Osteotomy planner: an open-source tool for osteotomy simulation

There has been a recent emphasis in surgical science on supplementing surgical training outside of the Operating Room (OR). Combining simulation training with the current surgical apprenticeship enhances surgical skills in the OR, without increasing the time spent in the OR practicing. Computer-assisted surgical (CAS) planning consists of performing operative techniques virtually using three-dimensional (3D) computer-based models reconstructed from 3D crosssectional imaging. The purpose of this paper is to present a CAS system to rehearse, visualize and quantify osteotomies, and demonstrate its usefulness in two different osteotomy surgical procedures, cranial vault reconstruction and femoral osteotomy. We found that the system could sufficiently simulate these two procedures. Our system takes advantage of the high-quality visualizations possible with 3DSlicer, as well as implements new infrastructure to allow for direct 3D interaction (cutting and positioning) with the bone models. We see the proposed osteotomy planner tool evolving towards incorporating different cutting templates to help depict several surgical scenarios, help 'trained' surgeons maintain operating skills, help rehearse a surgical sequence before heading to the OR, or even to help surgical planning for specific patient cases.