Auf dem Weg zur objektiven Evaluation von Form, Volumen und Symmetrie in der Plastischen Chirurgie mittels intraoperativer 3D Scans

Zusammenfassung

Hintergrund: Die 3-dimensionale (3D) Oberflächenerfassung durch Laserscanner und digitaler 3D Fotografie (Photogrammetrie) hat sich in den letzten Jahrzehnten stetig weiterentwickelt. Der Trend folgt ähnlich dem Smartphone Bereich der Maxime „kompakter, leichter, mobiler und komfortabler“. Obwohl 3D Scans in der Plastischen Chirurgie seit Ihren Anfängen in den 1980ern immer häufiger zur Beratung von Patienten und zur digitalen Dokumentation eingesetzt werden, so zeigte sich in den letzten Jahren keine einschneidende Entwicklung zur objektiven Unterstützung der Chirurgen für deren Eingriffe.

Patienten, Material und Methoden: Unsere Arbeitsgruppe stellt eine neue Methode der intraoperativen 3D Erfassung von plastisch-rekonstruktiven Eingriffen anhand einer Auswahl von mobilen 3D Scanner Systemen vor. Diese könnten in Zukunft prä-, post-, als auch intraoperativ in der Befunderhebung, Therapiewahl und –Beratung, sowie Dokumentation den Operateur unterstützen.

Ergebnisse: Anhand mehrerer Patienten konnten die 3D Scanner erfolgreich für den intraoperativen Einsatz validiert werden. Insbesondere eine objektive, intraoperative Volumenmessung im Hinblick auf Form und Symmetrie wird dadurch möglich.

Schlussfolgerung: Anhand dieser Arbeit teilen wir unsere ersten Erfahrungen in der Anwendung neuer mobiler 3D Kamera Systeme, diskutieren Vor- und Nachteile und präsentieren Beispiele des intraoperativen Einsatzes.

Abstract

Background: There has been ongoing development in the field of 3-dimensional (3-D) Surface Imaging by laser scanner and digital 3-D photography (Photogrammetry) in recent years. Manufacturers tend to make new 3-D cameras compact, light-weighted, mobile, and user-friendly, similar to the development on the smartphone market. Although 3D scans have been used for patient consultations and digital documentation in Plastic Surgery since the 1980, there has been no significant development lately regarding its use for objective assistance during surgery.

Patients, Material and Methods: Our research team presents a new intraoperative 3-D scanning method for plastic-surgical procedures with selected mobile 3-D scanner systems. In the future, these might assist surgeons with the pre-, post-, and intraoperative 3-D analysis, choice of therapy, consultation, and documentation.

Results: The 3-D scanners were successfully validated for their intraoperative application to several patients. With their introduction, an intraoperative, objective measurement of volume to evaluate form and symmetry was possible.

Conclusion: In this work, we share our first experience with the intraoperative use of new mobile 3D camera systems, discuss pros and cons, and show selected patient examples.

Schlüsselwörter

3-dimensionale Fotodokumentation - Operationsplanung - Intraoperativer Scan - Mobile 3D Scanner - Volumetrie

Key words

3-dimensional documentation - operation planning - intraoperative scanning - mobile 3D scanning - volumetry

