Michael Braukus Headquarters, Washington, DC (Phone: 202/358-1979

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June 12, 1996

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. -more-2The 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 -more-3being 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." -endNOTE TO EDITORS: Images are available on the Internet via the Ames Public Affairs Home Page. The URL is: http://ccf.arc.nasa.gov/dx Ames news releases also are available on the NASA Ames Public Affairs Home Page at URL, http://ccf.arc.nasa.gov/dx NASA press releases and other information are available automatically by sending an Internet electronic mail message to domo@hq.nasa.gov. In the body of the message (not the subject line) users should type the words "subscribe pressrelease" (no quotes). The system will reply with a confirmation via E-mail of each subscription. A second automatic message will include additional information on the service. NASA releases also are available via CompuServe using the command GO NASA.