Patient-specific trackable cutting guides
Inventors
GRANT, Gerald • LIACOURAS, Peter • Gordon, Chad • MURPHY, RYAN • Armand, Mehran
Assignees
Johns Hopkins University • US Department of Navy • US Department of Defense
Publication Number
US-10682147-B2
Publication Date
2020-06-16
Expiration Date
2034-11-24
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Abstract
A surgical guide assembly having an attachment device configured to be coupled to a bone. A cut location indicator is coupled to the attachment device. The cut location indicator identifies a location where the bone is to be cut. An arm is coupled to the attachment device, the cut location indicator, or both. A support structure is coupled to the arm. The support structure is configured to have a trackable feature coupled thereto.
Core Innovation
The invention is a surgical guide assembly designed for use in craniomaxillofacial surgery. It comprises an attachment device that couples to a bone, a cut location indicator to identify where the bone should be cut, an arm that connects to the attachment device or cut location indicator, and a support structure coupled to the arm. The support structure is configured to carry a trackable feature to enable intraoperative tracking.
This surgical guide assembly addresses challenges in complex procedures like facial transplantation, which involve skeletal, aesthetic, and dental discrepancies between donor and recipient. Existing computer-assisted surgery systems either focus on pre-operative planning or intraoperative navigation but lack integration and customization for the complexity of such transplantation surgeries. Moreover, no validated methods exist for optimizing outcomes related to mismatched facial, skeletal, and occlusal inconsistencies.
The invention further provides a fully integrated computer-assisted surgery platform that combines pre-operative planning, intraoperative navigation, and dynamic real-time feedback using biomechanical simulation and cephalometrics. It includes patient-specific cutting guides that enable accurate bone cutting and placement, allowing surgeons to overcome size mismatch and achieve better functional and aesthetic results. The system also tracks surgical tools and fragments in three-dimensional space, facilitating simultaneous donor and recipient surgery coordination and intraoperative updates to surgical plans.
Claims Coverage
The patent includes one main independent claim defining a surgical guide assembly with two main components providing trackable guidance during craniomaxillofacial surgery.
Dual surgical guide assemblies with trackable features
The assembly includes an implant surgical guide configured to attach to a craniomaxillofacial implant and a recipient surgical guide configured to attach to a bone of the recipient's craniomaxillofacial skeleton. Both guides have trackable features and corresponding trackers for intraoperative positioning feedback.
Cut location indicator on the recipient surgical guide
The recipient surgical guide includes a cut location indicator coupled to its attachment device that identifies precise locations on the recipient bone where cuts are to be made.
Dynamic tracking and intraoperative feedback
Trackers dynamically track the trackable features of both the implant and recipient surgical guides in three-dimensional space to provide real-time intraoperative positioning feedback to assist surgical navigation.
Communication link and computer workstations
The system includes communication links connecting recipient and implant surgical guide assemblies, both having computer workstations that enable data transfer and coordination between surgeries.
Material composition and configuration of components
The attachment devices and cut location indicators are made from polymers, resins, epoxies, or combinations thereof. The trackable features can be reflective spheres enabling optical tracking.
Applicability to different implant types
The surgical guide assembly is applicable to craniomaxillofacial implants including donor implants, dental implants, or craniofacial prosthetics.
These inventive features collectively provide a system and surgical guide assembly that enable precise, real-time navigation and feedback for complex craniomaxillofacial surgeries by integrating patient-specific cutting guides with trackable features and communication-enabled workstations.
Stated Advantages
Provides a fully integrated platform combining pre-operative planning, intraoperative navigation, and dynamic real-time feedback for surgical procedures.
Enables accurate placement and cutting of bones in complex surgeries such as facial transplantation, overcoming donor-recipient size mismatches.
Allows real-time intraoperative updates to surgical plans enhancing flexibility and precision during surgery.
Facilitates simultaneous tracking and coordination of donor and recipient surgeries via networked workstations and trackers.
Decreases total operative times due to pre-bent fixation plates and navigational guidance.
Improves surgical outcomes related to aesthetics, occlusion, and function using biomechanical simulation and cephalometric analysis.
Documented Applications
Computer-assisted craniomaxillofacial surgery, including face-jaw-teeth transplantation and orthognathic surgical procedures.
Navigation and modeling for skull and facial bone osteotomies in double-jaw and single-jaw transplants.
Placement and alignment of osseointegrated dental implants for restoring mastication.
Tracking and placement of craniofacial prosthetics for reconstructing absent facial features.
Craniomaxillofacial trauma reconstruction and fracture reduction with real-time navigation and feedback.
Neurosurgical procedures requiring craniotomies with improved navigation and patient positioning.
Correction of congenital craniofacial deformities using preoperative planning and intraoperative feedback.
Head, neck, and facial reconstruction surgeries, including post-tumor resection and free tissue transfer.
Orthognathic surgeries for jaw and dental segment repositioning with enhanced planning and real-time cephalometric feedback.
Computer-assisted planning and execution of single-stage cranioplasties with customized cranial implants following tumor resection.
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