Real Time Reconstruction: A 3-D surgical cutting guide for head and neck cancers

By 2020, BC Cancer predicts that the prevalence of oral cavity cancer will be greater than 1 in 1000. Starting in or near the mouth these types of cancers can spread to other parts of the body. For advanced cases the best possible cure is an intricate and challenging surgery, which removes the diseased bone and tissue from the jaw and/or cheek of a patient.

The surgery leaves a large defect behind and requires reconstruction. Surgeons have to take bone from the patients’ calf or shoulder, manually reshape it to fit the defective site and sew it onto the artery or vein in the neck to recreate a new functioning structure. Inadequate reconstructions can lead to fractures, inability to chew and swallow, and facial disfigurement.

This challenging surgery can be aided by preoperative virtual surgical planning and the use of 3-D surgical cutting guides. However, current methods of preoperative planning have a fragmented workflow, are costly, and remove the surgeon from key components of the reconstructive process.

VGH head and neck surgeon Dr. Eitan Prisman has designed an innovative, low-cost 3-D surgical cutting guide called Real Time Reconstruction. This guide uses an automated mathematical algorithm to create a patient-specific reconstruction plan with the highest degree of precision.

Eventually, the teams hopes to create reusable adjustable cutting guides, allowing surgeons to define cutting planes intraoperatively directly on the patient. This would decrease the lead time between taking CT scans and the surgical date, providing the best possible outcome for patients with oral cancers.

2019 Audience Choice Bradshaw Prize Winner

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