RAPID PROTOTYPING TECHNOLOGY –

Conjoined Twins Separation – A Model Surgery Using RPT,

“Turning Virtual Reality into Physical Reality”

ABSTRACT

In the manufacturing arena, productivity is achieved by guiding a product from

concept to market quickly and inexpensively. Rapid prototyping technology aids this
process. This physical model conveys more complete information about the product
earlier in the development cycle. The turnaround time for a typical rapid prototype
part can take a few days. Conventional prototyping may take weeks or even months,
depending on the method used.

RPT does not-and will not-replace completely conventional technologies such NC

and high-speed milling, or even hand-made parts. Rather, one should regard RPT as
one more option in the toolkit for manufacturing parts.

It is assumed, evidently, that the part can be manufactured by either technology such
that the material and tolerance requirements are met. The axis have no values; these
are company dependent. RPT offers clear advantages when more than one copy of a
complex part must be made.

Concerning material requirements, it is clear that when using milling one can
always obtain directly a part with the desired mechanical properties. This is usually the
choice when manufacturing production toolings. But, as mentioned earlier, using a chain
of processes that includes a RPT part, it is many times possible to obtain, indirectly, the
same results in a shorter period of time.

What Is Rapid Prototyping?

 The past decade has witnessed the emergence of new manufacturing technologies
that build parts on a layer-by-layer basis. Using these technologies, manufacturing
time for parts of virtually any complexity is measured in hours instead of days,
weeks, or months; in other words, it is rapid.

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  Since then, Rapid Prototyping Technologies (RPT) have taken enormous strides.
Nowadays, there are over 30 processes some of which are commercial, while
others are under development in research laboratories.
 The accuracy has improved significantly, and the choice of materials is relatively
large, to the extent that the term prototype is becoming misleading; the parts are
more and more frequently being used for functional testing or to derive tools for
pre-production testing. It is very likely that a new term, or one of the numerous
other expressions that are floating around, will replace it in the future.

Data transfer to RPT

As mentioned earlier, speed is one of the most distinguishing features of RPT when
compared to conventional methods. In fact, in many cases, the use of RPT can only be
justified if the part can be obtained quickly. Quite often, though, the limiting factor is the
time spent preparing the data. Once the data is correct, manufacturing time is known and
relatively fast. Figure 5 sketches a typical scenario.

The designer delivers the model to the manufacturer using surface mail or by
electronic means. The model will usually be represented in some neutral format,
e.g.VDAFS [27], IGES [25], or STL [1], or in some native format when both have access
to the same CAD system. The model is then verified for correctness and converted to a
suitable form if possible. Figure 6 depicts the state transitions of interest undertaken by a
model from the moment it is sent by the designer until it is manufactured.

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  All the state transitions in the diagram are possible. For instance, one can take
slices from medical imaging systems and interpolate intermediary slices that are
subsequently used in a LMT process. In this case, a 3D model is never evaluated
(path b+b).
 On the other hand, some processes cannot effectively handle sliced models-or
``D'' models-therefore, a faceted model is created and then sliced again (path
b+a,a+b). The reason is that in some cases it is important to be able to position
the model arbitrarily in the workspace of the machine, and this cannot be done
with sliced models.

The typical scenario is shown in Figure 7.

RPT In Manufacturing

During the development process, one is frequently faced with the choice of either
extending the development time or increasing the resources in order to meet the

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deadlines. Under these circumstances, time to market has been identified as a key factor
inprofitability; it is the development time and not the cost that is critical for the result.

 RPT allows a physical model to be available as soon as a 3D CAD model is ready.

The physical model is a perfect communication tool; if a picture is worth a
thousand words, then a physical model is worth a thousand pictures.
 In addition, parts produced via RPT are more and more frequently being used for
functional tests and for obtaining tools that can be used for pre-series production
tests. In this way, errors can be found at an earlier stage when changes are not so
costly. Requirements can be refined and better understood leading to better
products that meet the market demands. It has been estimated that using RPT
effectively, the development time for toolings can be reduced by half.

Another important aspect is the cost of introducing changes in the design of a

product. In this respect, development of a physical product does not differ from software
development: the cost of introducing changes increases significantly as one reaches the
final stages of development.

ENGINEERING APPLICATIONS

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RPT in Medical Applications

Applying RPT in the medicine is a new and exciting field. Many applications have
become possible due to the convergence of three distinct technologies, namely Medical
Imaging, Computer Graphics and CAD, and RPT.

Computer-Assisted Tomography (CT) and Magnetic Resonance Imaging (MRI)

provide high resolution images of internal structures of the human body, e.g.bone
structures and organs. Once these images have been processed by suitable software tools,
it is possible to transfer the result to a RP process and obtain a physical part, called a
medical model. Figure 13 depicts this process.

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 Together, these technologies provide doctors and surgeons with a new tool-
physical models of human internal structures-to better plan and prepare complex
surgeries. If the surgeries can be carried out more successfully, less costs associated to
post-operative treatment are expected, in addition to reduced risks, reduced patient
suffering, and improvements in the quality of the results.

Another recent application has been the manufacturing of a human chromosome.

Conjoined Twins' Separation a Model Surgery

Operation takes on-quarter the time, using rapid prototyping

Craniopagus twins — those who are fused at the tops of their heads —
are one of the rarest types of conjoined twins, occurring an estimated 1
in 2.5 million births.

The good news was that the twins’ brains were separate and complete,
with separated arteries and a dividing membrane. The veins draining
the blood, however, were interwoven and fed into each others’ circulatory system.
Separating conjoined twins is a highly complicated procedure, but surgeons determined
that an operation was possible. The members in the surgical team all had different
visualization needs in order to plan their role in the surgery. The plastic surgeons were
most interested in the structure of the skull, while the neurosurgeons were particularly
concerned with the arrangement of the blood vessels.

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Compiling data

 Because the blood vessels were

crisscrossed, tracking them
using standard, two-
dimensional x-rays would be
impossible. They suggested the
use of 3D rapid prototyping to
help the plastic surgeons
practice how to separate the
girls’ brain skulls, reroute the
blood supply and plan skin grafting to cover the separated brains.
 The UCLA team had to supply BMI with three CT scans at different angles — it
wasn’t possible to arrange the twins for one scan. The company registered and
combined the scans of the twins’ brains and the intersection of the two skulls into
a single, 3D model. BMI then used Materialise’s MIMICs software to merge the
scans and process the data, including a biomodel of the skulls that included the
maze of blood vessels.

Building an image

 The QuadraTempo system builds parts by

selectively jetting tiny droplets of acrylic
photopolymer creating layers and then curing
layer-by-layer, using UV light. A second, gel-like
photopolymer material is used for support and is
wiped off or removed by water jets.

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  BMI and InterPRO produced three biomodels — one of each of the twins' skulls,
which could be studied separately or combined to provide the surgical team with
a replica of the conjoined anatomy, and the third showing the region where the
twins were joined, enabling the surgeons to easily see the complex architecture of
arteries and veins. Dr. Clearihue adjusted each biomodel, orienting them to
correct their position and connecting them so that the models could be
manipulated in the operating room at the time
of surgery.
 The biomodels enabled them to make
important discoveries about the twins'
anatomy which were not apparent from X-
rays, or CT and MRI scans.

 Besides defining internal structures, models from BMI have been applied in the
creation of implants.
 The continuing progression, says BMI president Crispin Weinberg, in the quality
of medical imaging “is providing us with better views of soft tissues.
 This means that, in future, not only will we be rendering models of bone, but more
preparations for procedures involving blood vessels, nerves and internal organs.”

"We're so pleased to see that our technology was chosen for this humane
undertaking”

"We've had doctors reporting that we've saved them as much as 20 to 30

percent of their operating room time”. "The models have also allowed them to
perform multiple surgeries that they wouldn't have otherwise felt comfortable
doing."

