Development and Application of a Virtual Environment for Reconstructive Surgery

Objective: This paper details the development and application of a Virtual Environment for Reconstructive Surgery (VERS). It addresses the technical and user-interface challenges in developing such a system, and the lessons learned during application of the system in the case of a 17-year-old boy with a severe facial defect arising from the removal of a soft-tissue sarcoma. Materials and Methods: Computed tomography (CT)scans were segmented into bone and soft-tissue classifications using traditional and novel algorithms, a surface mesh was generated, and imaging arrifacts were removed, yielding a mesh suitable for visualization. This patient-specific mesh was then used in a virtual environment by the surgeons for preoperative visualization of the defect, planning of the surgery, and production of a custom surgical template to aid in repairing the defect. Results: This system was successfully used to plan the surgery of the patient and to produce a custom, patient-specific template that was used to harvest bone from a donor site in order to reconsu-uct the defect. Conclusion: Despite technical challenges, virtual-environment surgical planning is useful as a clinical tool for preoperative visualization, cephalometric analysis, and surgical intervention. It can provide a more precise surgical result than would otherwise be realized using traditional methods.