Advanced Visuohaptic Surgical Planning for Trauma Surgery

创伤手术的高级视觉触觉手术计划

• 批准号: 8466787
• 负责人: Rebeka Silva
• 金额: --
• 依托单位: VETERANS AFFAIRS MED CTR SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-10-01 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8466787
• 关键词: 3-Dimensional; Address; Anatomic Models; Anatomy; Automation; Bite; Blood Vessels; Bone Tissue; Cessation of life; Chest; Clinical; Communication; Communities; Complex; Computer Assisted; Computer Graphics; Computer Simulation; Computer software; Computers; Computing Methodologies; Congenital Abnormality; Craniocerebral Trauma; Data; Deformity; Dental; Detection; Development; Diagnosis; Electronics; Elements; Environment; Evaluation; Excision; Face; Feedback; Fingers; Generations; Goals; Head and Neck Cancer; Head and Neck Surgery; Head and neck structure; Healthcare; Healthcare Systems; Helmet; Hospitals; Image; Imagery; Individual; Injury; Intervention; Intuition; Iraq; Jaw; Knowledge; Left; Location; Malignant Neoplasms; Measurement; Measures; Medical; Medical Students; Methods; Modeling; Nature; Neck; Nerve; Operative Surgical Procedures; Oral; Oral cavity; Orthopedic Surgery procedures; Orthopedics; Outcome; Patient Care; Patients; Pattern; Phase; Plastic Surgical Procedures; Plastics; Positioning Attribute; Preparation; Procedures; Process; Provider; Quality of life; Reconstruction plate; Reconstructive Surgical Procedures; Research; Research Infrastructure; Research Project Grants; Resected; San Francisco; Scanning; Secure; Simulate; Site; Software Engineering; Software Tools; Soldier; Solid Neoplasm; Specific qualifier value; Surgeon; Surgical Models; Surgical Specialties; System; Techniques; Technology; Telemedicine; Temporal bone structure; Testing; Time; Tissues; Tooth structure; Touch sensation; Training; Trauma; Veterans; War; Work; X-Ray Computed Tomography; base; bone; combat; computer science; computerized tools; craniofacial; cranium; data exchange; design; digital; experience; flexibility; haptics; head/neck injury; improved; injured; instrument; interest; malformation; maxillofacial; medical specialties; models and simulation; multidisciplinary; operation; physical model; prototype; reconstruction; research study; response; simulation; skeletal; skills; soft tissue; software development; stem; tool; tumor; two-dimensional; usability; validation studies; virtual; virtual reality

DESCRIPTION (provided by applicant): Introduction: The treatment of patients with complex facial and neck trauma is one of the most challenging multidisciplinary tasks in surgery. Recent studies on injured soldiers returning from the Iraq war have shown that the pattern of combat injuries has changed significantly. Before the advent of Kevlar body armor, most combat deaths and injuries stemmed from wounds to the chest or skull. Today 21% of soldiers with battle injuries suffer from trauma to the head and neck below the helmet line. The introduction of plating systems and changes in surgical techniques over the last 20 years have made correction of severe malformations in the head and neck possible. Preoperative planning is essential for a successful outcome of these complex procedures. Imaging has evolved from 2-D to 3-D, and from static to animated graphic rendering, and this has greatly facilitated diagnosis of complex traumatic injuries. Simulation technology based on 3D data of an individual patient will have a critical impact on surgical planning and training. Onsite and remotely accessible virtual environments simulating deformable tissues will allow surgeons to plan and simulate operations and retain their skills for infrequent operations. Specific Aims: The research goal of this proposal is the development and evaluation of a computational environment for the planning of reconstructive surgery. The proposed tool will allow interactive visualization and haptic manipulation of images derived from computed tomography (CT) scans of an individual patient with a head and neck injury. We anticipate that a computational tool will be more precise, faster, and more flexible than conventional techniques that depend on physical models. The computational tool can also be accessed remotely and allowing a surgeon to simulate and plan a surgical case with expert feedback. The research plan consists of the following elements: 1) Develop a visuohaptic virtual environment for interactively exploring CT data, specifying surgical cuts, manipulating bone fragments, and positioning of reconstruction plates 2) Develop an interface for taking and recording physical measurements from 3-D models for surgical planning 3) Enhance the environment to include semi-automation features to further reduce planning time and potentially increase accuracy beyond what is available via conventional techniques 4) Perform a validation study to develop a Telemedicine application for surgery planning Significance: The significance of the proposed surgical planning environment stems from its ability to allow surgeons to simulate, plan, and iterate on complex procedures based on individual patient data in 3-D from a CT scan. The software will allow surgeons to both see and feel the results of their interventions - for example, the quality of the bite or bone alignment of a reconstructed jaw following severe head trauma - before the actual surgery, leading to better planning, fewer errors, shortened surgery time and improved outcomes for the patient. The system will be accessible remotely so that surgeons can use it independent of their location. Potential Impact on Veterans Health Care: A virtual surgical planning system can provide many benefits to VA patient with head and neck trauma and cancer requiring reconstructive surgery. The VA is in an ideal position for telemedicine applications such as a virtual surgery planning system due to a strong communications infrastructure and electronic network that connects all VA medical facilities allowing secure exchange of data. The treatment team can thus use the virtual surgical planning system to provide the best care for the patient, independent of patient or provider location.

