Haptic-Assisted Virtual Osteotomy As a Training Tool

The maxillofacial surgery is a complex surgical procedure to correct facial malformations located in the head of the patient. A precise and reliable surgical planning is necessary for a successful maxillofacial surgical procedure. The experience and clinical practice of surgeons play a very important role during the surgical procedures. Modern Computer Aided Systems (CAS) have been developed in order to speed up the surgical planning process and to increase the accuracy and reliability of the surgical procedure. However, CAS systems have not been focused on their ability to train and to provide experience and clinical practice to novice surgeons or medical student. In this way CAS systems could be a potential tool to improve the skill of surgeons in order to decrease human errors in the maxillofacial treatment and surgical procedures. This paper presents an investigation to evaluate the use of virtual reality and haptic systems as a training tool for maxillofacial surgeries, in particular osteotomies procedures. The aim is to evaluate the effect of virtual training on surgeon skills. Thus, a virtual osteotomy system has been developed and is presented. The system is based on an open source computer and programming resources, and makes use of haptic technologies to provide the users with the sense of touch. The virtual osteotomy procedures implemented are based on current surgical orthognathic surgery procedures. Free-form 3D manual cutting of bone is available in the system by means of the haptic device and the force feedback provided to the user, which increases the level of realism of the virtual procedure. The evaluation results show that the haptic-enabled virtual training of osteotomies increases the psychomotor skills of the practitioner, leading to an improved accuracy when carrying out the actual bone cut.

Bilateral shoulder arthrodesis in a Pekinese using three-dimensional printed patient-specific osteotomy and reduction guides

SummaryObjective: To report the use of computeraided design software for virtual surgical planning and design of three-dimensional printed patient-specific osteotomy and reduction guides for facilitation of bilateral shoulder arthrodesis in a dog.Methods: A three-year-old male entire Pekinese was presented unable to walk due to bilateral severe medial shoulder instability. Computed tomographic data was processed to yield three-dimensional mesh representations of the humeri and scapulae which could be manipulated in computeraided design software. Key virtual surgical planning steps included joint realignment, osteo-tomies of the glenoid and humeral head, and reduction. Virtual osteotomy and reduction guides were designed, three-dimensionally printed, and used intra-operatively.Results: Appropriate alignment, reduction and fixation of the humeri and scapulae were achieved bilaterally. The patient regained the ability to walk unassisted after two weeks and was subsequently able to exercise normally without lameness.Clinical significance: Patient-specific, three-dimensional printed osteotomy and reduction guides facilitated accurate bilateral shoulder arthrodeses.ORCID iD:http://orcid.org/0000-0002-2158-7133