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A Virtual Reality Atlas of Flap Anatomy
Darren M. Smith, MD, Anne E. Argenta, MD, S. Alex Rottgers, MD, Vu T. Nguyen, MD, Joseph E. Losee, MD.
University of Pittsburgh, Pittsburgh, PA, USA.

BACKGROUND:
Reconstructive surgery, and the anatomy upon which it is dependent, is three-dimensionally complex. Unfortunately, however, the vast majority of educational anatomy resources available are two dimensional (2D). To the authors’ knowledge, aside from a small number of craniofacial applications, there are in fact no 3D anatomy resources targeted to plastic surgeons and students of plastic surgery. As the plastic surgeon must master anatomy to effectively manipulate it, a virtual reality atlas of flap anatomy may prove useful in anatomical education and ultimately in surgical planning.
METHODS:
Three dimensional models of human anatomy are constructed as polygonal meshes based on data from the Visible Human Project imported into Adobe Photoshop and Autodesk Maya. Special attention is paid to anatomical details critical to flap harvest. Data available from the Visible Human Project includes cryosections for soft tissue modeling and CT scans for bone modeling. These meshes are registered to one another and supplemented with data from other sources in the literature and anatomical dissections. The resulting 3D models are subsequently modified to clearly portray clinically relevant anatomical relationships. Flap harvest procedures will be animated based on these models in Autodesk Maya.
RESULTS:
Anatomical models can be reliably constructed by this methodology. Complex 3D relationships are clearly illustrated from a unique perspective. Individual structures can be made partially transparent or completely invisible to customize the view of a particular 3D scene. The user can rotate, pan, and zoom the virtual camera in 3D space to view the scene from any position. The user can also directly manipulate the anatomical models (e.g. change a structure’s shape or remove segments of a given structure).
CONCLUSIONS:
Successful reconstructive procedures rely on a surgeon with an excellent grasp of anatomy. To our knowledge, this is the first 3D anatomical atlas designed specifically to demonstrate anatomical relationships critical to flap dissection and harvest. The anatomical meshes on which this atlas is based are compatible with future incorporation into surgical planning endeavors.


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