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A-1122 NT Visual - Developing a 3D Software for Nerve Surgeons
Clemens Gstöttner, Cosima Prahm, Johannes Mayer, Oskar Aszmann, CD Laboratory for Reconstruction of Extremity Function Medical University of Vienna Vienna, Austria
Friday, June 15, 2018 · 4:37 p.m. · 05m 43s
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thank you um good afternoon i'm i'm sure we're going to
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talk about a project of our working group we have
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been working on now for the last weeks and months and months involves a three d. model for nope surgeons
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and i would like to start with the breakup lexus so many of you probably know this fiction it's one of the
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more famous the pictures of the great but complexes and if you look closely you will see that on there's actually
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a lot of detail in that you see all the different routes you see how they intertwine into that
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i'm into the whole of put complexes how it forms did he owns a the interstate going to be on
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and for each one of the branches you see all the routes that contributed branches so
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all all it gives the impression that the breakup lexus is rather complex construct
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so what nerve surgeons like to do before doing surgery is to
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actually plan and visualise what they're going to do so
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nowadays this often looks like this so i think this
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is rather self explanatory and straight forward on you
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on many surgeons draw the using that they expect during the surgery from
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what they know a lot of c. t. scans and ultrasound
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and the clinics of course and then you want to visualise what you going to do so you draw the crafts
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that you need to did you need to put and you draw the the nerve transfers to your plan
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but of course as as always in like you have to adapt to the circumstances that you're in and sometimes
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these drawings may look a bit more than that on because you just didn't have enough time or
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you do need during surgery and stuff like that so what we were thinking is that there must be
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a better way at that that that there should be a more modern way of planning lexus surgery
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so at the centre of approach does a three d. model of all the numbers that go
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into it on so starting from the uh nerve roots onto the tip of the fingers
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and what you first want to do of course is to uh to visualise anatomy is so you look
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around the three d. model and you can zoom in zoom out look at all the different nerves
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um and of course there are also some nerve properties that are interesting form of surgeons this may include
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on the the accent counts and how many of these accents are sensory
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and motor accents and this is especially important from of transfers
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on and also if you're interested in the in the functions of each nerve
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and what you don't want to do is to create a vision pattern just like in the drawings to select an urge that are damage
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and then also to visualise to reconstruction and then afterwards look at the result again on
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the first when we needed to do of course was to look at the literature um the review on the
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detailed anatomy and surgical strategies norton followed you looked at
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everything that we wanted to include into our program
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then the three d. model was created in the graphics software blender
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so most of you probably don't know that problem so there's a short um
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screen shot of that a a as you can probably see there's a lot of functionalities
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in there and in the middle you have these three d. space where and
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this is what what enough looks like that is created in the space and if you zoom in
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you see that actually consists of small points and lines that you can move around in space so you can create your program
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and this a three d. model was an important to unity three d. which is a and
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on programming environment where the user interface was created the programme logic and all the functionality
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so um at the moment but i can show you is a bit of
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a preview of what a final um program will be able to do
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on the right side you see a few buttons and one of them is not information
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and in this example in the middle you see the pretty model and you see the the the upper roots of the breakup lexus
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and if you um quicken of information and then afterwards in this example to the
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c. five spinal nerve you don't see the accent cans you see the
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origin where it comes from the branches it gives off and the destination point
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enough on and of course also the the muscles and skin innards
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then what you want to do is to create a lesion this example is rather simple even though it's a superior tried
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and there's a shot yeah we should missing which shows us there's there's um
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some kind of damage and all the distal nerves from that lesion will then uh turn grey so
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you can assume out and look at all the nerves and see which of
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the nerves after type record lectures are affected by the reason and
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in this simple case you can also um i'm visualise rather simple reconstruction using a nerve croft
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and i'll what we also want to do with that is that you can create individual patients and planned the surgery
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and then also saved reconstruction so that you can review it before actually doing the surgery done
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so our tool should primarily be a planning tool for surgeons that was our goal arm
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but it kind of course also be used as a channel learning tool for
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anybody interested in peripheral nerves and we plan to launch it lobster
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final program and by the end of two thousand eighty and if you
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look to ride to see the domain of the website we've created
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um w. w. dot anti man's whittled organ if you are interested in that you can
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kind of review email address and we will update you as soon as we have um the final product
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