Listen to Beth Ripley discuss her work:
A Department of Veterans Affairs surgeon was scheduled to remove a mass from a veteran’s one fully functioning kidney, but he had serious concerns. If he made a mistake, it could mean the patient might have to go on dialysis for the rest of his life, according to Dr. Michael Tadych, director of the VA Puget Sound Health Care System.
To prepare, the surgeon held a 3D rendering of the kidney in his hands, examining it from all sides to map out a strategy as the patient awaited the operation.
Dr. Beth Ripley, a VA Puget Sound radiologist and director of the VHA 3D Printing Network, had helped the surgeon by taking MRI images and using them to print a 3D model made with two different textures—one representing healthy kidney tissue, the other representing the mass.
Ultimately, the surgeon was able to retain more than 80% of the patient’s kidney function, a success he attributes to Ripley’s work on 3D printing, Tadych said.
“The work she’s been doing around 3D printing is pretty incredible,” Tadych added. “She’s developed a network throughout the VA that’s doing 3D printing now.”
That network of VA hospitals and medical professionals has proven invaluable in light of the burgeoning coronavirus crisis facing the U.S. in 2020, and the frantic search for safety equipment for front-line health care workers. In late March, the VA, the Food and Drug Administration and the National Institutes of Health agreed to work together to increase supplies of personal protective equipment using 3D printing, testing it for safety and effectiveness, and then sending it through the FDA review process.
This printing can markedly cut the time it takes to design and produce a new product. Within weeks of turning to 3D printing for personal protective equipment, the VA had come up with 12 designs for face masks, shields and other protective facial gear that were approved for clinical use. The next step was for organizations capable of 3D printing to begin producing them.
The VA then turned to designing ventilator parts under the same process.
Even before the coronavirus pandemic, Ripley was leading the VA on 3D printing technology—in partnership with the University of Washington School of Medicine—creating an interconnected, hospital-based 3D printing network designed to share resources and knowledge throughout the Veterans Health Administration.
Everything the VHA is doing with 3D printing “has Beth’s fingerprints on it,” said Dr. Ryan Vega, executive director of the VHA Innovation Ecosystem. “She’s the heart and soul of the movement.”
The VHA 3D printing network developed in 2017 has grown from three hospitals to 30, and arguably has one of the most diverse and comprehensive hospital-based 3D printing programs in the world. It has benefited more than 1,000 veterans, reducing surgical times by an average of more than an hour, decreasing the number of hospital visits for some services, and delivering assistive technology devices to improve veterans’ quality of life.
These organ and tissue replicas can also steer physicians away from unnecessary surgeries.
For example, a veteran in Alaska with hip pain was going to be flown to Seattle for a hip replacement. A 3D rendering of the hip, however, showed significant calcification, and medical staff realized surgery might cause more harm. The operation was scrapped before the veteran ever left home.
Replicas of body parts also enable doctors to demonstrate to patients why a procedure is necessary—or not—and has increased veterans’ satisfaction with informed consent conversations.
“We have many stories with some really amazing patients that have been able to understand their disease better before they go into surgery,” Ripley said.
Ripley’s work is “groundbreaking” and “most certainly the future of medicine,” said Dr. Suresh Maximin, director of diagnostic imaging services at Puget Sound. It enables prosthetists and physical therapists to fit artificial devices, orthotics and splints with a near-perfect match, lessening the chance of a painful fitting or needless follow-up visits.
Ripley also is partnering with businesses on 3D printing of insoles to relieve pressure sores on the feet of diabetic patients and prevent limb loss; making models of organs for VA facilities without 3D printers; and partnering with General Electric to help develop criteria for FDA for printing implantable devices. “She’s doing a lot of innovative work,” Tadych said.
Carolyn Clancy, deputy undersecretary of health for discovery education and affiliate networks, said, “She’s got an incredible mind and the power to inspire other people.”
The next frontier is for the VA to create living tissue. Ripley is exploring projects to print vascularized bone for treating patients with bone tumors or chronic infections.
“We are witnessing innovation that may fundamentally change health care,” Vega said.
As Ripley continues to innovate, she focuses on the benefits for the nation’s veterans.
“In a world where medicine has become so depersonalized, this technology gives us a way to put the patient back at the center of medicine,” she said.