They are still there, impeccably aligned. As in an industrial production unit. Except that we are there in the “chapter room” of the chapel of the Cochin hospital, one of the establishments of the Public Assistance-Hospitals of Paris (AP-HP). The sixty 3D printers, which arrived in the midst of the Covid crisis, have not stopped purring and manufacturing protections of all kinds. But their fate is about to change. After the solidarity and health era, another era opens, innovative, commercial, cultural and international. With a move at the end of 2020, probably in one of the vast still empty rooms of the renovated Hôtel-Dieu.

Arrived in the midst of a health storm thanks to a donation of two million euros from the luxury group Kering, these tireless machines were originally intended to produce visors for caregivers and patients.

An idea from Roman Khonsari, maxillofacial surgeon at Necker Hospital, passionate about 3D technology, design graduate and full of imagination. With a friend, Jérémy Adam, founder in 2017 of the Parisian company Bone 3D, an expert in consulting and 3D engineering, at the end of March they proposed to Martin Hirsch, general manager of the AP-HP, to put an end to the shortage of protection. by creating a production site specific to public assistance. The case was settled in 24 hours, the 60 machines arrived by truck on April 1. The largest 3D hospital structure in the world had just been created.

“In the interpretation of the texts, France has been the most rigid”

In the beginning, the armada of printers and the engineers who supply them with models to reproduce focused on urgent needs: more than 10,000 visors and as many door handle adapters, designed on site, to avoid contact. with the hands, were produced, sometimes without blowing at night. Not found on the market, these handle adapters could be distributed free of charge to schools, administrations… Their cost price? “From 5 to 8 euros depending on the variants, to adapt to the different handles,” Jérémy Adam answers with a smile.

Doctor Roman Khonsari, from the maxillofacial surgery department at Necker-Enfants hospital (left) and Jeremy Adam, president of Bone 3D.  LP / Olivier Arandel
Doctor Roman Khonsari, from the maxillofacial surgery department at Necker-Enfants hospital (left) and Jeremy Adam, president of Bone 3D. LP / Olivier Arandel

“People quickly came to see us with their often urgent needs,” says Roman Khonsary. For example parts used in heart surgery, broken and out of stock. “In 3D printing, there is nothing that cannot be done”, explains Jérémy Adam, whose engineers easily took up the challenge.

But in France, we do not know how to produce “medical devices” in an emergency. European regulations may have been relaxed to facilitate responses to the crisis, “in the interpretation of the texts, France was the most rigid, regrets Roman Khonsary. Of the hundred or so references that we have created, there are several medical devices still awaiting authorization from the National Medicines Safety Agency to be used. “

Demand has never weakened

Among them, the 3D unit has designed plastic adapters to connect the full-face diving masks offered by Decathlon and which some doctors would like to wear to filters. Demand has never faltered. So much so that a real on-demand spare parts service has slowly grown up at AP-HP. Flexible, fast, economical, it avoids the paralysis of broken down equipment. No more dependence on China, the United States… for parts!

Very early on, for example, surgeons from Cochin had come with a device called a tulip, a hinged metal branch attached to the bed of the operated patient which holds the pipes together. “The plastic tip often breaks, but it is not sold alone, you have to buy the whole thing, it costs around 400 euros. We made the part in a more solid plastic, it costs us 5 euros ”, proudly reports the surgeon from Necker.

A nurse came in the midst of a health crisis with a simple sketch to ask if we could make a headrest for patients in intensive care that must be regularly placed in the prone position. “We did it, from design to production, it only took a day,” summarizes the founder of the engineering company.

A dozen projects underway in other hospitals

Occupational therapists also came with their handmade pieces, not always well finished but effective, to help people with motor difficulties, for example, to activate a zipper on a fly, to put their crutches on the edge of a table. . The 3D production unit has created much more stylish and often more efficient parts. The examples have multiplied and no less than a hundred different references have already left the printers.

A unique structure, exploiting the medical skills of the AP-HP, that Roman Khonsari and Jérémy Adam are working to duplicate in other hospitals. A dozen projects are underway, piloted by Bone 3D, in the provinces and abroad. In Paris, the doctor-engineer duo wants to dedicate part of the tool to internal training, another to research and development, with the filing of patents. Yet another in the design of medical tools.

With a Franco-African association, Roman Khonsari organizes the training of African doctors before setting up 3D hospital units in large capitals. Or how a donation can bring about a new exportable industrial model!