Mandibulectomy And Fibula Reconstruction Using Virtual Planning & 3D Printing
Virtual planning and 3D printing PSI for mandibular reconstruction with fibula free flap
Rabin Medical Center.
Initially, in Mandibular reconstruction with fibula free flap surgery, it is necessary to resect from the jaw the section affected by the tumor (Mandibulectomy) afterward the jaw is reconstructed with bone segments from the fibula, includes soft tissue and blood vessels.
In order to perform the jaw resection and reconstruction in the most accurate manner, the surgery is planned using 3D visualization and patient specific instruments designed and printed from biocompatible materials with sterilization capabilities.
At the first stage of 3D design, patient CT scans are converted to a computerized 3D model of the jaw and fibula bone.
At the planning stage, the patient’s anatomy is presented to the surgeon in 3D on a computer. The surgeon determines the mandibulectomy margins and reconstruction method using a computerized 3D simulation. Additional team can be involved in the pre-surgical plan stage and several approaches can be examined in order to find the most desired result.
After the surgeon approves the surgical plan, the instruments are designed according to the patient's anatomy. These instruments guide the surgeon during surgery to accurately perform the computerized plan: cutting guides for the mandibulectomy, a cutting guide for the fibula dissection, a guidance instrument for placing the fibula in the excision area just as in the pre-surgical plan.
By using the anatomical model which simulates the surgery’s final result, the plate used for stabilizing can be bent in advance, saving precious time during surgery.
The patient specific Instruments arrive in the OR sterile and ready for use. The surgeon arrives with a surgery plan which is determined in advance, performs the mandibulectomy and reconstructs the jaw exactly as planned in the 3D pre-surgical plan, using adapted instruments, which saves time in the OR and enables surgeons to commence surgery with full confidence and receive as accurate a result as possible.