# Surgical planning

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[[Image:SurgicalPlanningArtikulator.jpg|thumb|Surgical planning using [bone segment navigation](/source/bone_segment_navigation) for the osteotomy of the jaw bones, based on models fixed into an [articulator](/source/articulator) (registration based on infrared devices)]]

'''Surgical planning''' is the preoperative method of pre-visualising a surgical intervention, in order to predefine the surgical steps and furthermore the [bone segment navigation](/source/bone_segment_navigation) in the context of [computer-assisted surgery](/source/computer-assisted_surgery). The surgical planning is most important in [neurosurgery](/source/neurosurgery) and [oral and maxillofacial surgery](/source/oral_and_maxillofacial_surgery). The transfer of the surgical planning to the patient is generally made using a [medical navigation system](/source/Surgical_Segment_Navigator).
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== Principles of surgical planning ==
[[Image:StereolithographiemodellSchaedel.jpg|thumb|130 px|Surgical planning using [bone segment navigation](/source/bone_segment_navigation) for the osteotomy of the left [orbit](/source/orbit_(anatomy)), based on [stereolithographic models](/source/stereolithography_(medicine)) (registration based on infrared devices)]]
The imagistic [dataset](/source/dataset) used for surgical planning is mainly based on a [CT](/source/computed_tomography) or [MRI](/source/MRI). In [oral and maxillofacial surgery](/source/oral_and_maxillofacial_surgery), a different, more "traditional" surgical planning can be used for [orthognatic surgery](/source/orthognatic_surgery), based on cast models fixed into an [articulator](/source/articulator).{{cn|date=January 2022}}

== History of the concept ==

In order to make a surgical planning, one would need a [3D](/source/Three-dimensional_space) image of the patient. The starting point was made by [G. Hounsfield](/source/Godfrey_Hounsfield) in the 1970s, by using [CT](/source/computed_tomography) in order to record data about the anatomical situation of the patients.<ref>[https://royalsocietypublishing.org/doi/epdf/10.1098/rsbm.2005.0014 Wells PNT: ''Sir Godfrey Newbold Hounsfield'', ''Biogr. Mems Fell. R. Soc.'' 51, 221-235, 2005]</ref> In the 1980s, advances were made by the radiologist [M. Vannier](/source/Michael_W._Vannier) and his team, by creating the first computed three-dimensional reconstruction from a [CT](/source/Computed_tomography) dataset.<ref>{{cite journal | author = Vannier MW, Marsh JL, Warren JO | year = 1984 | title = Three Dimensional CT Reconstruction Images for Craniofacial Surgical Planning and Evaluation | url = http://radiology.rsnajnls.org/cgi/reprint/150/1/179.pdf | journal = Radiology | volume = 150 | issue = 1| pages = 179–84 | doi=10.1148/radiology.150.1.6689758| pmid = 6689758 }}</ref> In the early 1990s, the surgical planning was performed by using [stereolithographic models](/source/Stereolithography_(medicine)).<ref>{{cite journal | author = Klimek L, Klein HM, Schneider W, Mosges R, Schmelzer B, Voy ED | year = 1993 | title = Stereolithographic modelling for reconstructive head surgery | journal = Acta Oto-Rhino-Laryngologica Belgica | volume = 47 | issue = 3| pages = 329–34 | pmid = 8213143 }}</ref> During the late 1990s, the first [full computer-based](/source/Laboratory_Unit_for_Computer_Assisted_Surgery) virtual surgical planning was made for [osteotomies](/source/osteotomy), and then transferred to the operating theatre by a [navigation system](/source/Surgical_Segment_Navigator).<ref>{{cite journal | author = Marmulla R, Niederdellmann H | year = 1999 | title = Surgical Planning of Computer Assisted Repositioning Osteotomies | url = http://www.plasreconsurg.com/pt/re/prs/abstract.00006534-199909040-00007.htm;jsessionid=H8FQBGq1ly19ldpw1vTY1LyWGCnvsDrpFpHgTjZ4R9zbvQ5RQVbB!-383192544!181195628!8091!-1 | journal = Plast Reconstr Surg | volume = 104 | issue = 4| pages = 938–944 | doi=10.1097/00006534-199909020-00007| pmid = 10654731 | url-access = subscription }}</ref> Currently 3D Printed models are also used to plan a procedure and improve patient outcomes.<ref>{{Cite journal|last1=Thomas|first1=D. J.|last2=Azmi|first2=M. A. B. Mohd|last3=Tehrani|first3=Z.|date=2014-04-01|title=3D additive manufacture of oral and maxillofacial surgical models for preoperative planning|url=https://doi.org/10.1007/s00170-013-5587-4|journal=The International Journal of Advanced Manufacturing Technology|language=en|volume=71|issue=9|pages=1643–1651|doi=10.1007/s00170-013-5587-4|s2cid=109978006|issn=1433-3015|url-access=subscription}}</ref>

