Wednesday, 12 March 2014

Pioneering surgery to reconstruct the face using a series of 3D printed parts in Wales

 Stephen Power Stephen Power was photographed before the operation and afterwards

A survivor of a serious motorbike accident has had pioneering surgery to reconstruct his face using a series of 3D printed parts. Stephen Power from Cardiff is thought to be one of the first trauma patients in the world to have 3D printing used at every stage of the procedure. Doctors at Morriston Hospital, Swansea, had to break his cheekbones again before rebuilding his face. Mr Power said the operation had been "life changing". The UK has become one of the world's pioneers in using 3D technology in surgery, with advances also being made by teams in London and Newcastle.

While printed implants have previously been used to help correct congenital conditions, this operation used custom printed models, guides, plates and implants to repair impact injuries months after they were sustained. Despite wearing a crash helmet Mr Power, 29, suffered multiple trauma injuries in an accident in 2012, which left him in hospital for four months. "I broke both cheek bones, top jaw, my nose and fractured my skull," he said. "I can't remember the accident - I remember five minutes before and then waking up in the hospital a few months later." 

Views of Stephen Power's skull with temporary staples after the operation

In order to try and restore the symmetry of his face, the surgical team used CT scans to create and print a symmetrical 3D model of Mr Power's skull, followed by cutting guides and plates printed to match. Maxillofacial surgeon Adrian Sugar says the 3D printing took away the guesswork that can be problematic in reconstructive work. "I think it's incomparable, the results are in a different league from anything we've done before," he said. "What this does it allows us to be much more precise. Everybody now is starting to think in this way - guesswork is not good enough."

A skull model and implants produced using 3D printing
The procedure took eight hours to complete, with the team first having to re-fracture the cheek bones with the cutting guides before remodelling the face. A medical-grade titanium implant, printed in Belgium, was then used to hold the bones in their new shape. Looking at the results of the surgery, Mr Power says he feels transformed, with his face now much closer in shape to how it was before the accident. "It is totally life changing," he said. "I could see the difference straight away the day I woke up from the surgery." Having used a hat and glasses to mask his injuries before the operation, Mr Power has said he already feels more confident.

"I'm hoping I won't have to disguise myself, I won't have to hide away," he said. "I'll be able to do day-to-day things, go and see people, walk in the street, even go to any public areas." The project was the work of the Centre of Applied Reconstructive Technologies in Surgery which is a collaboration between the team in Swansea and scientists at Cardiff Metropolitan University. Design engineer Sean Peel has said the latest advance should encourage greater use of 3D printing within the NHS. "It tends to be used for individual really complicated cases as it stands, in quite a convoluted, long-winded design process," he said. "The next victory will be to get this process and technique used more widely as the costs fall and as the design tools improve." 


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