Wednesday 26 July, 4pm, Surgery seminar room, Level 5, Block E, Monash Medical Centre Clayton
Advanced modern imaging has become an essential component of preoperative planning in plastic surgery. Since the advent of free tissue transfer approximately 40 years ago, constant improvement particularly in the preoperative planning phase has led to improved patient outcomes. The use of relatively simple techniques, such as handheld Doppler ultrasound, to advanced imaging techniques, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA), for purposes of preoperative planning is now routine. Pre-operative planning for perforator based free flaps, in particular, is important due to the high degree of anatomical variations. Therefore, patients with favourable, and more importantly unfavourable, anatomy can be identified, and the optimal perforator of choice can be utilised. These are important considerations in improving outcomes, decreasing morbidity, and reducing operative time and stress, perhaps to be achieved through constant improvement and evolution of pre-operative planning.
In breast reconstructive surgery, the introduction of computed tomographic angiography (CTA) has enabled surgeons to accurately and reliably select the donor site, flap, perforators, and the optimal mode of dissection, which has translated to an improvement in the clinical outcomes. Recent development of three-dimensional (3D) and 4D CTA techniques have enhanced spatial appreciation of the perforator vessels, their vascular territory and dynamic flow characteristics preoperatively. However, current imaging modalities are limited by being displayed on a 2D surface, such as a computer screen. In contrast, a 3D printed haptic biomodel allows the surgeon to interact hands-on with the patient-specific anatomy and facilitates a superior understanding for operative planning. Despite its significant potential, technically challenging 3D softwares and the high prices of early 3D printers have forced clinicians to outsource 3D printing and the cost of outsourcing precluded it from being implemented widely.
A range of 3D printing techniques has been developed for industrial use; however, for clinical application, mainly fused filament fabrication (FFF) has been used due to its affordability, ready accessibility and convenience. For this research project, we’d like to establish accuracy and reproducibility of our bedside 3D printing technique and demonstrate its application in various plastic and reconstructive surgical cases.
Supervisors: Prof Julian Smith, A/Prof David Hunter-Smith, A/Prof Warren Rozen
Panel Chair: Prof Graham Jenkin
Independent Assessors: Dr Stuart Marshall, Mr George Pratt