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Singapore, 22 May 2022 — A 20-year-old man became the first in Singapore to receive a 3Dprinted implant at the Singapore General Hospital (SGH) last December to correct his sunken chest. The condition, known as pectus excavatum, had not only affected his self-esteem, healso had breathing difficulties as the sunken chest was putting pressure on his heart and lungs.
Patients with moderate to severe symptoms may choose to undergo a minimally invasive surgery known as the Nuss procedure. It is done by inserting a curved stainless steel bar into the chest cavity via a small incision on each side of the chest. The bar works like a brace, pushing the breastbone (sternum) outwards, and will be removed after three years when the chest is permanently reshaped.
“Pectus excavatum can affect an individual, both physically and psychologically. While the Nuss procedure can significantly improve patient’s breathing and cardiac function, it may not sufficiently correct the physical appearance as chest deformity is usually asymmetrical,” said Dr Chew Khong Yik, Senior Consultant, Department of Plastic, Reconstructive & Aesthetic Surgery at SGH.
To do so, injected fat cells or synthetic implants are typically used to fill the little pockets of sunken areas that are not corrected by Nuss procedure. “Existing options such as the use of silicone implant, however, may cause problems such as displacement, and infection. This led us to explore the use of 3D printing as a possibility,” added Dr Chew, who pioneered the treatment.
Using computerised tomography (CT) scan images of the patient processed by SGH’s Department of Diagnostic Radiology for 3D printing, the team was able to collaborate with homegrown medical devices business Osteopore International, to print a bioresorbable implant. The fit was pre-determined by placing a prototype model of the implant produced by Osteopore on chest wall models printed by the Hospital. The team also worked with two other companies to assemble the customised piece for the patient. Over a course of two years, the patient’s own bone will replace the implant that will dissolve.
“Currently, 3D models printed by SGH allow surgical teams to rehearse complex cases, as well as to pre-size and pre-shape implants before operation to improve their fit, patient outcomes, and decrease operative time. The Hospital will harness the potential of 3D printing and further expand its use to better patient care, starting with the launch of our very own 3D printing Centre in SGH at the end of this year,” said Dr Mark Tan, Associate Consultant, Department of Diagnostic Radiology, and Clinical Lead, 3D Printing Centre, SGH.
Pectus excavatum affects about one in every 600 children. It is more common in boys than girls, and may progress in severity with time.
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