Sunday, June 29, 2014

There's Something Afoot at MODA: An Interview with Dr. Nicholas Giovinco

I recently had the honor and pleasure of meeting and chatting with Dr. Nicholas A. Giovinco, a foot and ankle surgeon and one of the participants in the current exhibition at the Museum of Design ATLANTA (MODA)—Design for Social Impact.

He graciously gave me an interview to discuss his work in the medical industry and his exhibit at MODA—3D Printing for Surgical 'Practice' Templates. The interview is below, and you have the opportunity to meet him at a MODA Design Conversation event on Thursday, July 10.

An Interview with Dr. Nicholas A. Giovinco, MODA
An Interview with Dr. Nicholas A. Giovinco, MODA

wanderlust ATLANTA: Tell us a little about who are you and what do you do?

Dr. Giovinco: My friends call me "Nick". What I actually do is probably the hardest question of this interview already. I’m a foot specialist by trade, but rarely pass up an opportunity to learn something new. From an early age, I've always been fascinated with surgery and foot mechanics. By my late teens, I knew I wanted to be a foot surgeon.

Along the way, I've always kept a strong interest in technology an active part of my life. One of the coolest days of my adult life was when Buddy Smith, co-author of a paper on preoperative planning in Chracot food reconstruction, invited me to visit the Hackerspace called Freeside Atlanta to check out his work with 3D printing. Now, my current work with surgery and foot care have crossed paths at my new job at the University of Arizona, where I get to blend technology and doctoring together.

An Interview with Dr. Nicholas A. Giovinco, MODA
An Interview with Dr. Nicholas A. Giovinco, MODA

wanderlust ATLANTA: What's the most dramatic social impact your research/work has made?

Dr. Giovinco: My current boss, and mentor, Dr. David G. Armstrong has always told me that the most valuable thing you can provide somebody is "perspective". Having some of our efforts displayed in the current exhibit at the MODA is one of the most gratifying and humbling feelings I can remember. Although 3D printing has not influenced the vast majority of the healthcare industry, I would hope that our work inspires more creative perspective and exploration in this space.

An Interview with Dr. Nicholas A. Giovinco, MODA
An Interview with Dr. Nicholas A. Giovinco, MODA

wanderlust ATLANTAWhat previous limitations in foot and ankle surgery/treatment have been overcome since the adoption of 3D printing for medical purposes?

Dr. Giovinco: Good question. We have noticed a progressive uptake of additive manufacturing applications in foot and ankle care, as well as other medical and surgical specialties.

For example, orthotics are able to be 3D printed with a relatively decent material strength. 3D scanning of foot deformities and wounds is becoming increasingly convenient and can be performed from a smartphone, in an instant. This allows for improved and rapid planimetric assessment in a fairly objective manner.

Some current work we have done is to test the material properties of 3D printed surgical instruments. As well as some collaboration with our fellow cancer researchers in devising new chemotherapy ports for mouse studies.

Future work includes the construction and testing of an open-source Stem Cell printer with our colleagues at the University of Arizona’s Heart Center. As I said before, I have a hard time saying "no" when there are so many fascinating opportunities to explore with some very bright people. 

wanderlust ATLANTAWhat aspect of your work do you find the most fascinating, relative to 3D printing?

Dr. Gioviinco: 3D printing continues to become more durable, faster, larger, smaller, and detailed everyday. The most fascinating aspect of this space is the community innovation that is happening. Artists, Makers, Hackers, and Designers alike are pouring countless hours and ideas into these designs and sharing them freely at places like Grabcad or Thingiverse. The hobbyist creativity and exploration of this area is probably the most inspiring.

An Interview with Dr. Nicholas A. Giovinco, MODA
An Interview with Dr. Nicholas A. Giovinco, MODA

wanderlust ATLANTA: Any thoughts on what 3D printing may do to launch or bring to fruition the next step in medical/bio technology?

Dr. Giovinco: I feel that the biggest and arguably most important dilemmas in medical innovation are safety and funding. 3D printing and rapid prototyping are a process and not a product, per se. This creates challenges with regard to FDA clearance and such. Currently, additive manufacturing of prosthetics and other durable items, do not match up with traditional manufacturing methods for strength and repetitive loading. Also, true bioprinting would need to get very small to synthesize collagen fibers and "smart-scaffolds", where currently we are far from this level of detail. These are all issues that would need to be resolved before 3D printing is able to be applied broadly in medicine and surgery.

wanderlust ATLANTA: What do you expect the next generation (or two or three) of 3D printers to allow you to do or areas to be advanced?

Dr. Giovinco: I see high-resolution printers with multi-materials being possible for home and hobbyist printers, shortly. I also see other printing methods being more popular than just fused deposition modeling (FDMas more and more patents expire. It's possible that the our biggest benchmark of the proliferation is comparable to some previous ambitions.

The Lunar Missions of the 1960s brought us microwave ovens, velcro, Tang, etc. The Human Genome Project of the 1990s brought us Polymerase Chain Reactions, Microarrays, and eventually Synthetic Life. The RepRap project of the 2010s could show great promise in crossing the boundaries between the digital world, virtual reality, and physical reality together, while democratizing the physical commodities. Buckle Up!

An Interview with Dr. Nicholas A. Giovinco, MODA
An Interview with Dr. Nicholas A. Giovinco, MODA

wanderlust ATLANTA: How reluctant or excited have patients been to see this amazing, yet seemingly simple, technology as a force in designing treatment for their particular ailments?

Dr. Giovinco: A #1 rule that Dr. Armstrong has always tried to remind me of is that, "Patients don't care how much you know, until they know how much you care." That said, most people are genuinely intrigued to see this 3D replica of their own anatomy. I've had several patients request to keep a copy for their own surgical souvenir. I think it's validating for someone to know that their issues are being taken very seriously and that they are getting the best treatment possible.

wanderlust ATLANTA: What advice or insights would you like to impart to young people who are considering a career in foot surgery, relative to 3D printing?

Dr. Giovinco: More and more, I find myself saying that "science itself, is a liberal art". I believe that there is such a convergence of technology and technique, that we all need to be technologists as well as scientists. There are more options for specialization and exploration than ever before.

In a strange and familiar way, 3D printing reminds me of my first experience with programming. In programming, it was a very neat experience to write code and then see it do something on the screen. With 3D printing, it's a unique feeling to imagine something in your head, design it in the CAD software, and then see it manufactured right before your eyes.

When you hold it in your hands, there's a certain visceral satisfaction to it. I want young kids to have that same tangible feeling for something they did. That was something I never seemed to get from school, but it is clear that being engaged in your work is key to your long-term success.

An Interview with Dr. Nicholas A. Giovinco, MODA
An Interview with Dr. Nicholas A. Giovinco, MODA

wanderlust ATLANTA: Is there anything else you'd like to share with MODA/Social Impact visitors?

Dr. Giovinco: The only thing I could ask, is that visitors take a good look at the other features on display in this exhibit. The museum coordinators and curators have done such an amazing job gathering such a variety of projects together with this exhibit. It's a real honor and a pleasure to work with these passionate members of the MODA family. Stop a museum curator and tell them "thank you", because they're playing just as important a role in this exhibit as anyone being featured.

A huge wanderlust ATLANTA "thank you" to Dr. Nicholas Giovinco for the interview, the amazing insight into a world that I for one knew nothing about, and for vividly showing us such a strong passion for a career of helping others feel better.

Remember, you can hear and meet Dr. Giovinco at the July 10 Design Conversation event at MODA when he'll discuss more about 3D Printing for Surgical 'Practice' Templates—his display in the Design for Social Impact exhibition.

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