Sternal tumours are rare and often require complex chest wall reconstruction following tumour removal. Despite this, surgeons continue to face significant challenges in finding affordable and durable solutions that restore both function and appearance.

A complex chest wall reconstruction in a 16-year-old cancer patient sparked an innovation that could transform care for thousands of patients worldwide. Faced with the lack of an affordable and durable sternal implant, Dr Riaan Nel, a Cardiothoracic Surgeon at Netcare’s Kuilsriver hospital and Stellenbosch University (SU) and Prof Jacques Janson, Head of Clinical Division and Cardiothoracic Surgery at Tygerberg Academic Hospital and SU, developed a novel titanium sternal implant that is now patented through SU with support from the Innovus Technology Transfer Office (TTO). It is now poised for commercialisation.  The implant is a 3D-printed titanium alloy prosthesis designed to replace portions of the sternum removed during cancer surgery. Unlike existing solutions, it offers an affordable, durable and readily available option while maintaining both structural stability and cosmetic outcomes.

Dr Nel’s journey began with his undergraduate medical studies in Pretoria (MBChB), followed by specialist training in Cardiothoracic Surgery at Tygerberg Academic Hospital and Stellenbosch University (Fellowship of the College of Cardiothoracic Surgery and master’s in medicine - Thoracic Surgery). “I was drawn to cardiothoracic surgery because of its unique blend of technical precision and life-saving impact. The university offered not only rigorous training but also a collaborative environment where excellence in education, research and surgical innovation could thrive,” said Dr Nel.

Prof Janson completed all his studies at SU, including his Bachelor of Medicine and Surgery (MBChB), Master of Medicine: Thoracic Surgery - MMed (Thor) and is a Fellow of the College of Cardiothoracic Surgery - FCS (Cardio). He also obtained his Doctorate in Philosophy (PhD) in 2016 with a research dissertation entitled “Evaluating a bioprosthetic anterior mitral valve leaflet made from autologous jugular vein and expanded polytetrafluoroethylene (Gore-Tex) chordae in a sheep model.” Prof Janson’s research focuses on advancing innovative surgical techniques in Cardiothoracic Surgery, including published techniques for innovative mitral valve repair using a saphenous vein patch, sternoclavicular joint reconstruction and the co-development of the 3D-printed titanium sternum for sternal defect replacement.

The chest wall reconstruction research innovation aligns with the United Nations’ Sustainable Development Goal 3: good health and wellbeing. It helps improve surgical outcomes and reduce surgery complications, thereby strengthening healthcare systems and enhancing patient recovery. “Currently, no affordable, durable, off-the-shelf implant exists for this purpose,” said Dr Nel. “The cost-effective innovation surpasses other available innovations, which have significant limitations, particularly in younger patients, where achieving both structural integrity and a good cosmetic result is vital.” 

This breakthrough marks significant progress in sternal reconstructive surgery, while combining durability, biocompatibility, and improved patient outcomes.

This research has the potential to benefit local and international industries such as medical device manufacturers, thoracic surgeons, and hospital systems. “Partnerships with firms specialising in implant development and chest wall reconstruction are natural fits for scaling these innovations,” added Dr Nel.

Looking ahead, Dr Nel aims to establish the Thoracic Reconstruction and Innovation Centre (TRIC) Cape Town as a flagship centre for chest wall reconstruction, supported by strong branding and international collaboration. “Expanding multicentre clinical trials and commercialising the titanium implant are some of our immediate priorities at the moment,” he said.

Reflecting on his journey, Dr Nel offers the following advice to his younger self: “Trust the balance between precision and creativity. Medicine demands discipline, but innovation requires imagination; don’t be afraid to blend the two. Use your unique skills, exposure, and experience to think beyond convention and craft new solutions”.

Through their collaboration, Dr Nel and Prof Janson demonstrate how clinical challenges can inspire locally developed innovations, proving that medical technologies can emerge from South African healthcare environments. 

Read more about the novel titanium sternal implant here.

For more information, please send an email to Innovus TTO at [email protected].