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Wednesday
Apr092014

CARTIS Welcomes First Minister of Wales Rt. Hon Carwyn Jones AM 

L-R: Sean Peel (Design & Research Engineer - PDR), Rt. Hon Carwyn Jones AM, Gavin Cawood (Director - PDR), Emily Bilbie (Surgical & Prosthetic Design Technician - PDR)

We were very pleased this week to welcome the Welsh First Minister, Carwyn Jones, to PDR along with his guest, Jeremy Cliffe - journalist at The Economist. The visit was at the First Minister’s request to see the work of the CARTIS team first-hand - who have recently made headlines around the world following pioneering work using 3D printing and computer planning in reconstructive surgery.   

Also present to welcome the visitors were Adrian Sugar and Peter Evans of Morriston hospital in Swansea who, in addition to collaborating on the design and performing the surgery for this recent case, have worked in close partnership with the team at PDR for over sixteen years.  This partnership was formalised in 2006 by the establishment of CARTIS.  In addition to the focus on this recent case, the Surgical & Prosthetic Design team at PDR use advanced manufacturing technologies to produce hundreds of custom medical devices and models for use in surgery in UK hospitals each year - and continue to push the frontiers in this field to reduce costs and improve treatment outcomes.

L-R: Gavin Cawood (Director - PDR), Peter Evans (Maxillofacial Lab Manager - Morriston Hospital), Sean Peel (Design & Research Engineer - PDR), Professor Antony Chapman (Vice Chancellor - Cardiff Metropolitan University), Dr Dominic Eggbeer (Sugical & Prosthetic Design Unit Manager - PDR), Adrian Sugar (Consultant Maxillofacial Surgeon - Morriston Hospital / CARTIS Chair), Rt. Hon Carwyn Jones AM

Wednesday
Mar122014

Using Advanced Design to Rebuild a Face 

 

The CARTIS team L>R: Lawrence Dovgalski (Principal Maxfac. Prosthetist), Kelly Morris (Trainee Maxfac. Prosthetist), Peter Evans (Consultant Prosthetist & Lab Manager), Dr Dominic Eggbeer (PDR - Surgical + Prosthetic Design Unit Manager), Sean Peel (PDR - Design & Research Engineer), Mr Adrian Sugar (Consultant Maxfac. Surgeon), Ffion O'Malley (PDR - Research Student).

 

BBC article & video here: http://www.bbc.co.uk/news/uk-wales-26534408

 

A motorcyclist who was severely injured in an accident has undergone pioneering surgery using techniques developed by the Surgical & Prosthetic Design team at PDR, Cardiff Metropolitan University and the MaxilloFacial Unit at Morriston Hospital. 

 

The patient, Mr Stephen Power, was motorcycling with friends, when he was involved in an accident in Llantwit Major, near Cardiff.  He broke both arms and his right leg was so badly damaged it required a bone graft.  He also suffered major injuries to his head and face.  Stephen underwent emergency surgery at Morriston Hospital, Swansea. His limb injuries were very serious and were managed by the trauma and orthopaedic surgeons and the plastic surgeons.

 

Consultant maxillofacial surgeon Adrian Sugar said:

 

“We were able to do a pretty good job with all his facial injuries, with the exception of his left cheek and eye socket. We fixed his facial fractures pretty well but he had damaged his left eye and the ophthalmologists did not want us to do anything that might damage his sight further. That was a good move because his eyesight has mostly recovered. But as a result we did not get his left cheekbone in the right place and we did not even try to reconstruct the very thin bones around his eye socket. The result was that his cheekbone was too far out and his eye was sunk in and dropped.”


The goal of the most recent surgery was primarily to correct Stephen’s appearance by precisely cutting and moving facial bones.  This represented a significant challenge due to the complexity of the necessary movements and proximity of the operation to critical, sensitive anatomy.  In order to offer the optimum outcome, a multidisciplinary approach that utilised the latest surgical planning, computer aided design and 3D printing techniques was required.    

 

PDR’s Surgical & Prosthetic Design team are experts at working with hospitals across the UK to pioneer new ways of using advanced computer aided technologies to improve the predictability, efficiency and accuracy of surgical and prosthetic procedures (at lower overall treatment costs).  PDR has a formal collaboration with the Maxillofacial Unit at Morriston Hospital; the Centre for Applied Reconstructive Technologies in Surgery (www.cartis.org), which also involves the collaborative expertise of other local, national and international units. 

 

Sean Peel, Design & Research Engineer from PDR, with Dr Dominic Eggbeer and Research Student Ffion O'Malley assisted the Morriston team transforming the medical scan data of the patient into a virtual, 3D surgical model.  Precise locations for cuts that would free up sections of facial bone for movement were then decided upon in close collaboration with the clinicians.  In order to translate these cuts into theatre, a custom fitting saw guide was designed to fit securely around the anatomy, with slots positioned to guide the surgeon’s movement.  Once the bone sections were freed in the virtual plan, they were carefully positioned to reconstruct the anatomy and provide the best possible symmetry.  Custom implants, and a repositioning guide to enable the bone sections to be held securely whilst the implants were placed, were then designed.

