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Virtual Surgical Planning (VSP) at Penn Medicine: Precision in the OR

Virtual surgical planning (VSP) provides both surgeon and patient with a wealth of benefits, and virtually no downsides.

An essential tool for pre-surgical planning, VSP provides surgeons with clear 3D visualization of a patient’s anatomy to develop a surgical plan prior to entering the operating room.

“For the surgeon,” said Rabie Shanti, DMD, MD, Assistant Professor of Otorhinolaryngology - Head and Neck Surgery, Department of Oral & Maxillofacial Surgery at Penn Medicine, “VSP allows reconstructive surgeons to increase their precision and to carry out complex surgeries.” This means the time of surgery is cut by at least one hour, patients spend less time under anesthesia.

VSP: Personalized Medicine in Action

VSP, which Dr. Shanti described as “personalized medicine in action,” begins with a high-resolution CAT scan of the area under question. The scan is sent to bioengineers who then develop a 3-D rendering and a 3-D printing of the target area.

Then, said Dr. Shanti, the interdisciplinary team members discuss the approaching surgery with the benefit of these 3-D models. “The surgeons get a better appreciation of the anatomy and a better appreciation of how the surgery will come together.”

At least one study has borne out the accuracy of VSP. Another study, published in August 2018, reported that the tactile feedback of 3D printing significantly aides the comprehension of anatomical detail for surgeons. The report also elaborated upon the increasing applications for 3D printing in surgery, including pre-operative planning, counselling with patients, education of students and residents, surgical training and intraoperative navigation.

Also, said Dr. Shanti, there is less conjecture and few, if any, surprises with the application of VSP. Because “we can think through the case,” Dr. Shanti explained, “we have anticipated the challenges and there is less guesswork.”

Take, for example, the case of the 45-year-old man who had been shot in the jawbone. Treated at another hospital four years prior, he came to Penn seeking dental implants and mandibular reconstruction. It was not an easy project. The old wound required hardware to keep the jaw in place. In the time since the original surgery, moreover, several mandibular teeth had been compromised and much oral soft tissue contracture had occurred.

Using VSP, Penn surgeons decided on free flap reconstruction (from the fibula bone). The 3-D image gave them foresight and helped them plan, proceeding with two surgical teams for two procedures; one to remove to the existing hardware, the other to remove the fibula bone. A second surgery will add the dental implant and complete the procedure.

About this Blog

The Penn Physician Blog is a resource for health care professionals featuring Penn Medicine physicians and their research, innovations, programs and events. 

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