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Improved planning and perfomance of surgery - caesar research center at the Medica in Düsseldorf


Bonn research center caesar is presenting current medical technology projects at the “Medica 2004” in Düsseldorf (Hall 13, Stand C12) from November 24 – 27, 2004. Scientists support surgeons with innovative computer and laser technology in the planning and performance of operations. At the trade fair they are demonstrating a laser system enabling ultra-fine cuts of just 0.2 mm through bone and cartilage. Researchers are also presenting medical applications for the Rapid Prototyping technology established in mechanical engineering. They develop biocompatible materials for customized implants and manufacture patient-specific anatomical models for operation planning. Furthermore, the scientists are presenting a holographic method of generating three-dimensional facial computer models. These feature extremely high resolution and are used in preparation for complicated operations. caesar cooperates closely with physicians. Some processes are already being subject to clinical testing.

OsteoLas is a laser system which will serve as a high-precision bone cutting instrument for surgeons in future, for example in neuro, cardio, oral and maxillo-facial surgery. It enables non-contact cuttings and three-dimensional ablation of bones and cartilage avoiding thermal damage, bone dust and metal abrasion. For many years, the laser was considered inappropriate for cutting heat sensitive materials such as osseous tissue. The CO2 laser system features extremely short pulses combined with a fine air-water spray. Thus, damage to the surrounding tissue is avoided. The laser system enables non-contact cutting of bone and cartilage at arbitrary geometries for the first time. Fine incisions of 0.2 mm width and up to 7 mm depth are produced in a compact bone. Even deeper incisions can be produced, e.g. for the separation of jawbones. However, the cut width is increased in this process. A mobile prototype of the device has been successfully tested in several series of animal trials. The prototype is intended for further development with clinical and industrial cooperation partners into a medical product for serial manufacture.

At the medica, under the heading “3mat”, the caesar “Rapid Prototyping” research group is presenting its services, ranging from the development of biocompatible materials based on plastics and ceramics to their computer-operated processing. The researchers generate patient-specific anatomical models, implants or prototypes according to customer requirements. The group successfully implements project concepts and services for medical technology manufacturers, physicians and clients. For example, the scientists have developed a special Rapid Prototyping process for the future manufacture of computer designed, patient-specific implants. It is based on the so-called 3D printing process. It can be used for the generation of e.g. bone replacements from biocompatible material featuring properties extremely similar to and which can be resorbed by the body. Furthermore, the research group manufacturers customized anatomical planning models, in particular for oral and maxillo-facial surgery. These are optionally available with realistic soft tissue properties or colored surfaces, as well as transparent models featuring marked interior structures. Hence, operations can be planned more precisely in advance and implemented more rapidly, reducing the probability of complications.

The research group “Holography and Laser Technology” is developing a system for holographic three-dimensional facial topometry. A patient portrait hologram is generated using a short-pulsed laser and subsequently digitized. The data extracted provides a three-dimensional computer model of the patient which can be optionally enlarged or turned. A so-called texture is retrieved from topometric information with high resolution visualizing even skin pores and small hairs. The colored texture imposed on the model produces an extremely lifelike image. With the aid of computer tomography data models are retrieved demonstrating facial bone structure as well as the soft tissue on top. These images provide new options in oral or maxillofacial surgical planning and documentation to achieve optimal functional as well as aesthetic results. The first mobile holographic camera system for clinical three-dimensional facial topometry is currently being tested in the Rehabilitative Surgery clinic of University Hospital Basel (Prof. Dr. Zeilhofer). A further forensic use already deployed is soft tissue reconstruction of cranio findings for the identification of unknown individuals.

Francis Hugenroth | alfa
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