描述（由申请人提供）： 引言：复杂面颈部创伤患者的治疗是外科领域最具挑战性的多学科任务之一。最近对从伊拉克战争中返回的受伤士兵的研究表明，战斗伤害的模式发生了显着变化。在凯夫拉防弹衣出现之前，大多数战斗死亡和受伤源于胸部或头骨的伤口。今天，21%的士兵在战斗中受伤，头部和颈部的创伤在头盔线以下。在过去的20年里，钢板系统的引入和外科技术的变化使得头颈部严重畸形的矫正成为可能。术前计划对于这些复杂手术的成功结局至关重要。影像学已经从二维发展到三维，从静态发展到动态图形渲染，这大大促进了复杂创伤的诊断。基于个体患者3D数据的模拟技术将对手术规划和培训产生关键影响。模拟可变形组织的现场和远程访问虚拟环境将使外科医生能够计划和模拟手术，并保留他们的技能，以进行不频繁的手术。具体目标：本提案的研究目标是重建手术规划的计算环境的开发和评估。拟议的工具将允许交互式可视化和触觉操作的图像来自计算机断层扫描（CT）扫描的个人患者的头部和颈部受伤。我们预计，计算工具将比依赖于物理模型的传统技术更精确，更快，更灵活。该计算工具还可以远程访问，并允许外科医生模拟和规划具有专家反馈的手术病例。研究计划包括以下内容：1）开发用于交互式地探索CT数据、指定手术切口、操纵骨碎片的视觉触觉虚拟环境，重建板的定位2）开发一个接口，用于从手术计划的3-D模型中获取和记录物理测量结果3）增强环境，自动化功能，以进一步减少计划时间，并可能提高精度，超过通过传统技术可用的4）执行验证研究，以开发用于手术计划的远程医疗应用程序意义：所提出的手术规划环境的重要性源于其允许外科医生基于来自CT扫描的3-D中的个体患者数据来模拟、规划和检查复杂程序的能力。该软件将允许外科医生在实际手术之前看到和感受他们干预的结果-例如，严重头部创伤后重建颌骨的咬合质量或骨对齐-从而更好地规划，减少错误，缩短手术时间并改善患者的结果。该系统将可远程访问，以便外科医生可以独立于其位置使用。对退伍军人医疗保健的潜在影响：虚拟手术计划系统可以为需要重建手术的头颈部创伤和癌症的VA患者提供许多好处。由于强大的通信基础设施和连接所有VA医疗设施的电子网络允许安全交换数据，VA处于远程医疗应用（如虚拟手术规划系统）的理想位置。因此，治疗团队可以使用虚拟手术计划系统为患者提供最佳护理，而不受患者或提供者位置的影响。