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Microsurgery

Surgical planning

Authors: Mette Hørberg, consultant in oral and maxillofacial surgery, Frederik Gulmark Hansen, med.stud., Magnus Balslev Avnstorp MD and Jytte Buhl, consultant in oral and maxillofacial surgery

Surgical planning

Preoperative planning for virtual simulation of resection, grafting and reconstruction allows surgeons to craft patient-specific surgical plans and use tailored guides for clinical transfer to the operating room. Following the online planning session between a biomedical engineer and the surgeon; patient-specific surgical guides, models and instruments are designed, and 3D printed for use within the sterile field. 

The most widely used application is for mandibular or maxillary reconstruction using the fibula free flap and other vascularized grafts. 

Virtual surgical planning (VSP) enables surgeons to perform reconstructive procedures with more confidence and a 3D accuracy as compared to cases without pre-surgical planning and guides in helping to reduce surgical time and create more accurate reconstructions.

With VSP you get a reconstructed model of the anatomy showing the proposed post-operative outcome with graft in place. Patient specific resection guides for the mandible, allow accurate transfer of the digital plan. A graft osteotomy guide for the donor site contains precise osteotomies to create closing wedges (1).



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