Shilpi Sen was only a school-going girl when she lost her aunt to breast cancer. Being up close with the disease made her realise the mental agony it puts its patients through, she says.
“I used to watch not only my aunt, but also my grandparents suffering. Their mental and physical agony was enormous,” Shilpi, now 44, recalls to The Better India.
In 2015, while she was still working at Nuffic Neso involved in branding and promoting study in the Netherlands, during a new year’s dinner she met Vikas Garg, 32, a material scientist. This meeting would eventually lead to the formation of her organisation Prayasta — a startup that aims to personalise soft tissue implants and prostheses.
Launched in 2017, Prayasta focuses on developing technology that can help produce personalised soft tissue implants. They recently developed the world’s first 3D printer for implant-grade silicone in collaboration with the Indian Institute of Science (IISc), Bengaluru.
“While we were talking, we realised that we had a similar vision — we both wanted to fill the gap between technology and the healthcare domain,” she notes.
Meanwhile, Vikas says that he was fascinated with mixing different materials and amalgamating them with human bodies, which is why he pursued a PhD in material sciences. “l realised that I want to apply the knowledge rather than be on the research side of things. Academia is great but at that time it felt like it was not for me,” he says.
‘Personalisation — not a luxury’
The duo say they noticed there was no technology that caters to the personalisation of soft tissue implants in the country.
“When a woman is undergoing the surgery, and the doctors realise that the new breast and the other breast are not of the same dimensions, they do a surgery on the healthy breast to correct the imbalance. That really shook me. A woman who is already a survivor and has seen enough goes through rounds of surgery for no good reason,” Shilpi laments.
While such surgeries are painful procedures, an imbalance in the body needs to be corrected.
“Statistically speaking, the entire population can be categorised into say 10-20 sizes, but then every body is slightly different from another. Every person’s body is so unique. It is not only true for breasts — take the example of eyes, cheeks, or ears. Though personalisation might sound like a luxury, in such cases, it is really a necessity,” Vikas Garg, co-founder, Prayasta says.
He explains that the functionality of the body depends on the implant. “Clinically speaking, if a breast is absent from the body, a substantial amount of weight is absent. That gives rise to asymmetry. It is a requirement that the weight of the body stays balanced,” he says.
“In layman’s terms, the trachea or the windpipe is just a pipe. But it is not a straight one. It is rounded, somewhere the contours are different. When someone requires a solution for that — be it for cancer or lung disease — if the match is not right, the surgeon will end up making a smaller diameter trachea, leading to leaks and recovery issues. Hence the need for personalisation,” Vikas explains.
Plagued by the numerous gaps in the implant industry and the various issues patients go through, the duo decided that they need a solution.
This led to the birth of Silimac, the world’s first 3D printer for implant-grade silicone.
Silimac can directly 3D print implant-grade silicone material to make an implant within the hospital itself. The implants can be personalised not only in terms of shape, size, and contour, but also in terms of weight, stiffness, touch and feel, say the founders of Prayasta.
“We also have developed a technology that we call NIA, or novel internal architecture. It’s a plethora of designs that we use to manufacture personalised implants in terms of shape, size, touch, and weight. It is liquidless, making it rupture-proof,” Shilpi explains.
“With this technology we are solving three major problems — the issue of not having personalised implants, reducing the risk of failure in surgery, and making implants that are suitable for kids,” says Vikas.
He adds, “When kids require solutions like this, they are in a fragile and growing stage. So, the customisation of the implant needs to be even more precise.”
The 3D printer is now housed at IISc.
Dr Kaushik Chatterjee, associate professor, Department of Materials Engineering and Centre for BioSystems Science and Engineering, IISc, says, “The field of 3D printing is being adopted in a variety of industries for a wide spectrum of materials, including healthcare, among other applications. Silicone is used as a replacement for soft tissues in the body but these are mass manufactured. Such implants do not always fit well to meet the anatomical needs of all patients. We at IISc are excited to partner with Prayasta to leverage this new technology to offer patient-specific implants for improved clinical outcomes.”
Silicone is a complex material, informs Vikas. It has a different chemical composition and is not very easy to print.
“We cannot take a conventional 3D printer and use silicone. Silicone comes in millions of varieties, and we are using the implantable variety. The benefit of this is that silicone can stay in the body for 10-15 years without any side effects to the body,” he explained.
Implant-grade silicone is the best biocompatible material for human implants, which stay inside the body. There has been much research on other materials that can be used, but nothing is certain as of now, says Shilpi.
“Another problem that this kind of implant solves is that currently, breast implants are like a balloon. There is an outer shell of a thin film of silicone and inside would be silicone gel. The obvious risk is that there is a risk of leakage, and if the gel comes in contact with the bloodstream, it can be fatal,” says Vikas.
By 3D printing implants with Silimac, this risk gets eliminated completely, adds Vikas.
What’s next for Prayasta?
“It is unfortunate that implant-grade silicone is not manufactured in India. So we have to source it from the US and Germany. The cost of silicone is Rs 1 lakh per kg. However, we want to make it as affordable as possible for everyone. In the future, when the technology is more commercialised, then the affordability might increase,” says Shilpi.
The co-founders say that they want to take the technology to the last mile.
“We have very little control over the cost of raw materials. But we want to make it as affordable to everyone in the future, with investments from third parties, as possible,” added Vikas.
While the technology is novel, IISc associate professor Dr Kaushik Chatterjee says, “This is a cutting-edge technology that has enormous potential for patient care in the country and worldwide.”
“We believe in shaping lives to be better. We had to do everything from scratch as it was never done before. We want to take it to global levels and make personalised implants accessible to everyone, which is currently lacking in our healthcare system,” says Shilpi.
Edited by Divya Sethu
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