 

Sean Peel said: 

 

“3D Printing is often promoted in surgical use for its own sake – with an emphasis on the technological capabilities of the machines.  However, as this case amongst hundreds of others undertaken by PDR shows, developing and using a robust design process is just as important.

The interdisciplinary team works in two different technical languages using two contrasting skill sets from very divergent backgrounds.  Through the CARTIS collaboration, PDR’s design engineers are in a unique position to bridge this gap, translate, and find a balance between what is possible in the operating theatre and what is possible for design and fabrication.”


3D printing was the most logical choice for producing the complex guides and implant shapes.  PDR commissioned the manufacturing of cutting and positioning guides in bio-compatible cobalt chromium alloy to Renishaw, the only UK manufacturer of a metal 3D printing machine, which is increasingly applying its technology to medical applications.  The implants were 3D printed by another Belgium-based supplier (LayerWise) in medical grade titanium - supplied polished in the case of the orbital floor component. 

 

Mr Sugar led a multidisciplinary team that included ENT surgeon, Serryth Colbert, registrar, Ali Al-Rikabi, further theatre staff, and prosthetists Peter Evans and Lawrence Dovgalski.  The 8 hour operation went extremely smoothly, with the guides and implants fitting according to the plan.  Recovery has gone well since the operation and the swelling is gradually going down, revealing the final outcome. 


PDR SPD Unit Manager, Dr. Dominic Eggbeer said:


“The successful outcome is testament to the virtues of involving a multidisciplinary team that included University, NHS and industry partners.  PDR’s skilled team includes Design & Research Engineer, Sean Peel, Research Associate, Ffion O’Mailley and Technician, Emily Bilbie, who are routinely embedded in hospital departments to learn first-hand about the real-world requirements of clinicians.  We use design knowledge to provide the crucial link between surgical techniques and state of the art engineering technologies.”  

 

The next challenge is to refine the planning, design and manufacturing process to make these techniques as efficient as possible.  This is crucial to ensure much wider healthcare service benefits, which is the focus of on-going CARTIS research.  

Friday
Feb282014

PDR at BioWales 2014

CARTIS partner institution PDR (The National Centre For Product Design + Development Research) will be exhibiting at BioWales 2014 (6th-7th March, Wales Millenium Centre, Cardiff Bay).

We'll be showing examples of our custom implants, surgical guides, virtual surgical planning service, anatomical medical models and digital reconstruction.

Details about the conference & exhibition can be found at the BioWales 2014 website here: https://biowales.com/en/home/

Be sure to stop by the PDR stand for more information on our unique research partnerships, and our 16 years experience in collaborating with prosthetists, technicians and surgeons to deliver improved clinical outcomes at lower costs.

 

Monday
Feb242014

CARTIS To Present At Nottingham Trent University Conference

Dominic Eggbeer is presenting at the first 'Design for Health and Wellbeing' conference, organised by Nottingham Trent University, on the 25th February.  The conference aims to provide a timely forum to bring together researchers, healthcare companies and medical professionals to discuss medical design challenges, future developments, and share their research and development findings.  The conference seeks to build collaborative partnerships for developing research that informs the evidence base for practice, and to improve health and wellbeing outcomes.

Dominic’s talk will focus on maxillofacial surgical and prosthetic applications of computer aided design and 3D printing/additive manufacturing technologies, from research to practice. 

For further details on the conference, visit http://www.ntu.ac.uk/apps/events/22/home.aspx/event/150829/default/design_for_health_and_wellbeing_conference_  

Monday
Jan272014

CARTIS Partners Shortlisted At New Welsh Awards

 

The nominees with First Minister of Wales Carwyn Jones (including Peter Evans third from left and Lawrence Dovgalski fourth from left).

CARTIS’ maxillofacial team from Morriston Hospital is celebrating reaching the finals of the inaugural St David Awards for its innovative use of technology to improve patient care.

The team has been shortlisted in the Innovation and Technology category. It recognises its development of new techniques to provide life-changing treatments for patients with facial disfigurements following birth, trauma or illness. By using technology, the team enhance clinical outcomes and patient's quality of life.

Peter Llewellyn Evans, Consultant Maxillofacial Prosthetist, said:


“We are absolutely delighted and honoured to be shortlisted for the award. Developing new technologies is a vital part of our service. A facial disfigurement is upsetting for a patient and can cause them to have low confidence and self esteem. New technology improves the accuracy, symmetry and look of their treatment making it more realistic.

 

“Technology also helps to speed up treatment times. Patients used to need multiple appointments for us to plan their treatment and a lot of our design work started with a plaster cast. This could be claustrophobic for the patient, and if it didn’t set, they would have to come back and do it again. Using scanners and computer software we are able to take all the measurements we need in one sitting and then accurately design any surgery, implants or prostheses they need. The patients don’t need to come back to see us until we are ready to carry out their treatment.”

 

The team are responsible for setting up the first osseointegration service in the UK, which provides lifelike prostheses for patients without ears, nose or eyes.  In addition, the team can accurately reconstruct a patient’s face following disease or trauma.  

The unit sees around 2,000 patients a year and also works to help others develop similar techniques across the globe. Staff have produced over 60 research articles, spoken at international conferences and delivered training days.

Recognising achievements which make a difference to the quality of life in Wales, the Welsh Government awards take place for the first time in March.