Among the projects of Inworks, a joint innovation initiative of the University of Colorado Denver and the Anschutz Medical Campus, one remains close to the heart. That is, the literal hearts from Inworks’ high-end polyjet printer, which produces 3D model organs for surgical planning. For a young patient of Max Mitchell, MD, the model hearts served as illustrative surgical tools and a showcase of the collaboration between doctors and designers.
Associate Director Monika Wittig describes Inworks as the pre-pipeline to CU Innovations’ ecosystem. Where doctors and clinicians work with CU Innovations to refine and hone their ideas for commercialization, Inworks is where those ideas first come to life. Budding inventors can collaborate with Inworks designers to create animations, 3D models, virtual reality simulations, and other prototypes.
That dedication to cutting-edge technology and collaboration drew Dr. Mitchell to proposition Inworks for a customized approach to his patient’s dilemma.
Model of a patient's heart
As a pediatric congenital cardiac surgeon, Dr. Mitchell is well-versed in difficult cases but wanted to take extra precautions for a patient with Wolff-Parkinson-White syndrome. Cardiac ablation would correct the patient’s tachycardia, but prior procedures found that traditional catheterization was ineffective. Further surgery would be necessary, and, based on the patient’s organ structure, incisions would be difficult to predict and hard to place.
Dr. Mitchell approached Inworks to print a model of the patient’s heart so that he and the team — cardiologists Dr. Kathryn Collins, Dr. Johannes Von Albensleben, Dr. Martin Ruciman, Dr. Dale Burkett, Dr. Michael DiMaria, and radiologist Dr. Lorna Browne — might have a better idea of what to expect during surgery.
The request for a custom model didn’t spring up overnight. For several months, Inworks designers Nick Jacobson and Hayden McClain, a CU Denver graduate student in mechanical engineering, collaborated with surgical teams at Children’s Hospital Colorado. What began as an invitation to observe Dr. Mitchell, Dr. DiMaria, Dr. Browne, and other surgeons, evolved into sessions where Jacobson and McClain brought in models and discussed with doctors how to refine and improve them to better serve as surgical tools.
When Dr. Mitchell made his patient-specific request, about a week before the scheduled surgery, McClain was so experienced in the anatomy and process that he transformed the CT scans and patient data into models within 72 hours. After a design session where the doctors practiced and planned their surgery with the models, Jacobson and McClain delivered a second set, customized for view planes, cross sections, and access points based on the doctors’ feedback. The designers also used their first hand knowledge of the surgeons, like Dr. Mitchell’s position at the right side of the patient’s chest, to tailor their models to mimic the surgical experience as closely as possible.
Fast, inexpensive prototyping
In preparing for the operation, the model was used with the echo probe and the intracardiac navigation system and overlaid on the MRI study. Combining these techniques, Dr. Mitchell recalled the team was able “to pinpoint within millimeters where they were in the heart.” In the next day's surgery, Dr. Mitchell found he needed to be exactly where the model had predicted, which eliminated a certain amount of risk for the patient during the procedure.
According to Nick Jacobson, “the magic of 3D printing is that ideas can be prototyped quickly and inexpensively, making it easier to test out new concepts and ideas,” which “puts the power of innovation directly in the hands of those who have the best understanding of the problems that need to be solved.” In this case, both surgeon and patient benefited from the customizable nature of 3D printing and how it fits hand-in-hand with treating congenital diseases. The outcome epitomizes Inworks’ emphasis on human-centered design — improving patient care and outcome and developing tools tailored for the end user — as the designers continually push the limits of what is possible.
In addition to patient-specific cases, Inworks is also a maker workshop where physicians can prototype their ideas and, when suitable, gain traction toward commercialization. To do so, Inworks continues to grow its working relationship with CU Innovations to create the most successful outcome by collaborating from the start and merging Inworks’ design expertise with CU Innovations’ administrative and operational resources.
Guest contributor: Stephanie So