Computer-assisted face-jaw-teeth transplantation
Inventors
Gordon, Chad • Armand, Mehran • MURPHY, RYAN • GRANT, Gerald • LIACOURAS, Peter • WOLFE, Kevin
Assignees
United States, Defense, Secretary of • Johns Hopkins University • US Office of Naval Research
Publication Number
US-11232858-B2
Publication Date
2022-01-25
Expiration Date
2034-11-25
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Abstract
A computer-assisted surgical system can include a donor sub-system and a recipient sub-system. The donor sub-system includes a first reference unit having a first trackable element, a fragment reference unit having a second trackable element, and a first detector configured to provide at least one of a first signal corresponding to a detected location of one or more of the first trackable element and the second trackable element. The recipient sub-system includes a second reference unit having a third trackable element, and a second detector configured to provide at least one of a second signal corresponding to a detected location of at least the third trackable element.
Core Innovation
The invention relates to a computer-assisted surgical system and method designed for craniomaxillofacial surgeries, especially complex facial transplantation involving face-jaw-teeth segments. It integrates donor and recipient subsystems with trackable reference units and detectors that provide signals corresponding to the detected locations of these units, enabling real-time navigation and planning during surgery.
The system addresses several challenges in facial transplantation surgery due to skeletal, aesthetic, and dental discrepancies between donor and recipient. Existing computer-assisted surgery approaches either focus on pre-operative planning with manufactured guides or intraoperative feedback but lack a unified platform that combines both planning and seamless navigation with real-time feedback and intraoperative plan updates. There are no validated methods that optimize outcomes accounting for donor-to-recipient anthropometric mismatch, which limits precision and functional aesthetics.
Embodiments include workstation modules for integrated planning and navigation, simultaneous tracking of donor and recipient anatomy and surgical tools, and patient-customized cutting guides with "snap-on" fits. The system enables segmentation and volumetric reconstruction of anatomy, cephalometric analysis, biomechanical simulation, and mapping of vasculature. It further supports intraoperative evaluation and dynamic plan revisions through real-time tracking and feedback, enhancing accuracy in donor fragment positioning and attachment to the recipient.
Claims Coverage
The patent claims include multiple inventive features centered around computer-assisted craniomaxillofacial surgery systems and methods that provide integrated tracking, visualization, and navigation of implants and anatomical structures.
Integrated tracking of donor implant and recipient anatomy
A surgical system comprising an implant sub-system with a first reference unit having a trackable element and a detector providing signals corresponding to its detected location, and a recipient sub-system with a second reference unit and detector similarly configured, allowing real-time location tracking of both implant and recipient anatomy.
Computer system displaying updated 3D reconstructions
The system has a computer with memory and processor executing instructions to access a computer-readable 3D reconstruction of the implant or donor fragment, updating its orientation in real-time based on physical locations detected by the tracking system, and displaying this on at least one display.
Communication between donor and recipient workstations
Provision of a communications link allowing the first computer workstation associated with the donor sub-system and the second computer workstation associated with the recipient sub-system to exchange data related to location tracking and 3D reconstructions.
Use of different tracking technologies and IR markers
Detectors and trackable elements may employ optical trackers, magnetic trackers, or combined technologies. Trackable elements can include infrared (IR) reflectors or emitters integrated with reference units or cutting guides.
Patient-specific cutting guides with tracking
A method and system for designing and manufacturing patient-custom cutting guides that snap onto anatomical features following planned cutting planes. These guides incorporate trackable elements enabling their real-time tracking during surgery.
Superimposition and navigation of donor fragment on recipient anatomy
A method including attaching reference units to donor and recipient, tracking their locations to update corresponding 3D reconstructions, and superimposing a virtual donor fragment on the recipient's reconstruction to guide placement and attachment during transplantation with real-time navigation.
Size mismatch assessment and optimal fragment placement
Assessing skeletal size mismatch by measuring interfaces between donor implant and recipient anatomy and selecting attachment locations that minimize step-off deformities at osteosynthesis areas, thus optimizing functional and aesthetic outcomes.
Automated cephalometric computation and biomechanical simulation
Performing automated cephalometric calculations and biomechanical simulations on the hybrid reconstruction intraoperatively to assess and guide the alignment and function of transplanted facial skeletal structures.
Together, the claims cover a comprehensive system and method for computer-assisted facial transplantation surgery that integrates preoperative planning, intraoperative navigation, real-time tracking of donor and recipient anatomy and cutting guides, communication between workstations, and advanced analytical tools to optimize surgical outcomes.
Stated Advantages
Provides a fully integrated platform enabling both preoperative planning and intraoperative navigation for complex facial transplantation procedures.
Enables real-time tracking and dynamic feedback of donor and recipient anatomical features and surgical guides, improving surgical precision.
Facilitates intraoperative plan updates and verification with quantitative and qualitative feedback, increasing robustness and adaptability during surgery.
Custom cutting guides with optical navigation help compensate for donor-recipient size mismatch, reducing operative time and improving alignment.
Modular system design allows for ongoing addition of functionalities and can be adapted for various craniomaxillofacial, neurosurgical, and orthognathic procedures.
Small cranial reference mounts eliminate bulky skull clamps, allowing safer and more flexible surgical access and reducing contamination risk.
Documented Applications
Pre-operative planning and intraoperative navigation for face-jaw-teeth transplantation including Le Fort-based and orthognathic surgeries.
Tracking and surgical guidance for donor and recipient surgical procedures in transplantation.
Placement and navigation of patient-specific surgical cutting guides and pre-bent fixation plates.
Use in orthognathic surgery to improve jaw and dental alignment via real-time cephalometric feedback and biomechanical simulation.
Navigation and reconstruction in craniomaxillofacial trauma repair, including orbital and cranial fractures.
Guidance for osseointegrated dental implants and craniofacial implants or prosthetics.
Single-stage implant cranioplasty following tumor resection using customized cranial implants with preoperative planning and intraoperative adjustments.
Applications in neurosurgical procedures to allow head repositioning and safe surgical access without bulky skull clamps.
Correction of congenital craniofacial deformities with preoperative planning and real-time surgical guidance.
Head and neck (ENT) surgeries including tumor resection reconstruction, free tissue transfer planning and fixation.
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