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Haptics-assisted Virtual Planning of Bone, Soft Tissue, and Vessels in Fibula Osteocutaneous Free Flaps
Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Matematisk-datavetenskapliga sektionen, Institutionen för informationsteknologi, Avdelningen för visuell information och interaktion. Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Matematisk-datavetenskapliga sektionen, Institutionen för informationsteknologi, Bildanalys och människa-datorinteraktion.ORCID-id: 0000-0002-6805-6110
Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Matematisk-datavetenskapliga sektionen, Institutionen för informationsteknologi, Avdelningen för visuell information och interaktion. Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Matematisk-datavetenskapliga sektionen, Institutionen för informationsteknologi, Bildanalys och människa-datorinteraktion.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi.ORCID-id: 0000-0001-9590-2039
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2015 (Engelska)Ingår i: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 3, nr 8, artikel-id e479Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Virtual surgery planning has proven useful for reconstructing head and neck defects by fibula osteocutaneous free flaps (FOFF). Benefits include improved healing, function, and aesthetics, as well as cost savings. But available virtual surgery planning systems incorporating fibula in craniomaxillofacial reconstruction simulate only bone reconstruction without considering vessels and soft tissue.

Methods: The Haptics-Assisted Surgery Planning (HASP) system incorporates bone, vessels, and soft tissue of the FOFF in craniomaxillofacial defect reconstruction. Two surgeons tested HASP on 4 cases they had previously operated on: 3 with composite mandibular defects and 1 with a composite cervical spine defect. With the HASP stereographics and haptic feedback, using patient-specific computed tomography angiogram data, the surgeons planned the 4 cases, including bone resection, fibula design, recipient vessels selection, pedicle and perforator location selection, and skin paddle configuration.

Results: Some problems encountered during the actual surgery could have been avoided as they became evident with HASP. In one case, the fibula reconstruction was incomplete because the fibula had to be reversed and thus did not reach the temporal fossa. In another case, the fibula had to be rotated 180 degrees to correct the plate and screw placement in relation to the perforator. In the spinal case, difficulty in finding the optimal fibula shape and position required extra ischemia time.

Conclusions: The surgeons found HASP to be an efficient planning tool for FOFF reconstructions. The testing of alternative reconstructions to arrive at an optimal FOFF solution preoperatively potentially improves patient function and aesthetics and reduces operating room time.

Ort, förlag, år, upplaga, sidor
Wolters Kluwer, 2015. Vol. 3, nr 8, artikel-id e479
Nationell ämneskategori
Medicinsk bildvetenskap Kirurgi
Forskningsämne
Datoriserad bildbehandling
Identifikatorer
URN: urn:nbn:se:uu:diva-260771DOI: 10.1097/GOX.0000000000000447ISI: 000219082300005PubMedID: 26495192OAI: oai:DiVA.org:uu-260771DiVA, id: diva2:848386
Tillgänglig från: 2015-08-24 Skapad: 2015-08-24 Senast uppdaterad: 2025-02-09Bibliografiskt granskad
Ingår i avhandling
1. Haptics with Applications to Cranio-Maxillofacial Surgery Planning
Öppna denna publikation i ny flik eller fönster >>Haptics with Applications to Cranio-Maxillofacial Surgery Planning
2015 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Virtual surgery planning systems have demonstrated great potential to help surgeons achieve a better functional and aesthetic outcome for the patient, and at the same time reduce time in the operating room resulting in considerable cost savings. However, the two-dimensional tools employed in these systems today, such as a mouse and a conventional graphical display, are difficult to use for interaction with three-dimensional anatomical images. Therefore surgeons often outsource virtual planning which increases cost and lead time to surgery.

Haptics relates to the sense of touch and haptic technology encompasses algorithms, software, and hardware designed to engage the sense of touch. To demonstrate how haptic technology in combination with stereo visualization can make cranio-maxillofacial surgery planning more efficient and easier to use, we describe our haptics-assisted surgery planning (HASP) system. HASP supports in-house virtual planning of reconstructions in complex trauma cases, and reconstructions with a fibula osteocutaneous free flap including bone, vessels, and soft-tissue in oncology cases. An integrated stable six degrees-of-freedom haptic attraction force model, snap-to-fit, supports semi-automatic alignment of virtual bone fragments in trauma cases. HASP has potential beyond this thesis as a teaching tool and also as a development platform for future research.

In addition to HASP, we describe a surgical bone saw simulator with a novel hybrid haptic interface that combines kinesthetic and vibrotactile feedback to display both low frequency contact forces and realistic high frequency vibrations when a virtual saw blade comes in contact with a virtual bone model. 

We also show that visuo-haptic co-location shortens the completion time, but does not improve the accuracy, in interaction tasks performed on two different visuo-haptic displays: one based on a holographic optical element and one based on a half-transparent mirror. 

Finally, we describe two prototype hand-worn haptic interfaces that potentially may expand the interaction capabilities of the HASP system. In particular we evaluate two different types of piezo-electric motors, one walking quasi-static motor and one traveling-wave ultrasonic motor for actuating the interfaces.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2015. s. 79
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 1289
Nyckelord
medical image processing, haptics, haptic rendering, haptic gripper, visuo-haptic co-location, vibrotactile feedback, surgery simulation, virtual surgery planning, cranio-maxillofacial surgery
Nationell ämneskategori
Medicinsk bildvetenskap Människa-datorinteraktion (interaktionsdesign)
Forskningsämne
Datoriserad bildbehandling
Identifikatorer
urn:nbn:se:uu:diva-262378 (URN)978-91-554-9339-4 (ISBN)
Disputation
2015-10-16, Room 2247, Polacksbacken, Lägerhyddsvägen 2, Uppsala, 10:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2015-09-25 Skapad: 2015-09-14 Senast uppdaterad: 2025-02-09Bibliografiskt granskad

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Olsson, PontusNysjö, FredrikRodríguez-Lorenzo, AndrésThor, AndreasHirsch, Jan-MichaélCarlbom, Ingrid B.

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Olsson, PontusNysjö, FredrikRodríguez-Lorenzo, AndrésThor, AndreasHirsch, Jan-MichaélCarlbom, Ingrid B.
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Avdelningen för visuell information och interaktionBildanalys och människa-datorinteraktionPlastikkirurgiKäkkirurgi
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Plastic and Reconstructive Surgery - Global Open
Medicinsk bildvetenskapKirurgi

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