Surgical Guides to get it right

A virtual surgery plan is only valuable when you can translate it to the OR. An effective way to do so is by using surgical guides. On request we can assist you with a full pre-operative surgical planning,  including the cutting planes and drill holes and their respective angles. To transfer this plan to the actual procedure, we design surgical guides. A surgical guide or template is a small customized tool that guides your saw and/or drill in the planned direction. It fits exactly on a predetermined part of the patient’s bone, making sure you cut and drill at the right place, under the right angle (and to the right depth).

Guides can be used in any kind of surgery, but to illustrate we present here a mandible reconstruction case using a fibula graft.

Backward planning

A pre-operative virtual planning and the associated surgical guide(s) will assist you to drill and saw in the right direction, according to plan.
“Backward” planning can be used to find the best position of the bony parts. You start by predefining the optimal position of the mandibula, which determines the void that needs to be bridged by the bone graft.

Dislocated mandibula

Virtual repositioning

Optimal mandibula position

Matching the fibula to “bridge the gap”

Using a Computed Tomography (CT) scan of one of the legs, the necessary bony shape can be virtually matched from the patient’s fibula.

Optimal mandibula position

Fibula positioned for top part

 Top part is highlighted

Fibula positioned for bottom part

Necessary fibula segments

 

The cutting guide

Placing the Guide

The guide is designed in such way that it matches the patient’s anatomy perfectly and only fits on the region determined above. For the surgeon to know where to open the patient’s leg, we indicate the approximate position, in centimeters distance from the ankle point. This is done by engraving a number in the guide, number 13 in the example below.

Cutting

Cutting along the four angular planes will create the two pieces of fibula needed for the mandibula reconstruction.

Graft

Now you have two perfect graft pieces, ready to be placed.

Placing

The fibula pieces match the jaw and each other.

Fixating

Together, they make the right angle.