• Literatur

• 1 Jacobs RA. Three-dimensional photography. Plast Reconstr Surg 2001; 107: 276-277
• 2 Losken A, Seify H, Denson DD et al. Validating three-dimensional imaging of the breast. Ann Plast Surg 2005; 54: 471-476 discussion 477-478
• 3 Yip JM, Mouratova N, Jeffery RM et al. Accurate assessment of breast volume: a study comparing the volumetric gold standard (direct water displacement measurement of mastectomy specimen) with a 3D laser scanning technique. Ann Plast Surg 2012; 68: 135-141
• 4 Tzou CH, Artner NM, Pona I et al. Comparison of three-dimensional surface-imaging systems. J Plast Reconstr Aesthet Surg 2014; 67: 489-497
• 5 Spanholtz TA, Leitsch S, Holzbach T et al. 3-dimensional imaging systems: first experience in planning and documentation of plastic surgery procedures. Handchir Mikrochir Plast Chir 2012; 44: 234-239
• 6 Koban KC, Leitsch S, Holzbach T et al. 3D-imaging and analysis for plastic surgery by smartphone and tablet: an alternative to professional systems?. Handchir Mikrochir Plast Chir 2014; 46: 97-104
• 7 Lekakis G, Claes P, Hamilton 3rd GS et al. Three-Dimensional Surface Imaging and the Continuous Evolution of Preoperative and Postoperative Assessment in Rhinoplasty. Facial Plast Surg 2016; 32: 88-94
• 8 Khambay B, Nebel JC, Bowman J et al. 3D stereophotogrammetric image superimposition onto 3D CT scan images: the future of orthognathic surgery. A pilot study. Int J Adult Orthodon Orthognath Surg 2002; 17: 331-341
• 9 Nahabedian MY, Galdino G. Symmetrical breast reconstruction: is there a role for three-dimensional digital photography?. Plast Reconstr Surg 2003; 112: 1582-1590
• 10 Eder M, Grabhorn A, Waldenfels F et al. Prediction of breast resection weight in reduction mammaplasty based on 3-dimensional surface imaging. Surg Innov 2013; 20: 356-364
• 11 Catanuto G, Patete P, Spano A et al. New technologies for the assessment of breast surgical outcomes. Aesthet Surg J 2009; 29: 505-508
• 12 Khatam H, Reece GP, Fingeret MC et al. In-vivo quantification of human breast deformation associated with the position change from supine to upright. Med Eng Phys 2015; 37: 13-22
• 13 Eder M, Schneider A, Feussner H et al. Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging. Biomed Tech (Berl) 2008; 53: 112-121
• 14 Henseler H, Khambay B, Ju X et al. Landmark-based statistical procrustes analysis in the examination of breast shape and symmetry. Handchir Mikrochir Plast Chir 2014; 46: 342-349
• 15 Eder M, Waldenfels FV, Swobodnik A et al. Objective breast symmetry evaluation using 3-D surface imaging. Breast 2012; 21: 152-158
• 16 Xi W, Perdanasari AT, Ong Y et al. Objective breast volume, shape and surface area assessment: a systematic review of breast measurement methods. Aesthetic Plast Surg 2014; 38: 1116-1130
• 17 Kovacs L, Eder M, Papadopulos NA et al. Validating 3-dimensional imaging of the breast. Ann Plast Surg 2005; 55: 695-696
• 18 Kovacs L, Zimmermann A, Brockmann G et al. Accuracy and precision of the three-dimensional assessment of the facial surface using a 3-D laser scanner. IEEE Trans Med Imaging 2006; 25: 742-754
• 19 Maal TJ, Verhamme LM, van Loon B et al. Variation of the face in rest using 3D stereophotogrammetry. Int J Oral Maxillofac Surg 2011; 40: 1252-1257
• 20 Liu C, Ji K, Sun J et al. Does respiration influence breast volumetric change measurement with the three-dimensional scanning technique?. Aesthetic Plast Surg 2014; 38: 115-119
• 21 Henseler H, Ju X, Ayoub A et al. The importance of the pose in three-dimensional imaging of the ptotic breast. J Plast Reconstr Aesthet Surg 2013; 66: 1551-1556
• 22 Wheat JS, Choppin S, Goyal A. Development and assessment of a Microsoft Kinect based system for imaging the breast in three dimensions. Med Eng Phys 2014; DOI: 10.1016/j.medengphy.2013.12.018
• 23 Roostaeian J, Adams Jr WP. Three-Dimensional Imaging for Breast Augmentation: Is This Technology Providing Accurate Simulations?. Aesthet Surg J 2014; 34: 857-875