Anatomics: The neurosurgeon’s bone factory

28 Jan 2016

Author: Nigel Bowen

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A quarter of a century ago Paul D’Urso wondered if the then emerging technologies of 3D imaging and 3D printing could be combined to create artificial body parts. Anatomics, the medical devices company that grew out of that curiosity, is creating the technology that will allow surgeons all around the world to print off an implant to their exact specifications.
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Paul D’Urso decided early on he wanted to become a surgeon. There weren’t any doctors in the family and he didn’t go to the kind of school where that was a common career aspiration. Nonetheless, "I knew I wanted be a doctor at a young age. As I got older I figured out I should be a surgeon because I was good with my hands and liked fixing things”.

D’Urso graduated with Honours from the University of Queensland then spent four years working in Queensland’s public hospital system. It was there he first became intrigued by the potential of two technologies just beginning to gain traction.

“There’s a huge buzz around 3D printing now,” D'Urso says. “But back then people had either never heard of it or didn’t understand it. In 1991 I encountered a stereolithography machine, one of the first 3D printers. I think there were two of them in the country and the Queensland government had bought one. Around the same time 3D medical imaging was taking off. I wondered if you could connect up 3D printing and 3D imaging technology to print out models of organs or bones. The hospital I was working at gave me a $1200 grant to look into it. Then the Queensland government provided some assistance. My initial research convinced me I was onto something worth exploring. So I enrolled in a PhD to investigate what applications the technology could have.” 

D’Urso was indeed onto something worth exploring. However, the genesis of what was to become his high-end medical technology company, Anatomics, was anything but dramatic. 

“I had a wife and child to support so I’d do my research during the day then go and work at a 24-hour medical clinic in the evening. It became clear a lot of the applications of the technology I was developing were neurosurgical. So I eventually went and trained as a neurosurgeon. For five years, I was a mad scientist, collaborating with radiologists, IT professionals and neurosurgeons. I was trying to develop an algorithm that could collect data from a CAT scan and convert it to something a 3D printer could work with.” 

D’Urso wasn’t even convinced pushing himself to his limits would pay off. “I wasn’t the only person looking at combining the two technologies,” he says. “Down in Australia it was hard to know what was going on in the US and Europe. So when I was finally able to attend some overseas conferences, it was a pleasant surprise to find, I was leading the field by a long way.” 

In 1996, healthcare industry expert Robert Thompson suggested to D'Urso they start a company. The start-up, came to be named Anatomics. 

It was around this juncture, D’Urso's groundbreaking research started to have real-world impacts. 

“I’ve got a scrapbook which records all the world firsts,” he says. “It was a new frontier. In 1993 we put the first cranial reconstructive implant from a 3D printer into a patient. Kids with terrible facial deformities from Fiji and Vanuatu would come to Brisbane’s Mater [now called Lady Cilento] hospital, where we would manufacture custom models to assist in the reconstruction of their skulls. We also printed the custom models that allowed the separation of conjoined twins’ skulls. As more surgeons requested Anatomics implants, craniofacial surgery in Australia was transformed.” 

In 2005 healthcare executive Andrew Batty became CEO of Anatomics. D’Urso credits him with turning it into “a much more professionally-run company”. Anatomics’ product range now includes: cranial, facial and orthopaedic implants; a product for tissue engineering used in post-mastectomies; surgical, electrosurgical and neuromonitoring tools; as well as the software and hardware surgeons require to design implants. 

For all its growth and product deveopment success, Anatomics remains a nimble innovator. A standout recent example is its development of PoreStar. Conventional surgical implants comprise non-porous, inflexible materials. Anatomics, in collaboration with Australia’s national science agency CSIRO, developed an implant made of polyethylene, a type of plastic. It's capable of being moulded by surgeons and melding with the patient’s own bone and tissue, making it particularly useful for craniofacial surgery.      

In collaboration with technology and design university RMIT, Anatomics has also developed titanium implants. In 2014 the company made world headlines after custom printing a titanium heel implant that allowed a cancer patient to keep his leg. “With titanium you can create lightweight implants that match the patient’s bone density. You can also make shapes that aren’t possible with other materials,” observes D’Urso. Anatomics made headlines again in September 2015, with the world’s first 3D printed titanium sternum and partial rib cage.  The implant was designed and manufactured in Melbourne in collaboration with CSIRO and then successfully implanted into a cancer patient in Spain.  The 54-year old man was suffering from a chest wall sarcoma. 

 “I’m a proud Australian.I’ve spent time working in other countries, and at universities such as Cambridge and Harvard, and I believe Australia’s medical education and health system are world class. I appreciate the government funding I’ve received and the support from many of my fellow Australian surgeons. But it’s long frustrated me Anatomics hasn’t grown to its full potential.” D’Urso puts this down to  the small local market and the market dominance of large US firms.” 

D’Urso points to the manufacturing of knee and hip implants by US companies to illustrate his point. “Hospitals in Australia keep a large inventory of hip and knee implants manufactured in bulk in foundries in America,” he says. “Purchasing that inventory is expensive, and is only going to become more so as the population ages. An off the shelf implant isn’t as good as one custom designed to fit exactly and it may have to be removed if there’s a product recall.”

For all his achievements to date – and they include over 120 published scientific papers and presentations, multiple international patents and a trophy case full of research awards and prizes – it’s only now that D’Urso feels he’s on the cusp of “changing the game” of the global healthcare industry.

Anatomics has entered into partnerships with multinationals to distribute their state-of-the-art patient specific implants. These implants are now available across Asia and Europe. But what really excites D'Urso is creating the technology that will allow surgeons all around the world to print off an implant to their exact specifications. 

“The surgeon will get a scan of the relevant area then email it off. Possibly to a facility in the hospital they’re working in, perhaps to a factory nearby. The implant they need will then be printed and delivered,” D'Urso says. “Custom-made implants will be more durable, longer-lasting and cheaper than anything currently available," D'Urso continues. "And they will fit better, meaning fewer complications and a better patient outcome."  

While the scenario D’Urso outlines might sound like something out of science fiction, he’s planning on making it a reality in the near future. “When envisaging the future of medicine people imagine amazing advances,” notes D’Urso. “Those will happen but the fundamental issue is much more prosaic. It’s stopping healthcare costs spiralling out of control and creating affordable solutions for patients.”

D’Urso’s strategy to address that issue is to create a surgical software portal, AnatomicsRx,  that will “unlock the creativity of those in Australia and around the world”. 

“What I’m focusing my energies on now is AnatomicsRx software, linked to technology that facilities the design and printing of implants, AnatomicsRx software will allow surgeons anywhere to interact with biomedical engineers in real time to create patient specific solutions such as a spinal reconstruction or a disposable tissue retractor.  That will allow surgeons, not just in Australia but also in developing countries, to create their own innovations and service their own communities.”     

 

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