Case study Additive manufacturing in veterinary surgery - saving a well-loved member of the family Julius Liptak Seven year old Bernese Mountain Dog requiring excision of maxilliary tumour. Design and manufacture a custom implant to replace the removed tissue. Industry: Medical and healthcare Executive summary A truly international effort, involving input from Germany, Canada and the UK has seen additive manufacturing (AM), also known as metal 3D printing, used to great effect to help save a Canadian family’s dog. In a recent procedure, Renishaw helped to produce an implant designed by Voxelmed in Germany that was fitted in Canada, to replace the hard tissue lost due to tumour removal. Background More than 50 per cent of dogs over ten years of age are likely to develop a tumour. Often, tumours can be shrunk with chemotherapy and removed with surgery without excessive long-lasting trauma. However, in some cases the placement of the tumour is too difficult to operate on without severely impacting the quality of life for the dog. In the human world there has been a significant shift towards surgeons using customised implants to help improve the results of surgery and reduce patient recovery times. In the past, hospitals would only use patient specific implants (PSIs) for complex cases, but now — thanks to advances in technology — they are becoming part of standard practice. One of the most effective ways of producing a custom PSI is by using additive manufacturing (AM) with medical-specific CAD tools for the custom design. Without additive manufacturing technology, it would have been impossible to reconstruct the dog’s maxilla after tumour removal, because the area was extremely complex in geometry. Alta Vista Animal Hospital, Ottawa, C

Dog being prepared for surgery Surgery image showing incision marks Challenge A seven-year-old Bernese Mountain Dog with a tumour on the left side of his maxilla (upper jaw) had few options other than total excision of the growth followed by reconstruction. A customised 3D printed titanium implant supporting the dog’s bone structure was the most appropriate treatment due to the complexity of the region, requiring significant design and manufacturing freedom. PSIs have predominantly been used in human cases to date, but global engineering and healthcare technologies company, Renishaw, and 3D design...

The design and manufacture of the implant took just two weeks to complete. In this particular case, the dog was suffering with ongoing tumour growth. So, if the implant had taken too long to be produced it would have no longer been fit for purpose as the affected area would have grown. Results “Without additive manufacturing technology, it would have been almost impossible to reconstruct the dog’s maxilla after tumour removal, because the area was extremely complex in geometry,” Klasen commented. “The implant had to have a similar shape and functionality as the dog’s existing bone structure....

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