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）： 简介：对复杂的面部和颈部创伤患者的治疗是手术中最具挑战性的多学科任务之一。最近关于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很大变化。在凯夫拉尔身体装甲出现之前，大多数战斗死亡和伤害源于胸部或头骨的伤口。如今，有21％的战斗受伤的士兵遭受了头盔线以下的头部和颈部的创伤。在过去的20年中，引入电镀系统和手术技术的变化已使头部和颈部的严重畸形纠正。术前计划对于这些复杂程序的成功结果至关重要。成像从2-D演变为3-D，从静态图形渲染到动画，这极大地促进了复杂创伤性损伤的诊断。基于单个患者的3D数据的模拟技术将对外科计划和培训产生关键影响。现场和远程访问的虚拟环境模拟可变形组织将使外科医生能够计划和模拟操作并保留其不经常操作的技能。具体目的：该提案的研究目标是对计划重建手术计划的计算环境的开发和评估。所提出的工具将允许对具有头部和颈部损伤的个体患者的计算机断层扫描（CT）扫描得出的图像进行交互式可视化和触觉操纵。我们预计，与取决于物理模型的传统技术相比，计算工具将更精确，更快，更灵活。还可以远程访问计算工具，并允许外科医生模拟和计划具有专家反馈的外科手术案例。 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技术4）执行验证研究以开发远程医疗的手术计划意义：拟议的手术计划环境的重要性源于其允许外科医生根据CT扫描中的3-D中的单个患者数据模拟，计划和迭代复杂程序的能力。该软件将允许外科医生看到并感受到干预措施的结果 - 例如，在严重的手术前，重建下颌的咬合或骨头对齐的质量 - 导致更好的计划，较少的错误，缩短手术时间和改善患者的成果。该系统将可以远程访问，以便外科医生可以独立于其位置使用它。对退伍军人卫生保健的潜在影响：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。 VA是远程医疗应用的理想位置，例如虚拟手术计划系统，因为强大的通信基础架构和电子网络连接了所有VA医疗设施，允许安全的数据交换。因此，治疗团队可以使用虚拟手术计划系统为患者（独立于患者或提供者位置）提供最佳护理。