleased when we saw this one. Also, if you get 0:19:56.200 --> 0:19:59.240 a chance to look at the stories, you can see 0:19:59.359 --> 0:20:02.360 the actual three D models have been printed and they're 0:20:02.400 --> 0:20:05.560 pretty funky looking. They're they're a little bit gruesome. I 0:20:05.600 --> 0:20:08.520 like them a lot. Yeah, I want Yeah, you wonder 0:20:08.560 --> 0:20:11.919 if you can actually request what color plastic they're going 0:20:11.960 --> 0:20:16.360 to print yours in probably clear all around, but but yeah, 0:20:16.440 --> 0:20:18.320 yeah they had a bluish tinge but I couldn't tell 0:20:18.320 --> 0:20:21.359 if that was just the background there, and and and 0:20:21.560 --> 0:20:25.560 the three D printed models are just made of conventional plastics. Yeah, yeah, 0:20:25.600 --> 0:20:29.159 they're not made out of anything particularly bizarre or icky. 0:20:29.280 --> 0:20:33.320 But something that is made of particular stuff is our 0:20:33.440 --> 0:20:37.160 third and final story in our three D Printed Medicine 0:20:37.359 --> 0:20:41.520 kind of uh episode, which is this idea of creating 0:20:41.560 --> 0:20:47.320 three D printed scaffolding specifically to encourage nerve regeneration in 0:20:47.320 --> 0:20:51.000 the wake of injury or illness. Yeah, because when your 0:20:51.040 --> 0:20:54.119 nerves are damaged, that that sucks. Yeah. You could be 0:20:54.160 --> 0:20:57.320 in severe pain or even suffer paralysis as a result 0:20:57.359 --> 0:20:59.480 of it. Yeah, and it and it can be very 0:20:59.520 --> 0:21:03.400 difficult to get nerves to regrow, especially through damaged tissue, 0:21:03.600 --> 0:21:06.000 which tends to be the case when you have had 0:21:06.160 --> 0:21:09.680 nerve damage. Yeah, so it's a a very tough problem. 0:21:09.880 --> 0:21:13.480 And so we can we've seen some ways where people 0:21:13.560 --> 0:21:17.199 have have tried to address nerve damage. We've seen some 0:21:17.240 --> 0:21:21.840 surgical attempts that involve grafting healthy nerves in the area 0:21:21.880 --> 0:21:24.800 where there was nerve damage, and that that's exactly what 0:21:24.920 --> 0:21:27.760 sounds like. A surgeon will take healthy nerves from one 0:21:27.800 --> 0:21:30.679 part of your body and then graph them onto the 0:21:30.760 --> 0:21:34.359 nerves in your damaged or ill part of your body, 0:21:34.400 --> 0:21:37.280 whichever parts suffered the nerve damage in the first place. Right. 0:21:37.320 --> 0:21:39.320 But there can be a lot of problems with with that. 0:21:39.400 --> 0:21:42.639 You know, the graft can be rejected by by your 0:21:42.680 --> 0:21:47.600 body sometimes, right, or also you could have lasting pain 0:21:47.880 --> 0:21:50.320 and the sight of where they harvested the nerves in 0:21:50.320 --> 0:21:52.160 the first place. So, in other words, you've just traded 0:21:52.200 --> 0:21:54.800 where the nerve damage has because you're you're losing. Yeah. 0:21:54.840 --> 0:21:57.320 So so it's it's not ideal. Yeah. And and the 0:21:57.400 --> 0:22:00.520 plus you have to have two surgeries in that you 0:22:00.520 --> 0:22:02.360 have to have one on the site where they're harvesting 0:22:02.359 --> 0:22:04.720 and one on the site where they need to implant it. Yeah. 0:22:04.800 --> 0:22:07.840 And of course limiting that kind of invasion is one 0:22:07.880 --> 0:22:11.840 of the major points of modern medicine. Yeah, because, as 0:22:11.880 --> 0:22:14.840 we know, anytime you have any kind of surgical incision, 0:22:14.880 --> 0:22:19.440 you are opening up the opportunity for infection. And obviously, 0:22:19.600 --> 0:22:22.960 the fewer surgeries that are required to address any one 0:22:23.040 --> 0:22:26.640 problem the better, right, as long as they're effective. Obviously, 0:22:26.880 --> 0:22:31.720 you don't want to undergo ineffective medical procedures for well, 0:22:31.720 --> 0:22:33.880 we thought we would put a horse in this one. 0:22:34.240 --> 0:22:37.960 We dipped her in a pond. Uh didn't seem to help, 0:22:37.960 --> 0:22:41.320 but it was at least entertaining. So there's there's an 0:22:41.359 --> 0:22:45.840