The star patient, a nine-year-old dachshund named Patches is at the center of what Dr. Oblak believes is the first procedure of its kind in North America and a substantive leap from one other known case reports the Globe and Mail.
Patches for years had a small bump on her head that appeared to be harmless, according to her owner, Danielle Dymeck, who is from Williamsport, Pennsylvania. However, the bump began growing until it became the size of an orange and turned out to be cancerous.
Ontario researchers use 3D-printing tech to replace part of dog's skullpic.twitter.com/5bxLrRlvYA
— CP24 (@CP24) September 23, 2018
Dymeck was referred by her veterinarian to Cornell University‘s veterinary program, which in turn pointed her toward Dr. Oblak in Ontario, and this was a lucky move for Patches because Oblak had been studying the use of 3D printing technology – also called rapid prototyping technology for dogs.
Patches’ tumor had grown right through her skull, and usually, this would have required removing the tumor and part of the skull in surgery and then, while the animal was still under, titanium mesh would be fitted in place. Dr. Oblak said it was an imprecise, costly and lengthy procedure.
And because Patches needed almost 70 percent of her skull replaced after the tumor was removed, she suggested the new procedure, in which a 3D printer creates a custom-made titanium skull cap for a dog. According to Oblak, veterinarians in the United Kingdom had performed a similar procedure, though on a much smaller scale.
Dymeck, Patches’ owner was nervous about the surgery, but she decided to go ahead, saying “They felt she could recover from this. And to be part of cancer research was a big thing for me — if they can learn something from animals to help humans, that’s pretty important.”
Majority of dog's skull replaced via 3D-printing technology pic.twitter.com/H02BjFWvMV
— The Vancouver Sun (@VancouverSun) September 23, 2018
The procedure starts with a CT Scan
A CT Scan of Patches’ head was done. Then using several different software programs, The surgical team digitally cut out the tumor and diseased parts of the skull from the CT image. Then, they designed the 3D printed replacement, complete with holes for screws to hold it in place. This was then sent to ADEISS, a London, Ontario-based medical 3D printing company.
In all, it took about two hours to come up with the design for the skull cap, and ADEISS had the final print ready in about two weeks.
Oblak also created a cutting guide to follow during the surgery. “There’s very little room for error,” she said. “We’re talking less than two millimeters or else the plate wouldn’t fit.”
On March 23, Patches underwent a four-hour surgical procedure where the tumor and affected areas of the skull were removed. The 3D printed skull cap was carefully inserted. A mere 30 minutes after waking up, Patches went outside for a walk. Dr. Oblak hopes to have the details of the procedure, which she believes is the first of its kind in North America, published in the upcoming months.
To date, Patches is doing well and is cancer-free, even though in a separate incident a week after the surgery, she suffered a slipped disk that paralyzed her hind legs.
“She has a wheelchair that she refuses to use, so she pulls herself around on her two feet, but she’s pretty fast,” Dymeck said. “I feel lucky to be her owner, and she’s still the boss of the house… We called her our little unicorn because she had this bump on her head, but it would have killed her. It’s pretty amazing what they did for my girl.”
3D printing technology
The 3D printing technology that saved Patches from a life of misery has been around for decades and is now integral to manufacturing because it can create items using materials ranging from plastic to titanium.
The technology is so common that even the International Space Station has a 3D printer to produce tools, replacement parts, and other items. But 3D printing in veterinary cases is relatively newer than the technology used in human surgical procedures.
Some of 3D printing’s greatest benefits can be seen in surgical planning, particularly in the treatment of limb and skull deformities, oral/maxillofacial fractures, and mandibular reconstructive surgeries. Before the development of 3-D printing, veterinary surgeons commonly relied on x-rays and CT for imaging which only gives a two-dimensional view.
And 3d printing also is a boon for practicing on a damaged bone or skull before actually doing the surgery. This not only reduces the time an animal is under anesthesia but improves the outcome.
