Hayeem L. Rudy, Medical Student, Albert Einstein College of Medicine
Katie Weimer, VP, Medical Devices, 3D Systems – Healthcare
The separation of craniopagus twins is an extremely difficult undertaking not only due to the inherent risks and anatomical complexity of each case, but also due to the variation that is present between each set of twins. Limited autologous materials with which the plastic surgeons can reconstruct the scalp and skull after separation are also a key challenge. Virtual surgical planning (VSP) combines 3D-modeling and simulation software for the purpose of precisely planning complex surgery, making it an ideal tool in craniopagus separation. 3D-printing customized guides and jigs allows for the precise translation of VSP onto the operating table. Our presentation will report on how our team used VSP and 3D-printing in craniopagus separation to (1) design incision lines and osteotomy boundaries and precisely calculate the resulting surface area of scalp and skull deficits (2) precisely identify the tissue expander models that would be needed to generate adequate scalp to close the predicted defect, (3) produce osteotomy cutting guides that maximized the amount of bone that was repurposed for skull reconstruction, and (4) produce custom skull-caps based on normative, population-level data that were used intra-operatively to guide the shape of the reconstructed skull.