Mr Ira Goldsmith
The first 3-D printed anatomical titanium chest wall prosthesis designed, 3-D printed and used for chest wall reconstruction at Morriston Hospital.
A 70-year-old male presented with an enlarging right chest wall chondrosarcoma involving the 2nd to the 4th ribs anteriorly. This required a wide surgical resection and skeletal and soft tissue reconstruction. To reconstruct the large chest wall skeletal defect a 3-D printed titanium implant was custom designed as an anatomical fit and developed using 3-D digital technology at Morriston Hospital by Mr Ira Goldsmith and Heather Goodrum.
This was then printed using three-dimensional (3-D) printing technology with the help of the Renishaw’s medical prosthesis team in Wales. At surgery, following a wide surgical resection of the chondrosarcoma, the implant was anchored to the ribs laterally and the hemi-sternum medially. The histology confirmed clear resection margins. At one year the patient was asymptomatic, fully mobile, and described no pain, breathlessness, discomfort or paradoxical movement at the implant site. On chest-ray, there was no evidence of dislocation or recurrence.
Mr I. Goldsmith with the help of the Maxillo-facial team at Morriston Hospital made use of recent advances in three-dimensional (3-D) printing technology to design and develop a custom-made titanium implant, which was constructed prior to surgery. The surgery was carried out jointly with the Burns and Plastics surgeon Mr T. Bragg. This not only helped provide a satisfactory quality of life to the person receiving the implant but also helped save operative time and preserve the anatomical shape and respiratory function of the chest wall.
