25 MARCH 2018 HEALTHCARE INNOVATIONS Surgery in the virtual world


the region of interest is colour mapped. The tumour can then be marked with a specific dye so that the removal can be better planned to avoid injury to important neighbouring an- atomical structures. This is a crucial develop- ment in the constant battle against cancer as it gives surgeons precise information for ade- quate tumour removal while it helps with the surgical planning before surgery, minimising the risk of injury and long-term side effects. Tissue engineering is a new exciting field

Nicholas Kalavrezos N

icholas Kalavrezos is a head and neck re- constructive surgeon with a background in oral and maxillo-facial surgery. His

clinical practice includes major surgery for the head and neck with a special interest in bone sarcomas and functional outcomes fol- lowing major reconstructive surgery. His clinical practice also includes surgical treat- ment of salivary gland tumours as well as thy- roid surgery. Nicholas is interested in technological ap-

plications for tumour mapping and virtual surgical planning in cancer surgery as well as applications of tissue engineering in head and neck reconstruction. This is the cutting edge in precise tumour removal with immediate reconstruction of the missing part. Tumour mapping is an exciting develop-

ment in the resection of cancer from complex anatomical areas such as the head and neck. This involves scanning of the patient before the surgery using specific dyes. The images obtained are then computer-processed so that

From 3-D virtual planning to clinical application Depiction of tumour (dark green) and surrounding structures of the neck

Contact information: Consultations: 16 Devonshire Street London W1G 7AF T: 020 7388 3894 F: 020 7034 8276 E:

in reconstructive surgery, opening new av- enues in patient surgical treatments. We have the ability now to plan the specific re- constructive needs almost from bench to clinical practice. As a result of this, we’re able to produce more specific, custom-made reconstructions in a much shorter period of time, with the aim of achieving a complete head and neck rehabilitation by the end of the surgical procedure. Tissue engineering has already opened new ways of combining technology and surgery, leading to improved outcomes as far as the speech, the swallow- ing and, last but not least, the aesthetics of the patient is concerned. Reconstructive sur- gery aims to replace missing tissues from a

Tissue engineering is a new exciting field in reconstructive surgery, opening new avenues in patient surgical treatments. We have the ability now to plan the specific reconstructive needs almost from bench to clinical practice

specific part of the body by transferring new tissues from another part. The most com- mon site of missing tissue in the head and neck area following major surgery is the lower jaw. Lower jaw reconstruction is usu- ally done by transferring new bone and skin, most commonly from the lower leg. This is already known and has been applied suc- cessfully for quite some time now. However, tissue engineering has managed to improve outcomes vastly by helping the refinement of surgery. It’s not only bone and skin that we can transfer, we can also pre-load the bone harvested from the lower leg with dental im- plants. After a short period of between three and four weeks, the new structure of bone and implants can be transferred to replace the missing lower jaw, providing the basis for immediate dental rehabilitation.

This combination of technology and surgi-

cal practice is the future of modern recon- struction, aiming for completion of treat- ment in the shortest period of time with the least possible side effects for the patient.

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