Advanced Visuohaptic Surgical Planning for Trauma Surgery
2 juli 2020 uppdaterad av: VA Office of Research and Development
This study proposes to develop a computer-based software tool that will allow surgeons to plan and simulate surgery for patients with jaw trauma.
Studieöversikt
Status
Avslutad
Betingelser
Intervention / Behandling
Detaljerad beskrivning
The proposed tool will allow surgeons from different specialties to simulate, plan and iterate on complex procedures based on individual patient data in 3-D from a CT scan.
The software will allow surgeons to both see and feel the results of their interventions - for example, the quality of the bite or bone alignment of a reconstructed jaw following severe trauma - before the actual surgery, leading to better planning, fewer errors, shortened surgery time and improved outcomes for the patients.
The purpose of this study is the evaluation of a visuohaptic planning system for mandibular trauma surgery that is based on interactive manipulation of CT data.
Studietyp
Observationell
Inskrivning (Faktisk)
3
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
-
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California
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San Francisco, California, Förenta staterna, 94121
- VA Medical Center, San Francisco
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
18 år och äldre (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Testmetod
Icke-sannolikhetsprov
Studera befolkning
Study population will veterans who present to the Oral/Maxillofacial Surgery Clinic at the San Francisco VA Medical Center.
The study will use pre-existing data from patients undergoing reconstructive facial surgery at the San Francisco VA with clinic indications that require preoperative CT scans and preoperative radiographs as well as model casts.
Beskrivning
Inclusion Criteria:
- Craniofacial deformity, including post-traumatic, congenital or acquired deformity
- Patients who have already have surgery because there was a clinical indication for surgical correction
Exclusion Criteria:
- No craniofacial deformity
- No clinical indication for surgical correction
- Contraindication for surgical correction
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
Intervention / Behandling |
|---|---|
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Group 1
15 patients who underwent surgical repair of mandibular fractures at San Francisco VA Medical Center
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Patients will undergo whatever needed surgical repair of maxillofacial trauma that is necessary.
Records such as CT imaging and plaster models of the jaws will be utilized in the standard way to plan and carry out the surgery.
The CT scan will also be used within the visuohaptic computational environment to develop and evaluate the user interface.
The amount of time taken to work up and plan surgery using standard surgical practice and using the computational platform will be compared.
Real surgical outcome will be compared to the simulated surgical outcome using the proposed software tool.
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Percentage of Deviation From Actual Surgical Outcome During Virtual Repair of Mandibular Fractures, Using the Novel Visuohaptic Computational Platform That Was Developed by the Investigators
Tidsram: 6 months
|
The virtual surgical outcome was compared to the actual surgical outcome.
This was accomplished by measuring distances (mm) and angles between specific mandibular anatomic points in the virtual environment and comparing it to the same distances (mm) and angles between specific mandibular anatomic points in the actual surgical outcome, as seen in a 3D rendering derived from the patient's postoperative CT scan.
The actual surgical repair was considered to be the gold standard.
A deviation of more than 10% between the virtual surgical repair and the actual surgical repair was considered to be above threshold (inaccurate virtual fracture repair).
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6 months
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Development and Evaluation of Automation Features for the Visuohaptic Virtual Surgery Planning Environment
Tidsram: 3 years
|
The addition of automation features for the visuohaptic virtual surgical planning environment was envisioned to make it possible to predict the number, type, size, and position of reconstruction hardware (bone plates and screws) that would best fit the virtually repaired mandibular fractures.
The goal was to compare the hardware configuration selected and used in the actual surgical repair for the 3 participating patients with what the software predicted.
Unfortunately, the software development proved to be difficult to add this automated feature.
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3 years
|
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Implementation and Test of the Telemedicine Prototype
Tidsram: 3 years
|
Measurement of the accuracy of the virtual surgical repair generated by the surgeon operating the software when a remote surgeon digitally sends a CT scan of a patient with an acute mandibular fracture(s).
The telemedicine interface would require an automated method to segment the CT scan into the fractured components.
The operator would manipulate the bone fractures, select the hardware type and size for "best fit", and generate a report back to the remote surgeon.
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3 years
|
Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Samarbetspartners
Utredare
- Huvudutredare: Rebeka Silva, DMD, VA Medical Center, San Francisco
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna publikationer
- Schvartzman SC, Silva R, Salisbury K, Gaudilliere D, Girod S. Computer-aided trauma simulation system with haptic feedback is easy and fast for oral-maxillofacial surgeons to learn and use. J Oral Maxillofac Surg. 2014 Oct;72(10):1984-93. doi: 10.1016/j.joms.2014.05.007. Epub 2014 May 24.
- Forsslund J, Chan S, Selesnick J, Salisbury K, Silva RG, Blevins NH. The effect of haptic degrees of freedom on task performance in virtual surgical environments. Stud Health Technol Inform. 2013;184:129-35.
- Girod S, Schvartzman SC, Gaudilliere D, Salisbury K, Silva R. Haptic feedback improves surgeons' user experience and fracture reduction in facial trauma simulation. J Rehabil Res Dev. 2016;53(5):561-570. doi: 10.1682/JRRD.2015.03.0043.
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart
1 november 2011
Primärt slutförande (Faktisk)
1 december 2014
Avslutad studie (Faktisk)
1 februari 2016
Studieregistreringsdatum
Först inskickad
22 januari 2010
Först inskickad som uppfyllde QC-kriterierna
22 januari 2010
Första postat (Uppskatta)
26 januari 2010
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
7 juli 2020
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
2 juli 2020
Senast verifierad
1 juni 2020
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- F7124-R
Plan för individuella deltagardata (IPD)
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NEJ
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