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An interview with Dr Luke Hale, visiting researcher at the University College London Division of Surgery and Interventional Science.

It's no secret that some of the best innovations that we've seen in the medtech and healthtech space have been created by doctors. After working on 3D design and animation, Dr Luke Hale [pictured on the right], visiting researcher at the UCL Division of Surgery and Interventional Science and medical doctor by background, decided to apply the skills acquired throughout his career to start working in tissue engineering. At UCL, his research project, conducted in collaboration with the Royal National Orthopaedic Hospital, created a bespoke neck collar for a patient with a neurological disorder combining biomimetic design, 3D printing and 3D scanning. The study was published in Nature Scientific Reports earlier this year.

Below, in a Q&A with techUK, he talks about their findings and how the new workflow could benefit both patients and staff.

techUK: What can you tell us about the study?

Hale: So, the study describes a new way of making orthoses, which are medical devices used to support the body. The traditional way of making personalised orthoses involves multiple steps by a skilled clinician and can take up to six weeks. This new workflow involves a combination of 3D scanning, procedural design and 3D printing - and could make these devices much more quickly. The process uses algorithms to make the devices more comfortable and so that they use material efficiently, a bit like how nature optimises the structure of the bone. We then successfully applied the workflow to make a collar [pictured on the left; image credit: David Bishop] for a patient with a neurological disorder in whom all traditional approaches had failed.

techUK: You've mentioned that this can be done much quicker. What are some of the other benefits that this approach could bring compared to traditional methods?

Hale: Yes, hopefully, it's quicker - which is a huge benefit for patients - but also potentially cheaper. When we did the study, the price was comparable to traditional methods. Most of this cost was from using an external 3D printing company and could be reduced with a dedicated 3D printer in the hospital. The new workflow could be optimised to reduce the amount of material that you use.

There are other benefits - the patient can influence the process to decide what their orthosis looks like, reviewing and choosing from different designs before they are made. Then also certain complex cases like the one in which we demonstrated the workflow could benefit from this approach as well. Some patients require lots of custom orthoses in quick succession - in children or patients with progressive conditions - the workflow was made so that new devices can be easily altered in these circumstances.

techUK: Are there any limitations or downsides that would mean traditional methods are better?

Hale: The workflow is suited to patients that need a bespoke medical brace. For very straightforward cases, say a finger splint, it might be unnecessary to 3D scan and apply the full workflow. Also, the cost of equipment can initially be high - 3D scanners and 3D printers are expensive - but this cost would be offset over time. The clinicians that make bespoke devices are very skilled, and it is important that any new process should be applied whilst also using their knowledge and expertise.

techUK: What would be needed in order to expand this and make it readily available across the NHS, if proven to work further?

Hale: At the moment we've done a case study on one patient, so I think the next stage would be testing it on more people, having a wider range of conditions and optimising the workflow further. This larger study would give a good idea of the cost, time and labour saving. I think at this point you could clearly demonstrate the benefits of using these technologies in the NHS. Then, with funding, you could develop a kind of hub in each hospital where there is a 3D scanner and 3D printer and you have a seamless workflow of scanning patients and creating devices - with each hub sharing expertise and designs.

techUK: Looking more widely, where do you see 3D printing and 3D scanning play a role in the field going forward?

Hale: In medicine, 3D printing has lots of applications already - making implants, education, surgical planning, even creating customised tablets and medicines. There are also certain areas where it has massive potential which hasn't quite been realised yet. In tissue engineering, for example, 3D printing or bio-printing could create a revolution in creating artificial tissue, initially making simple tissues like bone, skin, cartilage then eventually functioning parts of organs, like the liver. Eventually, it could replace organ transplants. I think in general if you look at Neri Oxman's group's work you get an idea of where additive manufacturing will be in 10-15 years - working with nature to create useful structures. Also, I think exploiting ideas like 4D printing and self-assembly, where structures change in the body over time will become more relevant in the future.

3D scanning creates a very detailed 3D map of the body, so it's already useful in areas like dermatology or in estimating burn surface area. I think 3D scanning and 3D printing are very powerful together and can be used to make something that is completely personalised and conforms to the body. For example, in trauma and reconstructive surgery, you could scan a defect, then 3D print something to repair the defect. With VR and AR, I think quite soon depth-sensors will be widespread on mobile devices and so you would be able to 3D scan with your phone. I think that this is the area in which the greatest changes could happen, once these technologies become accessible to everyone. Then, someone could maybe make a device like we made in the study at home, with input from a collaborative open-source community. I think these decentralised communities could be very beneficial for patients in managing their own conditions and feeling empowered. There are lots of exciting things happening!