A Patient-Specific Surgical Simulation System for Spinal Screw Insertion Composed of Virtual Roentgenogram, Virtual C-Arm, and Rapid Prototyping

In the last years, cardiovascular diagnosis, surgical planning and intervention have taken advantages from 3D modelling and rapid prototyping techniques. The starting data for the whole process is represented by medical imagery, in particular, but not exclusively, computed tomography (CT) or multi-slice CT (MCT) and magnetic resonance imaging (MRI). On the medical imagery, regions of interest, i.e. heart chambers, valves, aorta, coronary vessels, etc., are segmented and converted into 3D models, which can be finally converted in physical replicas through 3D printing procedure. In this work, an overview on modern approaches for automatic and semiautomatic segmentation of medical imagery for 3D surface model generation is provided. The issue of accuracy check of surface models is also addressed, together with the critical aspects of converting digital models into physical replicas through 3D printing techniques. A patient-specific 3D modelling and printing procedure (Figure 1), for surgical planning in case of complex heart diseases was developed. The procedure was applied to two case studies, for which MCT scans of the chest are available. In the article, a detailed description on the implemented patient-specific modelling procedure is provided, along with a general discussion on the potentiality and future developments of personalized 3D modelling and printing for surgical planning and surgeons practice.

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Autologous Ear Reconstruction: A Semi-Automatic Procedure for Patient-Specific Surgical Guides

Volume 5: Biomedical and Biotechnology ◽

10.1115/imece2020-23152 ◽

2020 ◽

Author(s):

Elisa Mussi ◽

Rocco Furferi ◽

Michaela Servi ◽

Yary Volpe ◽

Flavio Facchini

Keyword(s):

Surgical Simulation ◽

Hospital Staff ◽

Cartilage Tissue ◽

Patient Specific ◽

Ear Reconstruction ◽

Anatomical Region ◽

Surgical Guides ◽

The Creation ◽

Shape And Size

Abstract Autologous ear reconstruction, i.e. the reconstruction of the outer ear from autologous cartilage tissue, is a very important surgery considering the psychosocial repercussions of an individual affected by microtia (i.e. the total or partial absence of the outer ear). The execution of this surgery can be very complex due to the unique characteristics of this anatomical region. In order to help the surgeon in the process of cutting and suturing, innovative surgical guides were designed that can transmit information about the shape and size of the anatomy to be reconstructed. This work lays the foundation for the creation of a semi-automatic and easy-to-use tool for the modeling of surgical guides. The goal is to make the hospital staff autonomous in the creation of instruments that can be used in pre-surgical simulation and during surgery.

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Towards Patient-Specific Anatomical Model Generation for Finite Element-Based Surgical Simulation

Surgery Simulation and Soft Tissue Modeling - Lecture Notes in Computer Science ◽

10.1007/3-540-45015-7_33 ◽

2003 ◽

pp. 340-352 ◽

Cited By ~ 5

Author(s):

Michel A. Audette ◽

A. Fuchs ◽

Oliver Astley ◽

Yoshihiko Koseki ◽

Kiyoyuki Chinzei

Keyword(s):

Finite Element ◽

Surgical Simulation ◽

Patient Specific ◽

Model Generation ◽

Anatomical Model

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A rapid prototyping-based methodology for patient-specific contouring of osteotomy plates

Rapid Prototyping Journal ◽

10.1108/rpj-09-2018-0257 ◽

2019 ◽

Vol 25 (5) ◽

pp. 888-894

Author(s):

Behnam Gomari ◽

Farzam Farahmand ◽

Hassan Farkhondeh

Keyword(s):

Rapid Prototyping ◽

Locking Plate ◽

Patient Specific ◽

Osteotomy Site ◽

Content Type ◽

Tibial Plate ◽

Important Challenge ◽

Surgical Application ◽

Bone Fragments ◽

Plate Spring

Purpose An important challenge of the osteotomy procedures, particularly in the case of large and complex corrections, is the fixation of the osteotomy site. The purpose of this study is to propose a practical and cost-effect methodology for the plate adapting problem of osteotomy surgery. Design/methodology/approach A novel patient-specific plate contouring methodology, based on rapid prototyping (RP) and multi-point forming (MPF) techniques, was developed and evaluated. In this methodology, a female mold is fabricated by RP, based on the geometry of the osteotomy site and estimation of the plate spring back. The mold is then used to configure a MPF die, which is then used for press forming of the factory-made locking plate. The applicability of the methodology was assessed in two case studies. Findings The results of implementing the methodology on a femoral and a tibial locking plate indicated very good conformity with the underlying bone, in both the frontal and sagittal planes. The surgical application of the pre-operatively contoured tibial plate facilitated the plate locating and screw inserting procedures, and provided a secure fixation for bone fragments. Practical implications The results are promising and provide a proof of concept for the feasibility and applicability of the proposed methodology in clinical practice, as a complementary to the existing surgical preplanning and patient-specific instrument preparations. Originality/value The advantageous features of RP and the MPF were used to provide a solution for the plate adapting problem of osteotomy surgery.

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Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135118771323 ◽

2018 ◽

Vol 9 (4) ◽

pp. 454-458 ◽

Cited By ~ 8

Author(s):

Sarah A. Chen ◽

Chin Siang Ong ◽

Nagina Malguria ◽

Luca A. Vricella ◽

Juan R. Garcia ◽

...

Keyword(s):

3D Printing ◽

Aortic Arch ◽

Surgical Simulation ◽

Three Dimensional ◽

3D Models ◽

Digital Design ◽

Patient Specific ◽

Aortic Arch Reconstruction ◽

Arch Reconstruction ◽

And Training

Purpose: Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction. Description: Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction. Evaluation: Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation. Conclusions: Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.

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Low-cost physiological simulation system for endovascular treatment of aneurysms

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2018-0010 ◽

2018 ◽

Vol 4 (1) ◽

pp. 37-40

Author(s):

Oskar Pfau ◽

André Kemmling ◽

Philipp Rostalski

Keyword(s):

Blood Flow ◽

Endovascular Treatment ◽

Low Cost ◽

Specific Treatment ◽

Simulation System ◽

Sensor Data ◽

Patient Specific ◽

Treatment Needs ◽

New Device ◽

Physiological Simulation

AbstractMinimally invasive procedures are more and more becoming the standard treatment for many surgical procedures such as the treatment of cerebral aneurysms. In an endovascular procedure the aneurysm is filled with flexible platinum coils leading to embolization and blocking the blood flow in the aneurysm. This established treatment needs high skills and experience on the surgeon. In order to practice and plan a specific procedure or test a new device, a realistic simulation environment is needed. Modern 3D printing technology allows the fabrication of patient specific models incorporating the exact geometry of the pathological anatomy. This article describes the development of a low-cost physiological simulation system for the training of the endovascular treatment of aneurysms. In order to practice the procedure in a realistic scenario, a 3D printed model of the aneurysm is embedded in a fluidic simulation s ystem. In addition to the patient-specific anatomy of the aneurysm a pulsatile water flow is generated, which emulates the influence of blood flow on the behaviour of catheters and coils during deployment. The system consist of a controllable pump circuit generating a pulsatile flow which can be regulated automatically and additionally controlled externally by the user. For a suitable representation, a display which graphically represents the sensor data and settings is employed. The components were compactly integrated in a small case allowing for easy deployment in training workshops. The simulation setup was successfully tested in prospective patient specific treatment planning and workshops for students.

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