What is Surgical Planning?

Surgical planning is the use of models and computer programs to plan out a surgery ahead of time and guide the surgery itself to target the desired area and avoid vulnerable structures. This is particularly important for neurosurgery, where people want to avoid sensitive areas of the brain, and for procedures where doctors will be working close to nerves or could create significant scarring or impairment with a mistake in surgery. Several companies make surgical planning tools including software, computer-assisted surgical equipment, and so forth.

The first step in surgical planning is conducting a detailed evaluation of the patient. People can use medical imaging studies and physical casts to create precise three dimensional models of internal and external structures. A computer can map this information, select a surgical site, and develop a plan for accessing it while avoiding other tissues. For procedures like stereotactic radiosurgery, where the patient receives a beam of radiation in the involved area, the surgical planning helps the surgeon program the precise location for the beam, taking care to avoid healthy tissue.

In surgeries where people will need to make an incision, surgical planning can help them plot out the surgery in advance. In the operating room, the surgeon can use assistive devices to stay on track with the procedure. For something like brain surgery, where abnormal tissue may look like healthy tissue, having an MRI and location reference will help the surgeon reach the right point in the brain and excise the unhealthy tissue while leaving neighboring structures alone. Navigation systems can assist with guidance, allowing for surgical precision.

People can also use models and molds during surgical planning to plan their angle of attack and practice the various techniques they will use during the procedure. It can be disorienting to work directly on a patient and getting familiar ahead of time with a model can be very helpful. Surgeons can also make sure prostheses and other fittings will fit properly, using the model as a frame of reference so they do not need to make last minute adjustments in the operating room.

In the process of surgical planning, people can identify specific issues and areas of concern they want to address. They can use models and computer demonstrations to show patients how they will perform surgery and to draw attention to particular topics of interest, like the location of structures in the brain. During this consultation, patients can ask questions about what the surgeon will do, and how. This may help patients prepare by familiarizing them with the surgery and making it less frightening.