Now in 3D

Illustration by Madeleine Witt

“This is half a lung.” Mark Michalski held up a twisting piece of plastic, one inch thick, to his chest. To me, it looked like roots on the underside of a tree, with small white tendrils poking through brown mesh. This was one of Michalski’s first attempts to create customized plastic models of human organs.

Michalski is a fourth-year resident at Yale-New Haven Hospital. Over the past year, he has been making plastic replicas of body parts using the machines at Yale’s Center for Engineering Innovation and Design (CEID), an engineering workshop space located on the bottom floor of Becton Center on Prospect Street. The CEID provides materials, tools, and advising for any Yale student who signs up to be a member. One such tool is a 3D printer. It works like a regular inkjet printer, but rather than depositing one layer of ink on paper, it deposits many layers of material, usually plastic, to create a three-dimensional object.  Michalski converts patients’ medical data into instructions for the printers at CEID, which then produce plastic models unique to each patient.

What started as a pet project is morphing into a technology that could revolutionize surgery and, more importantly to Michalski, help doctors communicate with patients about their diseases. Aside from the lung, his recent projects include a fractured pelvis, a diseased kidney, and a cancerous prostate.

As a radiologist, Michalski spends his days looking at MRI and CT scans of the insides of people’s bodies, analyzing these scans to diagnose diseases and plan treatments. In his office, Michalski used his laptop to show me a 3D skeleton with a fractured pelvis. He rotated the skeleton with a computer mouse, highlighted various bones, and opened 2D slices of the 3D model. Staring at the screen, I felt nowhere near the real thing, an operating room where a surgeon would manipulate a patient’s pelvis.

“3D reconstructions give you some great data,” Michalski said. “But…for a lot of populations who are not radiologists”—he lowered his voice—“even within the radiologist community, frankly, there’s value that comes from being able to hold [the organ].” So he looked into 3D printing at the CEID. He created his first model on a low-end 3D printer, which is about the same size and twice the price of a new MacBook Pro.

“It all started on that MakerBot right there,” Michalski told me, pointing to the printer. Within a wooden frame, a small black box moved back and forth along metal rods, squeezing out plastic like glue from a hot glue gun. This machine had printed the root-like lung Michalski had shown me earlier. While Michalski and I spoke, two other students watched the MakerBot spit out a custom iPhone case.

About a year ago, Michalski was printing a version of the lung when his project caught the attention of Joseph Zinter, associate director of the CEID. Zinter and Michalski started talking about the concept and they were soon partnering to advance the work of 3D printing. Zinter has since put hundreds of hours into the project and established a special fund for organ printing at the CEID. The two have discussed potential applications for this technology, including educating medical students, informing patients about their conditions, and helping surgeons prepare for complicated procedures.

This last idea has already been put into practice. Joseph Turek, chief of pediatric surgery at the University of Iowa Children’s Hospital, has been using 3D-printed models of hearts for almost a year. They help him finalize his strategy and gain confidence for performing surgery when the stakes are much higher. “When I go into the operating room, it’s the exact same thing that I’m seeing,” Turek said.

This summer, Michalski printed a cancerous knee for an orthopedic surgeon at Yale. While preparing for surgery, the surgeon put the model on his desk, took out his surgical tools, and determined the best way to excise the tumor without damaging the surrounding area. The model allowed him to practice technique without consequence.

These 3D printing projects now take up most of Michalski’s time. But in addition to his residency, he is pursuing a Ph.D. in investigative medicine at Yale. “I have no idea if you can write a thesis on this sort of thing,” Michalski said. “But I think it’s interesting enough”—he corrected himself —“important enough, that I’ve got to do it.”

The models’ educational and surgical applications are significant. But Michalski is primarily drawn to this work because it could better inform patients about how a disease affects their own organs. Holding a model of your liver when you have been diagnosed with a tumor gives you a concrete sense of what that means.

“The story, for me, won’t end until I’ve used this technology to make patients understand better what’s going on inside their body,” Michalski said. “If we can print new bracelets and trinkets with these [printers], then we can print meaningful objects for people who are really undergoing the battle of their life.”

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