A CAD Procedure for Planning and Modelling Custom Surgical Guides for Tumor Resection

Abstract

The use of customized surgical guides for the removal of bone tumors is an increasingly common practice in advanced hospitals. These devices are modeled directly on the 3D model of the patient's anatomy and produced using additive techniques; therefore, they have the ability to perfectly anchor to the bone anatomy and allow the tissue of the tumor mass to be removed according to cutting paths predetermined by the physician during preoperative planning. This work proposes a semi-automatic framework for modeling custom surgical guides composed of two main modules: 1) a web application, called Precise, that allows the surgeon to visualize and manipulate 3D anatomical models and enter a set of cutting planes that determine the correct tumor resection paths and other useful information for modeling the surgical guide; 2) a fully automatic procedure that based on this information creates the guide's STL model. The entire procedure aims to create a specific type of cutting guide designed to guide an oscillating saw in a series of planar cuts, thus isolating the tumor. The cutting guides produced are composed of three main elements: a base, the blade slot, and pin’s holes.