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 Biomedical Modeling, Inc. works with surgeons and physicians worldwide to
analyze medical imaging data and produce accurate 3D Biomodels for surgical planning
and prosthesis fabrication. By offering superior service and the ability to work with

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different RP service bureaus, Biomedical Modeling provides biomodels to meet a broad
range of medical needs. They have successfully produced biomodels from CT, MRI, and
ultrasound to visualize a variety of hard and soft tissue structures.
“We have the Technology” – The Story of Ganga & Jamuna

 To help the surgeons visualize and understand the interlocking structures of the
twins’ brain tissues, Nanyang Polytechnic was called upon to produce separate
models of the twins' skulls, brains, skin and blood vessels.
 To deliver the “goods,” the Polytechnic had to draw on its capabilities in
Computer-Aided Design and Rapid-Prototyping technologies as well as its
experience in similar projects for medical applications.
 Working closely together, our specialist engineers and the SGH surgeons
meticulously converted data from CT and MRI scans into 3-dimensional CAD
images. These images were then transferred to the Rapid-Prototyping equipment
to produce the life-size models using a process called “laser-sintering”.

“Although we have done more than 30 such models, none was as complex. For this
project, we had to deal with a lot of soft tissue. The biggest challenge was in identifying
which part of the interlocked brains belonged to which twin. Creating the model of the
blood vessels was equally challenging because the arteries and veins were very intricate
and fine,” remarked by the Manager of Rapid Prototyping Centre.

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Advantages of Biomedical Models

Accurate three dimensional solid models have proven to be invaluable tools in all stages
of the successful planning and completion of complex surgeries. Moreover, their utility in
producing perfectly matched prosthetic implants is unsurpassed by any other available
technology.

Doctors and surgeons who wish to examine possible operating scenarios prior to
entering the operating room, as well as enjoy the opportunity to work with a physical
model which illuminates solutions to complications encountered during the surgical
process, may now do so. In addition, the use of a physical model as a precursor to surgery
has shown significant reductions in operating time, which translate to reduced trauma to
the patient as well as cost savings to the patient, hospital and insurance carrier.

Scientists and engineers wishing to explore "what if" scenarios in the areas of
medicine and biology can now create physical models for testing and experimentation of
subjects under study. This provides the opportunity to gather scientific information using
non-evasive techniques. This information has the benefit of retaining the specific
properties of the subject which are lost when using generic models.

Fabrication of Biomedical Models:

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 At BMI we process and interpolate C.T. and M.R.I. images, in close cooperation
with the radiologist and surgical team to fabricate extremely accurate 3D physical
models. We use these highly detailed cross-sectional images to create a series of very thin
layers of resins or other specially engineered materials. Their accuracy is determined by
the sharpness and contrast of the original images. Our processes allow us to fabricate
solid models to greater tolerances possible with the most accurate C.T. or M.R.I.
equipment. For the final product, we utilize materials and coloring deemed most
appropriate for the procedure.

Visualization and Assessment:

M.R.I. and C.T. scans are currently the diagnostic basis for most complex surgeries. At
BMI we employ those identical M.R.I. and C.T. files to produce highly accurate three
dimensional solid models to any scale desired. These models are produced to tolerances
that exceed those of the original M.R.I. and C.T. files. Leading surgeons who employ
accurate biomodels as assessment and communication tools find them to be invaluable
aids, increasing knowledge and confidence.

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Conclusion

 It is impossible to cover all aspects of these relatively new manufacturing

processes without being brief at times. More important, though, is their effective
introduction in the current working practices of companies.
 It is clear that these technologies, when applied correctly, can bring benefits in the
form of better products in shorter lead times, and at reduced costs.
 Many researchers feel that within a few years, there will be a range of products
from 1 million to 10 million using this technology.
 Thus this new technology has a ample scope for future research and development,
thus making it truly a rapid prototyping technology.

References:

www.wohlers.com
www.biomodel.com
www.howstuffworks.com

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