Leveraging technology for preoperative planning

Leveraging technology for preoperative planning

Dr. Kshitij Chaudhary, MS, DNBConsultant Spine SurgeonSir HN Reliance Foundation HospitalMumbai

DISCLAIMER

No financial interestsBut, I wish I had !!

Chirurgia magna, treatise I, Doctrine I, Ch IA blind man works on wood the same way as a surgeon on the body, when he is ignorant of anatomy.

First prerequisite for preoperative planning is knowing anatomy.

Proper preoperative planning prevents piss-poor performance(Seven Ps of success)

We use this knowledge of normal and pathological anatomy to plan surgery.

Surgical planning:

Helps to Mentally rehearse operationAnticipate pathological anatomy to avoid problemsAlternative planning (Having a Plan B).Pre-emptive implant contouring / selection

(Failing to plan is planning to fail)

16th Century

Surgery as a specialty bloomed only after the publication of this book by Vesalius in the 16th century, which contained the first accurate drawings of the human anatomy.

This was the book surgeons used to plan their surgeries and to navigate through the human body.

And we have come so far since .

In the first half of the talk i am going to show some, Softwares that can help us with preoperative planning.

These are basically DICOM manipulation softwares. Osirix is free for the Mac and Surgimap is free on Mac and Windows.

THR Planning (Osirix)

Surgimap

Surgimap

3D Planning

DICOM 3D manipulation and multi planer reconstructions.

Courtesy:Dr Arjun Dhawale

Anticipation of pathological anatomyCourtesy:Dr Arjun Dhawale

Courtesy:Dr Arjun Dhawale

Pedicle anatomy / dimensions

Pedicle entry points

Virtual Surgery

16y BoyCervical dysraphism

If a picture is worth a 1000 words

Then a 3D model is worth a thousand pictures !

Slide courtesy - Dr Vaibhav Bagaria

But the model used in this surgery done at our hospital is not a regular normal anatomy model.

It actually is a Patient specific model of the fractured pelvis that has been 3d printed.

The biggest advantage of 3D models is that they can be taken to the operative field, and touched and viewed during the operation, helping surgeons to re-assess the complicated fracture pattern or pathological anatomy.

What is 3D Printing?

24th Century (Star Trek)

Imagine downloading a set of plans from the Internet for just about any solid object that you desire, adding the correct base materials to your 3-D printing machine and printing the object at your home or business. This is what 3-D printing may potentially deliver.

Video Courtesy - Dr Vaibhav Bagaria

Medacta UKSignature BiometCustomized Surgical Guides and JigsPedicle screw jigsTKR Jigs

4WEB Medical Spine Truss System

Customized Implant manufacturing

3D POSTProsthetics and Orthotics

Bespoke Braces

The Future is Bio-printing

Dr. Lawrence J. Bonasser at Cornell University

Cartilage bio-printing

Lumbar disc bio-printingDr. Lawrence J. Bonasser at Cornell University

I never think of the future. It comes soon enough.