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  • Dr. Tarangini V

Relevance of Surgical Planning

Updated: May 6, 2022

What is surgical planning?

Surgical planning is a preoperative method of pre-visualizing surgical procedures to predefine surgical steps and bone segment navigation in the context of computer-assisted surgery. By this means surgeons define the expected outcome and, with early feedback, if that outcome is achievable.

How surgical planning is achieved?

The main components of the preoperative planning system are visualization, modeling, analysis, and planning.

  • Visualization consists of displaying the original image, the structure of interest, the implant, and the surgical instrument in a way that is intuitive and useful to the physician.

  • Modeling consists of creating mathematical representations of the structures of interest, surgical tasks, their limitations, and the physiological phenomena considered for planning.

  • Analysis consists of investigating the solution space for planning problems through manual investigation, simulation, and/or optimization.

  • Planning consists of choosing the most suitable solution for the intervention, based on the results of visualization and analysis.

Image credits: Shutterstock


Major types of surgical planning tasks:

Identification of Surgical Targets- Determining surgical subjects and their location in preoperative patient images, and identifying associated surrounding structures.

Image credits: Shutterstock


Planning a Surgical Approach- Planning a surgical access point / surgical site and route to a predefined target structure that minimizes or causes no damage to the associated surrounding structure.

Surgical Instrument and Implant Placement- Determine the position and/or implant position of the surgical instrument and probe used to perform the treatment.

Evaluation of Selected Plans- Prediction and evaluation of expected effects of treatment. Example: radiation therapy, cryosurgery, brachytherapy, stent placement.

Importance of surgical planning

Although patients with congenital anomalies of the ear present with a few facial asymmetries, reference factors ought to be taken to estimate the brand new organ. Usually, sufferers with demanding amputation of the auricle do now no longer display facial asymmetry. However, reconstruction of the ear will enhance the facial contour. The medical professional ought to consider the auricle already projected far from the head. In consequence, making plans for the brand new ear is an exercise of “creativeness in the space” earlier than surgery. The auricles are crucial organs for reinstating facial contour in congenital and bought deformities.

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Current perspectives of surgical planning

Facial imbalance and its related esthetic appearance are the principal motives why sufferers are trying to find a reconstruction of the auricle. The absence of one ear offers an excessive imbalance to the affected person`s facial contour and posture, in particular, while the center and internal ears are also concerned with inside the congenital anomaly. In addition to the mental aspect, the bodily appearance is an excessive esthetic problem that calls for good enough assessment if you want to facilitate surgical making plans.

Surgical plans start at some point in the primary appointment while the affected person is sitting in front of the medical professional asking questions, keen for facts approximately the technique, post-operative care, and very latest results. During the consultation, the medical professional must cautiously take a look at the auricular vicinity and the face in addition to the entire body, because congenital deformities and demanding amputation can also additionally present different deformities related to ear anomalies.

 

References

  1. Avelar JM (1977) Total reconstruction of the auricular pavillion in one stage. Recontrução total do pavilhão auricular num único tempo cirúrgico. Rev Bras Cir 67:139

  2. Avelar JM (1978) Total reconstruction of the ear in one single stage – technical variation with cutaneous flap with inferior pedicle. Folia Med 76:457–46

  3. Avelar JM (1986) Deformidades congênitas do pavilhão auricular: experiência em 138 casos de reconstrução da orelha. Rev. Soc. Bras. Cirurg. Plast, 1986; 1:28–43

  4. Avelar JM (1987) A new technique for reconstruction of the auricle in acquired deformities. Annals of Plastic Surgery; vol. 18. n. 5, pp 454–464

  5. Avelar JM (1989a) Modelagem do arcabouço auricular nas reconstruções da orelha.

  6. Avelar JM (ed) Cirurgia Plástica na Infância. Ed. Hipócrates, São Paulo, pp 287–290

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