All staff and students are invited to Michael Chae's mid-candidature review.Wednesday 26 July, 4pm, Surgery seminar room, Level 5, Block E, Monash Medical Centre Clayton
Synopsis:
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
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