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Cutting guide for determining the size of the soft tissue surface replacement flap

A technology of soft tissue and guide plate, which is applied in the field of medical treatment, can solve the problem of high personal requirements of the surgeon, and achieve the effect of saving operation time, requiring low experience and shortening the learning period

Active Publication Date: 2020-11-20
ZHEJIANG CANCER HOSPITAL
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

Therefore, how to accurately determine the size of the cutting guide plate has become a technical problem (in the prior art, the cutting guide plate is generally not established by building a three-dimensional model, but the doctor’s personal experience is used to prepare the cutting guide plate and perform skin flap removal. Surgeons have high personal requirements, which is a challenge for inexperienced novices)

Method used

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  • Cutting guide for determining the size of the soft tissue surface replacement flap
  • Cutting guide for determining the size of the soft tissue surface replacement flap
  • Cutting guide for determining the size of the soft tissue surface replacement flap

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0053] Patient Lu **, male, 34 years old.

[0054] The right tongue ulcer appeared more than 2 months ago, and she went to the local hospital for treatment, considering tongue ulcer and anti-inflammatory treatment. In the past one month, the mass has increased significantly, and the pain has increased.

[0055] Biopsy: "Tongue" consistent with well-differentiated squamous cell carcinoma.

[0056] Examination: The right tongue mass was about 4cm in size, ulcerated, with limited tongue movement, and multiple enlarged lymph nodes in the right upper neck.

[0057] Diagnosis: Malignant tumor of the tongue

[0058] like Figure 1-4 As shown, the surgery includes the following steps:

[0059] 1) Obtain the patient's thin-slice CT data (thickness 0.2mm), convert it into DICOM data format and import it into the 6D dental implant design software (6D-DENTAL Tech Co, Ltd, China) to reconstruct the soft tissue model shape and tumor shape of the patient area, Obtain editable .stl forma...

Embodiment 2

[0065] Patient Cai**, male, 58 years old.

[0066] 2016.5 Oral cavity: squamous cell carcinoma of the floor of the mouth (moderately differentiated). Esophagus: Poorly differentiated (squamous) carcinoma of the esophagus 29-31cm from the incisors (esophagus).

[0067] 2016-8-10 "1. Extensive excision of the malignant mass on the floor of the mouth; 2. Partial resection of the malignant mass of the tongue; 3. Neck dissection (bilateral); 4. Tracheotomy; 5. Mandible Partial amputation (titanium plate reconstruction); 6. Right pectoralis major muscle reconstruction; 7. Mouth floor reconstruction".

[0068] Postoperative pathology: 1. (Floor of mouth) high-moderately poorly differentiated squamous cell carcinoma (tumor size 4.5×3.5×2.7cm), infiltrating into submucosa and striated muscle tissue, involving salivary gland, mandible and nerve tissue. 2. Chronic inflammation of lymph nodes in 10 (left neck II, III) and 23 (right neck), see also some submandibular gland tissues. Rema...

Embodiment 3

[0083] The difference between this embodiment and Embodiment 1 is that the three-dimensional model is first printed as a curved surface physical model, which specifically includes the following steps:

[0084] 1) Obtain thin-slice (0.2mm) CT data of the patient through CT scanning, then convert it into DICOM data format and import it into the 6D dental implant design software (6D-DENTAL Tech Co, Ltd, China) to reconstruct the soft tissue model shape and Tumor morphology, obtain editable model data in .stl format.

[0085] 2) Combining magics design software (Materialise Ltd, The Kingdom Of Belgium) and Geomagice Studio design software (Geomagice, USA) to edit the 3D model, plan the repair plan, and consider the safe range of tumor resection to demarcate the lesion tissue resection boundary and determine the resection lesion area; then the repaired surface is extracted by the GeomagiceStudio design software, calculated and converted into a Nurbs surface, and saved as data in a ...

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Abstract

The invention relates to the field of medical treatment, and discloses a method for preparing a cutting guide plate used for determining the size of a substitutional flap on the surface of the soft tissue by utilizing digital space reconstruction and 3D printing. The method comprises the following steps: (1) carrying out CT scanning, thus thin-layer CT data of a patient is obtained, the soft tissue model state and tumor state of a disease area are reconstructed, and editable three-dimensional model data is obtained; (2) editing the three-dimensional model, planning a repairing scheme, calibrating the safe cutting boundary of the focus tissue, determining the focus area to be cut, extracting a repairing curved surface, and calculating a curved surface needed by conversion; (3) converting the curved surface to a plane through calculation, and carrying out thickening treatment on the plane, thus obtaining a three-dimensional plate model; and (4) carrying out 3D printing, thus preparing the cutting guide plate. With the prepared cutting guide plate provided by the invention, the substitutional flap can be accurately cut from a donor site, and thus the purpose that the most accurate conformal functional reconstruction of a recipient site is obtained with the minimum injuries of the flap donor site is realized.

Description

technical field [0001] The invention relates to the field of medical treatment, in particular to a method for preparing a cutting guide plate for determining the size of a soft tissue surface replacement flap by using digital space reconstruction and 3D printing. Background technique [0002] After tumor resection, the space left by the resected soft tissue needs to be filled and repaired, and repairing complex soft tissue defects is extremely challenging for surgeons. Currently, the main methods for repairing soft tissue defects include pedicled flaps, free flaps, and artificial substitutes. At present, it is required to retain more functional peripheral soft tissue under the premise of safe tumor resection margins, and try to restore the shape, function and tissue volume of the reconstructed organs as much as possible. At the same time, there is often a lack of precise preoperative design and intraoperative strain when faced with cases of large-area defects involving mult...

Claims

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Application Information

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Patent Type & Authority Patents(China)
IPC IPC(8): A61B17/32B33Y50/00B33Y10/00
CPCA61B17/32A61B2017/320052B33Y10/00B33Y50/00
Inventor 徐加杰葛明华陈超兰霞斌刘云峰于长洋孙晶晶李升谭卓朱秀
Owner ZHEJIANG CANCER HOSPITAL
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