The first commercially available neurosurgical planning systems appeared in the 1990s (the StealthStation by [Medtronic](/source/Medtronic),<ref>{{cite journal | author = Smith K R, Frank K J, Bucholz R D | year = 1994 | title = The NeuroStation--a Highly Accurate, Minimally Invasive Solution to Frameless Stereotactic Neurosurgery | journal = Computerized Medical Imaging and Graphics | volume = 18 | issue = 4| pages = 247–56 | doi=10.1016/0895-6111(94)90049-3| pmid = 7923044 }}</ref> the VectorVision by [Brainlab](/source/Brainlab)<ref>Vilsmeier, Stefan, and Fotios Nisiropoulos. "Introduction of the Passive Marker Neuronavigation System VectorVision." In Computer-Assisted Neurosurgery, edited by Norihiko Tamaki M.D and Kazumasa Ehara M.D, 23–37. Springer Japan, 1997. {{doi|10.1007/978-4-431-65889-4_3}}.</ref>). As newer imaging modalities emerged providing increasing anatomical and functional detail for the patient in the 2000s, these surgical planning systems started to incorporate [virtual reality](/source/virtual_reality) technology to facilitate the visualisation and manipulation of the 3D data. One example of such systems is the [Dextroscope](/source/Dextroscope), manufactured by [Volume Interactions Pte Ltd](/source/Volume_Interactions_Pte_Ltd). The Dextroscope is mostly used in the planning of complex neurosurgical procedures.<ref>Ferroli, Paolo, Giovanni Tringali, Francesco Acerbi, Domenico Aquino, Angelo Franzini, and Giovanni Broggi. "Brain Surgery in a Stereoscopic Virtual Reality Environment: A Single Institution’s Experience with 100 Cases." ''Neurosurgery'' 67, no. 3 Suppl Operative (September 2010): ons79–84; discussion ons84. {{doi|10.1227/01.NEU.0000383133.01993.96}}</ref><ref>{{cite journal | author = Kockro R. A., Serra L., Tseng-Tsai Y., Chan C., Yih-Yian S., Gim-Guan C., Lee E., Hoe L. Y., Hern N., Nowinski W. L. | year = 2000 | title = Planning and Simulation of Neurosurgery in a Virtual Reality Environment | doi = 10.1093/neurosurgery/46.1.118 | journal = Neurosurgery | volume = 46 | issue = 1| pages = 118–135 | pmid = 10626943 | doi-access = free }}</ref><ref>{{cite journal | author = Matis Georgios K, Danilo O de, Silva A, Chrysou Olga I, Karanikas Michail, Pelidou Sygkliti-Henrietta, Birbilis Theodossios A, Bernardo Antonio, Stieg Philip | year = 2013 | title = Virtual Reality Implementation in Neurosurgical Practice: The 'Can't Take My Eyes off You' Effect | journal = Turkish Neurosurgery | volume = 23 | issue = 5| pages = 690–91 | pmid = 24101322 }}</ref><ref>{{cite journal | author = Robison R. A., Liu C. Y., Apuzzo M. L. J. | year = 2011 | title = Man, Mind, and Machine: The Past and Future of Virtual Reality Simulation in Neurologic Surgery | journal = World Neurosurgery | volume = 76 | issue = 5| pages = 419–30 | doi=10.1016/j.wneu.2011.07.008 | pmid=22152571}}</ref>

== References ==
<references/>

Category:Oral and maxillofacial surgery
Category:Health informatics
Category:Radiology
Category:Tomography
Category:Computer-assisted surgery

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Adapted from the Wikipedia article [Surgical planning](https://en.wikipedia.org/wiki/Surgical_planning) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Surgical_planning?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.