Virtual surgery remodelling craniofacial operations

Surgeons at Sydney Children’s Hospital, Randwick, are pushing the technological boundary of craniofacial surgery by preparing for the long and invasive cranial vault remodel procedure virtually, ensuring the best possible outcome for young patients, like Flex who was born with a rare form of craniosynostosis.

Craniosynostosis affects around one in 2200 children globally. It is a condition where one or more of the fibrous joints (cranial sutures) of a baby’s skull close earlier than usual. Brain growth continues, however, the fused joint creates an uneven growth pattern resulting in a misshapen appearance of the skull.

Flex’s rare form of the condition meant that all of his sutures had closed before he was even born, he urgently needed his first surgery just nine weeks old to relieve the pressure on his brain and has now undergone a complete cranial vault remodel with incredible results. 

A cranial vault remodel has been performed by craniofacial surgeons for decades and involves removing the child’s skull in segments, reshaping and rearranging the pieces in theatre to re-build the skull, much like an incredibly complex jigsaw puzzle. Craniofacial surgeon, Dr Michael Rtshiladze alongside a team of plastic and neurosurgeons who, together with biomedical engineers based in the United States are now using Virtual Surgical Planning, or VSP, to digitally ‘test’ many different approaches to reshaping the skull.

Performing the operation virtually allows us to trial several approaches to the surgery, we can see the outcome of each option so we know going into the operating theatre that we have found the best possible and most individualised approach for each child. Better still, with the custom 3D printed moulds and cutting guides providing even greater precision, we can reduce operating and time under general anaesthesia by up to 5 hours," Dr Michael Rtshiladze, Craniofacial Surgeon. 

While the technique is not required for all children with craniosynostosis, VSP is helping children like Flex and many more with complex cases to help correct a misshapen skull, life-changing surgery giving their brains the space they need to grow and develop.

“We are amazed by the results and how fast Flex is recovering from such a major operation, he’s been so brave and we're thankful that this technology is available to us here,” Lucy, Flex’s mum.

The use of VSP means that the craniofacial team can be even more confident of a great surgical outcome for more complex cases and while the team will continue to monitor Flex’s growth, the expectation is that this one big operation is all that he will need and he will continue to grow in a happy, healthy child.

Seven News recently met Flex and his surgeon Dr Michael Rtshiladze following his incredible surgery: