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INTERVIEW

Mimics Innovation Awards Finalists: Dr. Alessandro Tel and Prof. Massimo Robiony

2 min read

Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach

What was the dream?

Improve preoperative understanding and intra-operative assistance of complex resections performed for malignant head and neck surgery.

What was the challenge?

Deep facial compartments are difficult-to-access areas in the head and neck region due to their location, accessibility, and densely packed critical anatomical structures such as blood vessels and nerves. When malignant lesions arise in this region, they present unique challenges as the affected anatomy needs to be identified, and a surgical approach needs to be designed for each patient. There is a lack of imaging and virtual reconstruction protocols for such challenging cases. Therefore, Dr. Tel took up the challenge to develop a novel workflow to virtually reconstruct the complex head and neck anatomy of deep facial compartments — including skeletal, vasculature, and soft tissue structures — and translate this into a clinical application by using intra-operative navigation and simulated endoscopy. 

What are the results?

Dr. Tel, under the leadership of Prof. Massimo Robiony, implemented a protocol that allows for multilayer anatomical reconstruction and virtual surgical planning in complex head and neck resections. The developed workflow was successfully used on seven patients, providing the surgeon with an improved understanding of the preoperative condition and intra-operative guidance in critical phases of the surgery. This novel technique personalizes the surgical approach and limits morbidity for each patient.    

Why this research won

Dr. Tel and the rest of Prof. Robiony's team used the Mimics Innovation Suite to develop a detailed multilayer imaging and segmentation protocol for complex head and neck anatomy. This allowed them to virtually plan and personalize the surgical approach for each patient in their study. They translated the preoperative plan to the operating room by implementing a virtual endoscopy technique and intra-operative navigation. Their patients were successfully treated, and thanks to their novel workflow, surgical time was reduced due to a deeper understanding of the patient’s anatomy and surgical plan. 

  L-102992-01


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Biography

Dr. Alessandro Tel

Dr. Tel graduated in medicine and surgery in 2017, introducing in the maxillofacial surgery department of the University of Udine the importance of virtual surgical planning and 3D printing technologies. Under the leadership of Prof. Robiony, he founded the Virtual Surgical Planning and 3D Printing Lab in the Hospital of Udine, developing the importance of virtual planning and 3D printing in a point-of-care (PoC) environment and defining innovative workflows for the management of cranio-maxillo-facial disorders. Moreover, he acquired bioengineering competences to enable physicians to design their own surgeries and incorporate technological skills. In 2020, Dr. Tel and Prof. Robiony were awarded as global winners of the Mimics Innovation Awards for an innovative research about the minimally invasive treatment of orbital floor fractures. Dr. Tel is currently exploring new frontiers to push PoC to its limits, by defining hybrid clinical and engineering protocols to maximise the impact of personalisation in surgery.

Headshot of Prof. Massimo Robiony

Biography

Prof. Robiony Massimo

Prof. Robiony leads the Chief Maxillofacial Surgery Department Academic Hospital of Udine and is Head of the Post-Graduate School for Maxillofacial Surgery at Udine University in Italy, where he was the first to propose the teaching of virtual planning and 3D printing. Prof. Robiony is also the promoter and coordinator of Facial Care Project. Facial Care Project's objective is to serve as a frame of reference for the development of action-research projects in the field of counseling, prevention, medical and surgical treatment of diseases of the cranio-maxillo-facial area. This Innovative Advanced Technological Project and Humanization offer to the patient a truly personalized treatment and adhering as closely as possible to their needs, it is necessary to resort to innovative surgical techniques, which apply in the clinical field the technological resources and the results of experimental research, in view of a translational medicine.

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