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 • Johns Hopkins University • US Department of Navy • US Department of Defense
Publication Number
US-11328813-B2
Publication Date
2022-05-10
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
Face-jaw-teeth transplantation is one of the most complex scenarios in craniomaxillofacial surgery due to skeletal, aesthetic, and dental discrepancies between donor and recipient. Conventional computer-assisted surgery systems lack a fully integrated platform that provides both pre-operative planning and intraoperative navigation with real-time feedback to optimize accurate guide placement and outcomes, especially in cases of donor-to-recipient anthropometric mismatch. Existing systems do not allow for dynamic intraoperative plan updates or provide a seamless integration of planning and navigation tailored to complex procedures like facial transplantation.
The invention provides a computer-assisted planning and execution (C.A.P.E.) system that integrates preoperative planning, intraoperative navigation, and dynamic real-time feedback through biomechanical simulation and cephalometrics. The system uses computer-readable 3D representations of donor and recipient skeletal fragments, determines surgical cutting planes and virtual cutting guides, and performs virtual osteotomies to isolate donor skeletal portions. It enables positioning of donor skeletal fragments within recipient regions to form a hybrid representation. Real-time tracking and navigation using reference units and trackable cutting guides allow intraoperative verification, plan updates, and optimized surgical execution, improving precision and outcomes in complex facial transplantation and related surgeries.
Claims Coverage
The patent discloses one independent claim defining a computer-implemented method for computer-assisted planning of craniomaxillofacial surgery involving intraoperative tracking and fixation of an implant.
Hybrid computer-readable representation for intraoperative surgical planning and execution
The method includes obtaining computer-readable representations of an implant and recipient skeletal fragment, positioning the implant within the recipient, creating a hybrid 3D representation, and intraoperatively studying this hybrid model to assist surgical decisions.
Intraoperative tracking with real-time surgical navigation assistance
The method involves intraoperatively tracking both implant and recipient skeletal fragment using a reference unit that provides real-time surgical navigation guidance during the procedure.
Navigation and placement of cutting guides during surgery
The method includes intraoperative navigation and placement of cutting guides to assist in accurate surgical osteotomies and implant positioning.
Visual tracking of implant placement
Tracking during surgery includes visual tracking of the implant, providing spatial feedback on the final three-dimensional placement of the implant relative to the recipient anatomy.
Applications to various craniomaxillofacial surgeries
The method is applied to cranioplasty, single-stage implant cranioplasty, orthognathic surgery, and reconstructive craniomaxillofacial surgeries, demonstrating versatility to different procedural types.
Overall, the independent claim focuses on computer-assisted intraoperative planning and navigation by creating and studying a hybrid computer-readable representation of the recipient and implant, real-time tracking, and fixation, supporting accurate placement and execution in craniomaxillofacial surgery.
Stated Advantages
Intraoperative plan updates based on discrepancies between planned and executed procedures improve surgical accuracy.
Provides dynamic real-time cephalometric feedback during surgery to guide optimal placement and alignment.
Pre-designed fixation plates matched to virtual plans reduce operative time and improve surgical precision.
Increases robustness by addressing intraoperative deviations and challenges not accounted for preoperatively.
Improved clinical outcomes and decreased morbidity through shorter surgery times, precise maneuvers, and enhanced safety margins.
Documented Applications
Craniomaxillofacial surgery involving Le Fort-based face-jaw-teeth transplantation and orthognathic surgical procedures affecting dental alignment.
Osseointegrated dental implant placement assisting in restoring ideal occlusion and predicting mastication function.
Osseointegrated craniofacial prosthetics for patients with facial disfigurements requiring implant-based prosthetic reconstruction.
Craniomaxillofacial trauma reconstruction including facial fracture reduction and orbit/cranial fracture repair.
Neurosurgical procedures requiring craniotomy and delicate skull interventions with enhanced navigation and head positioning.
Congenital deformity correction including craniosynostosis and craniofacial skeletal abnormalities in pediatric and adult patients.
Head, neck, and facial reconstruction surgeries in Otolaryngology including post-tumor resection and free tissue transfer planning.
Orthognathic surgery for jaw segment repositioning including pre-operative planning and real-time intraoperative guidance.
Computer-assisted cranioplasty, including single-stage customized cranial implant reconstruction following tumor resection or trauma.
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