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探索性台架研究评估了在游离腓骨瓣下颌骨重建中使用手术设计和模拟的情况。

Exploratory benchtop study evaluating the use of surgical design and simulation in fibula free flap mandibular reconstruction.

机构信息

Institute for Reconstructive Sciences in Medicine, 1W-02, 16940-87 Avenue Misericordia Community Hospital, Edmonton, AB T5R 4H5, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2013 Jun 24;42(1):42. doi: 10.1186/1916-0216-42-42.

Abstract

BACKGROUND

Surgical design and simulation (SDS) is a useful tool to help surgeons visualize the anatomy of the patient and perform operative maneuvers on the computer before implementation in the operating room. While these technologies have many advantages, further evidence of their potential to improve outcomes is required. The present benchtop study was intended to identify if there is a difference in surgical outcome between free-hand surgery completed without virtual surgical planning (VSP) software and preoperatively planned surgery completed with the use of VSP software.

METHODS

Five surgeons participated in the study. In Session A, participants were asked to do a free-hand reconstruction of a 3d printed mandible with a defect using a 3d printed fibula. Four weeks later, in Session B, the participants were asked to do the same reconstruction, but in this case using a preoperatively digitally designed surgical plan. Digital registration computer software, hard tissue measures and duration of the task were used to compare the outcome of the benchtop reconstructions.

RESULTS

The study revealed that: (1) superimposed images produced in a computer aided design (CAD) software were effective in comparing pre and post-surgical outcomes, (2) there was a difference, based on hard tissue measures, in surgical outcome between the two scenarios and (3) there was no difference in the time it took to complete the sessions.

CONCLUSION

The study revealed that the participants were more consistent in the preoperatively digitally planned surgery than they were in the free hand surgery.

摘要

背景

手术设计和模拟(SDS)是一种有用的工具,可以帮助外科医生在手术室实施之前在计算机上可视化患者的解剖结构并进行手术操作。虽然这些技术有许多优点,但需要进一步证明它们提高手术效果的潜力。本台式研究旨在确定在没有虚拟手术规划(VSP)软件的情况下完成的徒手手术与使用 VSP 软件完成的术前计划手术之间是否存在手术结果的差异。

方法

五名外科医生参与了这项研究。在 A 会议期间,要求参与者使用 3D 打印腓骨徒手重建带有缺陷的 3D 打印下颌骨。四周后,在 B 会议期间,要求参与者进行相同的重建,但这次使用术前数字设计的手术计划。使用数字注册计算机软件、硬组织测量和任务持续时间来比较台式重建的结果。

结果

研究表明:(1)计算机辅助设计(CAD)软件中生成的叠加图像可有效比较术前和术后的结果;(2)根据硬组织测量,两种情况下的手术结果存在差异;(3)完成会议所需的时间没有差异。

结论

研究表明,与徒手手术相比,参与者在术前数字规划手术中更加一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9ba/3729729/4204280c2251/1916-0216-42-42-1.jpg

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