Reconstruction and rehabilitation
Each year a large number of people are involved in serious accidents in which they sustain severe head and facial injuries, while others develop cancer of the head and neck region, or are born with craniofacial malformations. The severe problems that result can often be alleviated by reconstructive surgery.
Despite extensive evidence that rehabilitation can be improved through meticulous planning and the use of new, patient-specific biomaterials, in most cases surgery is still carried out based solely on the knowledge and experience of the surgeon. To prepare for complicated surgeries, we are working on creating an integrated functional solution based on visualization of 3D images and haptics, in which a robotic hand can work within the image to practice and plan in detail prior to surgery. This approach makes it possible to design and adapt bone grafts, biomaterials needed for the procedure and transmit electronic data for production of materials such as patient-specific titanium plates to be used for fixation of bone segments. Inserting screws for fixation or installation of dental implants the intention is to be able to evaluate in advance of surgery the biomechanical stability possible to achieve.
A unique technology, additive manufacturing which involves electron beam melting of titanium powder or alternative material, is used to manufacture implants with various properties. The surgical plan can be converted to real time with patient-specific guides or to computer-assisted surgery and in the future even to robotic surgery.
The project group is working to develop a new generation of guides and patient-specific biomaterials that can be more quickly and efficiently integrated into both soft and hard tissues, and with biomechanical properties that meet the load requirements demanded by the situation.
Visualisation of 3-D images and virtual haptic surgical planning
Our project includes studies of bone formation and incorporation of modified implants. The new technologies will be evaluated in extensive preclinical in vivo studies using molecular methods and PET/CT to assess how bone reacts, after which they will be tested in actual surgery. We want to achieve a fully usable commercial system for clinical use in the treatment of complicated congenital or acquired conditions involving the face, jaw and cranium.
We propose to implement a haptic surgery planning system that will facilitate shaping and fitting of bone replacement, design of customized biomaterials, and fixation devices such as plates and screws to restore bone structure in patients with congenital or acquired facial deformities, using a virtual model derived from, casts or scanning of areas of interest, and the patient’s CT and MRI data. Unlike vision and hearing, haptics provides bi-directional communication between an individual and his/her environment. The great challenge in haptic research is to build a device that can engage the entire hand, i.e., a system that allows simulation of touch to the fingertips and force feedback to the joints of the fingers and wrist.
The depiction above illustrates cranio-maxillofacial surgery planning which requires manipulation of both bone and soft tissue which makes it a good bench-mark for the developed technology. The system will allow a surgeon to plan and practice complicated reconstructive surgical procedures prior to surgery.