Yonsei Med J.  2016 Jan;57(1):265-268. 10.3349/ymj.2016.57.1.265.

The Role of Virtual Surgical Planning in the Era of Robotic Surgery

• Kim JY
• Kim WS
• Choi EC
• Nam W

• KMID: 2466380
• DOI: http://doi.org/10.3349/ymj.2016.57.1.265

Abstract

Among various surgical methods introduced to optimize esthetic results, robotic surgery has gradually expanded in scope. As incision, approach, and operation view in robotic surgery differ from existing surgical methods, we should consider reconstruction from a different perspective. We recently experienced two mandibular reconstruction cases after tumor ablative surgery with robotic neck dissection using the conventional reconstruction method and virtual surgical planning (VSP), respectively. We found that the conventional reconstruction method is inappropriate in modified facelift incision in robotic neck dissection because it provides limited surgical scope, restricts access to the defect area, and therefore, consumes considerable time before anastomosis. For these reasons, the authors consider VSP far more viable in the era of robotic surgery.

Keyword

Rhytidoplasty; mandibular reconstruction; microsurgery; virtual surgical planning

MeSH Terms

Adult
Carcinoma, Squamous Cell/radiography/*surgery
Chondrosarcoma/radiography/*surgery
Female
Humans
Imaging, Three-Dimensional
Mandibular Osteotomy/*methods
Mandibular Reconstruction/*methods
Neck Dissection/methods
Rhytidoplasty
Robotic Surgical Procedures/*methods
Robotics/*methods
Treatment Outcome

Figure

• 

  Fig. 1 Appliances for virtual surgical planning.

• 

  Fig. 2 Post-operative imaging study. (A) Immediate postoperative 3-dimensional image operated with virtual surgical planning showing symmetrically reconstructed mandible. (B) Five-month follow-up panoramic view operated with virtual surgical planning showing well remodeled grafted bone. (C) Seven-month follow-up panoramic view operated without virtual surgical planning showing necrosis of grafted bone.

Reference

1. Handschel J, Naujoks C, Hofer M, Krüskemper G. Psychological aspects affect quality of life in patients with oral squamous cell carcinomas. Psychooncology. 2013; 22:677–682.

2. Bianchi B, Ferri A, Ferrari S, Copelli C, Sesenna E. Facelift approach for mandibular resection and reconstruction. Head Neck. 2014; 36:1497–1502.

3. García-Díez EM, Cho-Lee GY, Raigosa-García JM, Sieira-Gil R, Martí Pagès C. Rhytidectomy approach for mandibular reconstruction with microvascular free flaps after resection of mandibular benign tumors. J Oral Maxillofac Surg. 2013; 71:2156–2168.

4. Koh YW, Chung WY, Hong HJ, Lee SY, Kim WS, Lee HS, et al. Robot-assisted selective neck dissection via modified face-lift approach for early oral tongue cancer: a video demonstration. Ann Surg Oncol. 2012; 19:1334–1335.

5. Nkenke E, Agaimy A, von Wilmowsky C, Eitner S. Mandibular reconstruction using intraoral microvascular anastomosis following removal of an ameloblastoma. J Oral Maxillofac Surg. 2013; 71:1983–1992.

6. Yang X, Hu J, Zhu S, Liang X, Li J, Luo E. Computer-assisted surgical planning and simulation for condylar reconstruction in patients with osteochondroma. Br J Oral Maxillofac Surg. 2011; 49:203–208.

7. Zheng GS, Su YX, Liao GQ, Chen ZF, Wang L, Jiao PF, et al. Mandible reconstruction assisted by preoperative virtual surgical simulation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 113:604–611.

8. Kim JY, Cho H, Cha IH, Nam W. Esthetic neck dissection using an endoscope via retroauricular incision: a report of two cases. J Korean Assoc Oral Maxillofac Surg. 2014; 40:27–31.

9. Xia JJ, Phillips CV, Gateno J, Teichgraeber JF, Christensen AM, Gliddon MJ, et al. Cost-effectiveness analysis for computer-aided surgical simulation in complex cranio-maxillofacial surgery. J Oral Maxillofac Surg. 2006; 64:1780–1784.

10. Zhao L, Patel PK, Cohen M. Application of virtual surgical planning with computer assisted design and manufacturing technology to cranio-maxillofacial surgery. Arch Plast Surg. 2012; 39:309–316.

11. Wong AK, Joanna Nguyen T, Peric M, Shahabi A, Vidar EN, Hwang BH, et al. Analysis of risk factors associated with microvascular free flap failure using a multi-institutional database. Microsurgery. 2015; 35:6–12.

12. Pattani KM, Byrne P, Boahene K, Richmon J. What makes a good flap go bad? A critical analysis of the literature of intraoperative factors related to free flap failure. Laryngoscope. 2010; 120:717–723.

13. Chang EI, Chang EI, Soto-Miranda MA, Zhang H, Nosrati N, Crosby MA, et al. Comprehensive Evaluation of Risk Factors and Management of Impending Flap Loss in 2138 Breast Free Flaps. Ann Plast Surg. 2014; 07. 04. [Epub ahead of print].