Michael Braukus

Headquarters, Washington, DC June 12, 1996

(Phone: 202/358-1979)

Ann Hutchison
Ames Research Center, Mountain View, CA
(Phone: 415/604-4968)

Mike Goodkind
Stanford University Medical Center News Bureau, Palo Alto,
CA
(Phone: 415/725-5376)

RELEASE: 96-119

NASA TECHNOLOGY ASSISTS RECONSTRUCTIVE SURGERY

NASA technology is making it possible for surgeons to

plan complex surgical procedures and to visualize the
potential results of reconstructive surgery in a virtual
environment simulator.

NASA's Ames Research Center, Mountain View, CA, is

collaborating with the Department of Plastic and
Reconstructive Surgery at Stanford University Medical
Center, Palo Alto, CA, to develop the technology. Their
goal is to develop a virtual environment workbench for
planning complex craniofacial reconstructive surgery and for
training new surgeons, using 3-dimensional
(3-D) reconstruction and virtual environment technologies.

The technology will use special software to integrate

laser images with computer tomography (CT) scans of a
patient's head. This enables the creation of highly
precise, 3-D images of the face and skull. Development of
these tools also will make it possible to produce virtual
environment simulations of common surgical procedures to be
used in space for long-term missions.

"Our goal is to allow surgeons to 'see' the face with

the skull and enable them to use the same tools in a virtual
environment that they would use in the actual surgery," said
Muriel Ross, Ph.D., director of Ames' Biocomputation Center,
where the work is being done. "We will be able to do
patient-specific reconstructions that will allow surgeons to
work on the affected bones as though the surgical
manipulations were real. The surgeons will be able to
remove pieces of bone, cut them into appropriate shapes and
place the pieces as desired. Then they can replace the soft
tissues and observe the new features before they operate,"
she said.

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The NASA-Stanford team is especially interested in

working with children who need reconstructive surgery to
correct deformities of the head and face, and with
mastectomy patients needing breast reconstruction. However,
since the system is very generalized, Ross said eventually
it should be applicable for use in other medical specialties
or surgical procedures.

"This technique will allow us to practice an operation

several different ways to see which outcome is the best,"
said Dr. Stephen Schendel, chair of the Department of
Plastic and Reconstructive Surgery at Stanford. "This is
something surgeons could not do before with any accuracy.
They had to rely on many years of experience doing these
operations, which was at times less than perfect."

Ross said the new software has several important

benefits. Patients with disfigurements should be better
satisfied with their appearance after surgery, because
"surgeons can see what the result will be before the surgery
is even started." It also will increase efficiency by
improving the outcome of the surgery and by reducing the
time the patient spends in surgery, which should reduce the
cost of the procedure.

Since the system is interactive, surgeons in other

hospitals can collaborate in complex or critical surgery via
high-speed networking lines. "This will allow surgeons at
different centers to cooperate in the planning of surgery by
sharing 3-D patient data, which expands the existing
possibilities for patient care delivery," Schendel said.
"Doctors in outlying areas can confer with a specialist in a
center miles away."
 Finally, the system will make it possible to train
craniofacial surgeons, even those in remote areas, without
their having to do actual surgery. The surgeons will be
able to pick up the same surgical instruments, make cuts and
move bone as they would in an actual surgical procedure,
only in a virtual environment. Eventually, the training
program will include force feedback, sound and tactile
components. "There are real financial stresses on medicine
today, so training becomes a critical issue, as does time in
actual surgery," Schendel said.

To build the 3-D image of the face, plastic surgery

resident
Dr. Michael Stephanides makes pre-operative laser scans of
the patient's face. Ames computer specialists then match
facial features to the skull features in CT scans by
extracting the bone structure from the series of scans,
contouring it and using the special software to reconstruct
the skull. Since the reconstructed face is transparent, the
bone structure is visible behind it.

The new, advanced technology is based on 3-D

reconstruction software originally developed for space
research to visualize structural changes in the organization
of gravity sensors in animals exposed to microgravity. This
software is not only used in NASA's gravitational biology
program but it is also

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being used by more than 20 scientists around the country,

through Space Act Agreements, for a variety of scientific
studies including embryonic development, effects of toxic
agents on embryos and the organization of the retina. The
virtual environment workbench is a new application of this
NASA-developed software.

"This exciting opportunity is highly relevant to Ames'

focus as NASA's Center of Excellence in Information
Technology, and it will help set standards for this type of
virtual environment research," Ross said. She hopes to have
the final product ready for physician testing within a year.
"Everybody here is really excited about what we're doing.
It's a situation where everyone wins."

-end-

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