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Inside the world of 3-D printing with a man on a personal mission
Dawn Brazell | MUSC News Center | January 22, 2016

craniosynostosis 3D Printer
Photos by Sarah Pack

Replicas of Rhett Bausmith's skull were printed on two different 3-D printers at MUSC. Surgeons used them to plan his surgical treatment and explain to his family what was to be a very complicated surgery to treat the birth defect craniosynostosis. (Photo Gallery) 

At the punch of a button, Mark Semler can leave the room that houses his lab’s 3-D printer and know when he comes back 24 hours later, he will have a skull.

Recently, it was a replica of the skull of baby Rhett Bausmith, who was born with a genetic condition that caused his head to be misshapen. Surgeons used the replica of Rhett’s skull to help plan his treatment and explain to the family what was to be a very complicated surgery to treat the birth defect called craniosynostosis. (Read more about Rhett Bausmith here.)

Now with one surgery successfully done, Rhett is well on the road to recovery. Semler, who is chief technology officer for the Zucker Institute for Applied Neurosciences (ZIAN) at the Medical University of South Carolina, says it’s one reason he loves his job.

Dr. Mark Semler 
Mark Semler talks about how 3-D technology gives surgeons a better idea of the issues patients face before going into surgery. 

“You’ve seen MRIs on a screen – that’s a nightmare – you’re trying to figure out what you are seeing. You’re trying to visualize a kid’s 3-D skull. If a picture is worth a thousand words, this is worth a million. This is the patient’s actual skull shape and the issues that are inside. If it can comfort them and give them more information, it’s a very powerful tool.”

MUSC has two labs that handle 3-D printing, including ZIAN and the Advanced Tissue Biofabrication Center (ATBC), which also produced a replica of Rhett’s skull for the use of his surgeons to prepare for the case. Michael J. Yost, Ph.D., director of general surgery research at MUSC, said the 3-D models help in two main ways.

“First, it provides the surgeon a true-to-life-size 3-D model of the anatomy to use to plan the procedure.  We can print multiples of these models, we can print different sections or cut them apart and reassemble similar to the surgical procedure. It allows the physician to complete several dry runs before actually performing the procedure.”

They also serve as important communication tools among the patient, the family, the surgical care team and the physician.
Dr.Michael Yost 
Dr. Michael Yost 

Yost said the main mission of the ATBC is to develop advanced biofabrication techniques, including 3-D printing and bioprinting. “We are to then translate these technological developments into useful tools to improve patient care, improve outcomes and reduce overall health care costs.”

Early work in 3-D tissue biofabrication was spearheaded by investigators at Clemson University and MUSC. The lab has a Palmetto Printer, a fully automated bioprinter designed by MUSC and Clemson researchers at the ATBC. It also has a MakerBot Replicator 2 to introduce students to 3-D printing technology.

Among the center’s many accomplishments, it has succeeded in printing microvascular structures using living cells. These structures, measuring 100 microns by 10 millimeters, mimic the design of blood vessels or tissues.
 Images from patients' scans are put into special software to make replicas using 3-D printers.

For the creation of the skull for the Bausmith family, the process was to get computerized tomography scan data and reconstruct Rhett’s skull in 3-D using a software package. It cost about $250 to create the model. “We translate the reconstruction into data the printer can understand. We print the anatomy, and we cross-check the anatomical landmark dimensions from the scans and the printed object.”

Semler said the process is similar at ZIAN.

ZIAN’s 3-D printer uses a photopolymer material that prints with an accuracy of .004 of an inch. CT scans are fed into software that translates them into stereolithography files that can be read by the 3-D printer. They load the machine with the correct material and print. “It tells you to come back in 24 hours and you come back and scrape the skull off with a spatula and you start cleaning it."

The 3-D printer, which functions much as an inkjet printer would, uses a liquid plastic that turns to a solid when it’s exposed to ultraviolet light. As the print head comes across, it lays down either the clear scaffold material or the colored solid material (in this case, white). The UV light comes right behind it, and turns it into a solid.

Semler says the software translates the imaging scans down to the millimeter to match the patient’s physical geometry. “You get a very clear idea of what you’re going to see before you start cutting the skin.”

Dr. Mark Semler - Lab 
A 3-D skull in the ZIAN lab is partially printed on the left and the final product is on the right. 

Semler, who has been involved in 3-D printing for 20 years, said 3-D printing is not new. What has radically changed is pricing and software tools to make the technology much more accessible and affordable. His lab has an Objet 30-pro printer that comes with a $60,000 price tag for an upgraded model. It has superior accuracy and ability to print multiple materials, including clear, multiple solid color and high temperature variations. Rhett’s skull cost about $350 in materials to produce.

Semler said he’s glad to see the Department of Neurosurgery embrace the technology, especially given the sensitive nature of what they do. “Every teaching hospital should have this type of support. It’s the next frontier, and neurosurgeons are always trying to figure out how the brain works and this is the next technology that can help them do that. They’re inventive.”

3-D printing obviously has a promising future, he said, including new materials that are emerging, such as metals that can be implanted. As 3-D printing becomes more commonplace, it will be easier to get insurance coverage for preoperative planning. The ultimate will be the printing of organs.

Semler, a mechanical engineer, went into medical devices because of family reasons. He lost both parents when he was in high school, his father from cancer and his mother, a heart attack from complications of an asthma attack.

“I suffered losses as a kid, and every skill that I had I wanted to devote to improving patients’ lives. When they come and say they have a kid – a brand new life – absolutely, I want to improve all patients’ lives, but you really want to be able to help kids. This is a no-brainer.”



Making muscle: Tissue engineering in MUSC's Department of Surgery

Photo Gallery of MUSC 3-D Printer labs

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Resources >>

MUSC Department of Neurosurgery


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