title: Development and application of a virtual environment for reconstructive surgery.
abstract: OBJECTIVE
  This paper details the development and application of a Virtual Environment for Reconstructive Surgery (VERS). It addresses the technical and user-interface challenges in developing such a system, and the lessons learned during application of the system in the case of a 17-year-old boy with a severe facial defect arising from the removal of a soft-tissue sarcoma.
  
  
  METHODS
  Computed tomography (CT) scans were segmented into bone and soft-tissue classifications using traditional and novel algorithms, a surface mesh was generated, and imaging artifacts were removed, yielding a mesh suitable for visualization. This patient-specific mesh was then used in a virtual environment by the surgeons for preoperative visualization of the defect, planning of the surgery, and production of a custom surgical template to aid in repairing the defect.
  
  
  RESULTS
  This system was successfully used to plan the surgery of the patient and to produce a custom, patient-specific template that was used to harvest bone from a donor site in order to reconstruct the defect.
  
  
  CONCLUSIONS
  Despite technical challenges, virtual-environment surgical planning is useful as a clinical tool for preoperative visualization, cephalometric analysis, and surgical intervention. It can provide a more precise surgical result than would otherwise be realized using traditional methods.
authors.affiliation: National Biocomputation Center, Stanford University, CA 94305, USA. kevin@biocomp.stanford.edu
authors.forename: K
authors.initials: K
authors.lastname: Montgomery
authors.forename: M
authors.initials: M
authors.lastname: Stephanides
authors.forename: S
authors.initials: S
authors.lastname: Schendel
mesh_terms: D000293:Adolescent; D005145:Face / Q000000981:diagnostic imaging / Q000601:surgery*; D005153:Facial Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures; D012509:Sarcoma / Q000601:surgery; D013813:Therapy, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface