HEALTH & WELFARE

DELIVERING

3D-PRINTEDPROSTHETICSTO ALL IN NEEDJAPANA Japanese startup is using 3D printing to develop
high-quality prosthetic legs at a lower price, contributing toquality-of-life improvements for amputees living in the Philippines.
With Tokyo as the first city ever to host theParalympic Games for a second time, Japan seeks
to create an inclusive society and remove obstacles
that prevent people from demonstrating their fullpotential. However, many people worldwide whohave lost a leg due to illness or an accident, have
had to put up with their disability as they cannot
afford prostheses, which tend to be high priced.
In the Philippines, for example, where diabetes isprevalent owing to a sugar-rich diet, countless poorpeople, unable to pay for a hospital visit, suffer fromincreasingly severe symptoms that force them to havea leg amputated. According to a survey commissioned
in 2017 by the Japan International Cooperation

A verification test was conducted in 2018
in collaboration with the University of
the Philippines General Hospital. Shown
here with the hospital staff,
TOKUSHIMA Yutaka, the CEO, is in
the middle of the front row. On his left isprosthetist KOBAYASHI Yoshiaki.

PHILIPPINES

Agency ( JICA), there are 1.23 million people in thePhilippines who need a prosthetic leg.
TOKUSHIMA Yutaka, CEO of the Japanesestartup Instalimb, Inc., founded his company to give
disabled people—including those in the Philippines—
affordable prosthetic legs through 3D printing. Aftera career working for manufacturers of IT components
and medical devices, Tokushima joined the Japan
Overseas Cooperation Volunteers. When he visitedthe Philippines at that time, he noticed many people
who had lost their hope along with a leg.
Because a prosthetic leg must be manually fitted,
mass production is difficult. Hence, prostheses
become expensive, and the poor have no choice but

to go on living without one. Since many such people
are manual laborers, they may lose their jobs, making
them even more impoverished.
Tokushima then had an idea: “I believed that
if I leveraged my knowledge, I could change thesituation. I wanted to give prosthetic legs to thepeople who needed them.” He developed 3D design
software for prosthetic legs, and in 2018, started up
Instalimb basing it in Tokyo. After several attempts
developing various prototypes, the company finallysucceeded in designing a prosthetic leg costing
only 20,000 Philippine pesos (PHP), equivalent toabout USD400-the average monthly salary for a
recent college graduate in the Philippines-or just
one-tenth the normal price. Instalimb was also able
to significantly reduce the time needed to produce
prosthetic legs, which typically take more than three
to four weeks to make. According to Tokushima, a3D printer, carrying out production overnight, canperform the whole process, from measurement tocompletion, in as little as 24 hours.
In 2019, Tokushima established a local subsidiaryin the Philippines, where he began selling hiscompany’s prosthetic legs. The production process
begins by taking a cross-section 3D scan of thecustomer’s leg, based upon which Tokushima’s selfdeveloped 3D modeling software then corrects theshape before printing. Once a preliminary mold iscreated, the next step is a test fitting. If any parts hurt,or any other problems arise, a prosthetist makes thenecessary adjustments and applies them to the data.
The finalized data is then sent to the 3D printer toMany people in the Philippines have suffered amputations
owing to such diet-related diseases as diabetes.

Top left: On a street in Manila, a patient who was fitted with a prosthetic leg says he has beenable to return to his normal life.
Top right: Instalimb’s prosthetic leg, made from polylactic acid carbon—a reinforced material
consisting of plastic mixed with carbon—is both lightweight and comfortable to wear.
Bottom: 3D printers have significantly shortened the time needed to complete a prosthetic
leg tailored to each person.

create a mold.
To provide prosthetic legs to those people whoneed them, Tokushima thought up his simple
process for creating custom-made prosthetics thatare nevertheless affordable and quick to produce.
Speaking about the advantages of 3D-printed
prosthetic legs, KOBAYASHI Yoshiaki, thecompany’s prosthetist, says, “Because we canproduce the item in a short time, the patient canstart relearning how to walk soon after their leg isamputated, before the muscles begin to atrophy. This
allows them to return to society early.”
Instalimb is now focusing on developing automatic
designs with AI. If data on a prosthetic leg can bedigitized after a prosthetist has made adjustments, thecompany might be able to create designs in the futureeven in locations where there are no prosthetists.
With the COVID-19 pandemic making it difficultfor people to move around and contact each other,
AI offers greater promise in such cases. Henceforth,the company is considering expansion to otherdeveloping countries facing similar issues, as well as
to conflict areas where many people have lost legs.
Instalimb’s policy is to “create a world where
everyone in need can access prosthetics.” Tokushimasays, “I hope more people will be able to newly dreamof returning to their former lifestyle by obtaining a
prosthetic leg and regaining their independence.”