Úvod: Použití technologie 3D tisku k výrobě implantátů ze slitiny titanu, které nahrazují lidské kosti, se v Číně vyskytlo mnoho případů, včetně kyčelních kloubů, páteře, hrudní kosti atd. Jak tedy Indie v této oblasti postupuje?
10. února 2022 složitá operace v nemocnici Manipal v Indii úspěšně odstranila pacientovi rakovinu a rekonstruovala jeho hrudní kost a žebra pomocí 3D-vytištěných titanových slitin. 50-letý muž z Bangladéše má vzácnou a komplexní rakovinu, která postihuje jeho hrudní kost a prvních osm žeber vlevo a vpravo. I kdyby bylo možné rakovinu chirurgicky odstranit, neexistovalo žádné schůdné řešení, jak znehybnit jeho hrudní kost a žebra, která jsou kritická pro normální dýchání.
Dr. Somashekhar, Chairman and Chief of Oncology Surgery at Manipal Hospital, said: "Advanced technologies are now available to provide treatment for complex cancer cases that were otherwise considered incurable by many. The credit for this case goes to Manipal Syndrome. The excellent coordination between the cancer center and the plastic surgery department, which has experts in modern technology and medicine, brings hope to millions of cancer patients worldwide."
△The hospital removes the tumor for the patient and implants the 3D printed titanium alloy sternum
zvlášť složitou operaci
The patient was taken to Manipal Hospital, where his MRI showed a 15 x 12.7 cm tumor mass over his lungs and heart that had destroyed the length of the patient's sternum and the inside of his ribs. Before surgery, the surgeon performed a CT scan of the patient area, created a personalized 3D model of the desired implant, which was then 3D printed in titanium.
Someshekhar explained, "We 3D printed a new titanium sternum, custom-made for this patient based on his size, height, weight and the part of the bone to be removed, and we worked with the company's technologists, engineers and Manipal Oncology Surgery and The plastic surgery team held several meetings". The patient underwent tumor removal surgery and his entire sternum and ribs were removed without much blood loss. This area was then replaced with a custom-made titanium alloy implant, which was held in place using new drilling techniques and titanium wire. Finally, before the skin is sutured, the implant is covered with a muscle flap removed from the patient's chest to restore normal breathing function.
Someshekhar continued: "The implants are often very heavy, up to 5kg, which is too heavy for the patient to carry on the chest. To correct this, we used a modified honeycomb technique to keep the weight of the sternum and sternum below 250 grams".
plné zotavení
After the operation, the patient recovered smoothly, and after physical therapy of the chest, he was able to move gradually. During his discharge from the hospital, he was reported to be able to eat, breathe and walk normally without any complications. According to Dr. Ashok, Consultant Plastic, Reconstructive and Aesthetic Surgeon at Manipal Hospital, 3D printed implants offer a number of important benefits for patients' recovery.
"The implants are strong, durable and lightweight," he said. In addition, they are well received by the body and are less prone to immune responses and implant rejection. The implants reduce osteoporosis disease, as well as the risk of fracture around the implant due to uneven stress transfer between the implant and surrounding bone tissue". The successful placement of 3D-printed titanium alloy implants means that after the tumor and affected parts of the bone have been removed, the patient no longer has to permanently rely on mechanical ventilation to breathe. "New-age technologies and materials are helping patients with complex problems get resolved and recover quickly," Ashok added.
"This patient is a perfect example of a combination of excellent medical care and technology."
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