Abstract

Virtual surgery planning is a non-invasive procedure, which uses digital clinical data for diagnostic, procedure selection and treatment planning purposes, including the forecast of potential outcomes. The technique begins with 3D data acquisition, using various methods, which may or may not utilize ionizing radiation, such as 3D stereophotogrammetry, 3D cone-beam CT scans, etc. Regardless of the imaging technique selected, landmark selection, whether it is manual or automated, is the key to transforming clinical data into objects that can be interrogated in virtual space. As a prerequisite, the data require alignment and correspondence such that pre- and post-operative configurations can be compared in real and statistical shape space. In addition, these data permit predictive modeling, using either model-based, data-based or hybrid modeling. These approaches provide perspectives for the development of customized surgical procedures and medical devices with accuracy, precision and intelligence. Therefore, this review briefly summarizes the current state of virtual surgery planning.

Highlights

  • Virtual surgical planning (VSP) addresses operative procedures using digital data.The primary objective of VSP is to improve the clinical workflow, but it may help in selecting/customizing a procedure for a specific patient

  • Qadry et al [53] compared pre-operative, planned and post-operative results among various craniofacial treatment groups. Their results revealed that the differences between pre-operative and post-operative measures were statistically significant (p < 0.05), as expected, and the differences between pre-operative measures and the planned configuration were statistically significant

  • Differences between the planned configuration and the post-operative measures were non-significant (p > 0.05), suggesting that VSP using patient-specific splints and cutting guides designed for accurate transfer of placement might be reliable

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Summary

Introduction

The primary objective of VSP is to improve the clinical workflow, but it may help in selecting/customizing a procedure for a specific patient These objectives can be met in a variety of ways since VSP can be used for pre-operative planning, decreasing surgery time and visualization of potential post-operative outcomes. VSP can be combined with other techniques such as 3D printing to create patient specific surgery tools, implants, and virtual reality with or without haptics for training purposes. To achieve these tasks, VSP requires robust techniques to interrogate pre-treatment data to predict post-treatment configurations. Unlike 2D cephalometric techniques, the fundamentals of VSP methods rely on industry standard imaging protocols (such as DICOM) to: permit data integration from different sources; select the global reference frame and simulate surgical movements prior to designing and fabricating surgical splints for craniofacial, orthognathic and maxillofacial surgery inter alia

Virtual Surgery Planning Procedure
Alignment
Alignment and Integration
Virtual diagnosis
Treatment planning
Manufacturing
Prediction Based Virtual Surgery Planning
Model-Based Prediction
Data-Based Prediction
Hybrid Prediction
Selection of Prediction Method
Prediction
Mathematical landmarks
Automated Landmark Detection
Correspondence
Difference Quantification
Findings
Discussion
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