Computer-assisted planning and execution system
Inventors
Gordon, Chad • Armand, Mehran • MURPHY, RYAN • GRANT, Gerald • LIACOURAS, Peter • WOLFE, Kevin • Basafa, Ehsan
Assignees
United States, Defense, Secretary of • United Dtates Of America Navy, Secretary of • Johns Hopkins University • US Department of Navy • US Department of Defense
Publication Number
US-10842504-B2
Publication Date
2020-11-24
Expiration Date
2034-11-26
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Abstract
A method for computer-assisted planning of a transplant surgery is provided. The method includes obtaining a computer-readable representation of a donor and recipient skeletal fragment; determining surgical cutting planes on the computer-readable representation of the donor skeletal fragment from which a portion of the donor skeletal fragment from the computer-readable representation of the donor skeletal fragment will be harvested; determining virtual cutting guides; performing a virtual osteotomy to separate the portion of the donor skeletal fragment from the computer-readable representation of the donor skeletal fragment from a remainder portion of the donor skeletal fragment based on a position of the virtual cutting guides that are attached to the computer-readable representation of the donor skeletal fragment; positioning the donor skeletal fragment within a transplant region of the recipient skeletal fragment; and creating a hybrid computer-readable representation comprising the recipient skeletal fragment and the portion of the donor skeletal.
Core Innovation
The invention provides a computer-assisted system and method for planning and executing complex craniomaxillofacial surgeries, particularly face-jaw-teeth transplantation and related orthognathic, neurosurgical, and head/face/neck surgical procedures. The system integrates preoperative planning, intraoperative navigation with trackable surgical guides, and dynamic real-time feedback including cephalometric measurements and biomechanical simulations. This includes creating virtual 3D reconstructions of donor and recipient skeletal features, determining surgical cutting planes and virtual cutting guides, performing virtual osteotomies, and generating hybrid models for surgical guidance and outcome optimization.
The problem addressed by the invention is the complexity and challenges inherent in craniomaxillofacial surgeries, especially face-jaw-teeth transplantation, which involves skeletal, aesthetic, and dental discrepancies between donor and recipient. Existing computer-assisted surgery platforms lack a single integrated solution combining both preoperative planning and intraoperative navigation with real-time feedback for guide placement and outcome optimization. Furthermore, conventional systems provide limited capacity for intraoperative plan updates, making it difficult to handle size mismatches and anatomical variances dynamically. There is also a lack of validated methods for optimizing facial and dental alignment during surgery, critical for achieving improved functional and aesthetic outcomes.
Claims Coverage
The patent contains independent claims directed to computer-implemented methods and systems for computer-assisted planning of craniomaxillofacial surgery involving implants and recipient skeletal fragments.
Computer-assisted planning and updating of hybrid skeletal representations
Obtaining computer-readable representations of an implant and a recipient skeletal fragment; positioning the implant within the recipient skeletal fragment region; creating and updating a hybrid computer-readable representation during or after positioning; tracking movement of the implant; and providing the hybrid as output.
Integration of anatomical segmentation in planning
Creating computer-readable representations of implant and recipient skeletal fragments as segmented 3D reconstruction models with associated anatomical attributes classifying each voxel.
The claims cover methods and systems that provide an integrated platform for planning, positioning, tracking, and updating skeletal and implant models during craniomaxillofacial surgeries, supporting dynamic surgical guidance and outcome optimization.
Stated Advantages
Intraoperative plan updates based on hard tissue discrepancies between planned and executed procedures.
On-table feedback in the form of dynamic, real-time cephalometrics.
Pre-designed fixation plates matching the virtual plan.
Increased robustness of conventional computer-assisted surgery paradigms by accommodating intraoperative needs beyond preoperatively designed tools and templates.
Improved surgical outcomes and decreased morbidity via shortened operative times, more precise surgical maneuvers, and improved safety margins.
Documented Applications
Face-jaw-teeth transplantation surgery including Le Fort-based facial transplantation.
Orthognathic surgical procedures involving jaw and dental alignment corrections.
Cranioplasty, including single-stage implant cranioplasty for customized craniofacial implant placement.
Craniomaxillofacial reconstructive surgery and trauma reconstruction.
Neurosurgical procedures benefiting from flexible reference mounts and navigation.
Congenital deformity correction involving craniofacial skeletal abnormalities.
Head and neck (ENT) reconstructive surgeries such as tumor resections with bone reconstruction.
Dental implant placement utilizing real-time cephalometric feedback for optimized occlusion.
Osseointegrated craniofacial prosthetic placement involving 3D prosthetic design and navigation.
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